Health Care/Joan Retsinas

Dystopian Health-Speak: Medical Freedom

Let’s toast the power of language to shape thought, to reconfigure history, to turn truth into truthiness. With a pen, our Civil War morphs into the War Between the States, as though the South battled the North for the right to levy taxes. No hint of slavery. Advertisers excel at manipulating language: a “used car” can be a lemon, which nobody wants; but a “pre-owned car” hints of pedigree. A decrepit house becomes a “fixer-upper.” Depending on the labeler, an immigrant is “illegal” or “undocumented.”

So too some Americans have have restated public health into a citizen’s prerogative, akin to free speech. The newly minted term: medical freedom.

The Governors of Florida and Arkansas (Ron DeSantis and Sarah Huckabee Sanders) are turning this mantra into a campaign slogan. And a slew of politicos have jumped onto this linguistic bandwagon, pushing state legislation that frees citizens from those pesky regulations issued by “public health” nerds in government. The mantra goes: Make your own decisions, based on your own sense of “health,” fashioned by a coalition of right-wing demagogues preaching on you-tube.

The key shackle of a shackling Uncle Sam: the COVID mandates, from vaccinations to masks. But why stop there: why mandate vaccinations at all? Polio? Rubella? Measles? The government can issue their advisories, but advisories are not mandates.

We, of course, are free to ignore all the strictures, prescriptions, and warnings of physicians. You can spurn pills for high blood pressure, infections, and cholesterol. You can eat your way into diabetes, drink your way to cirrhosis, indulge promiscuity to a sexually transmitted disease. Your choice. We might label this “medical freedom” as “medical stupidity.” You can espouse “medical stupidity,” a term without the cachet of “medical freedom.”

Admittedly, medical science is neither foolproof nor static. Physicians make mistakes, rethink hypotheses, give new advice that negates the old. Thalidomide, prescribed to help with pregnancies, was found to damage the newborns. Decades ago, women routinely took estrogen to relieve symptoms of menopause, before clinical trials tamped down that enthusiasm. Indeed, in substituting web-fueled home remedies for the current medical wisdom, you may be ahead of the curve. Maybe.

When diseases are contagious, though, the state steps in. If your freedom-to-spurn endangers others, the public health nerds push for legislation. Consider vaccination. States generally require it for entrance to schools. States that have liberally given philosophical or religious exemptions for measles/mumps/rubella vaccines have seen those diseases spike. With tuberculosis, the public health department will “mandate” treatment for an infected person, sometimes with a “directly observed” regimen.

States are not so much protecting the individual, but the people who cluster around the individual: family, co-workers, friends, and those in contact with family, co-workers, and friends. The circle of contagion spreads; those “others” risk getting sick.

The spread is costly, because sick patients drive up health insurance costs. We all pay that tab, through private health insurance or through government, mostly Medicaid and Medicare. From a fiscal vantage, a sick populace is expensive. The much-vaunted “medical freedom” translates into “medical extravagance” or “fiscal waste.”

Most crucially, though, medical freedom is “medical cruelty,” because that patient who flaunts those pesky regulations may well make others sick. Most Americans hated these past years of “mandated masks,” arguing that they made it hard to breathe, that the regulations didn’t make sense since you could remove them to eat (once restaurants re-opened), that we needed to see each other to meet, to worship, to date. Now, in retrospect, some are questioning the utility of masks. But at the time of the mandates, the government’s rationale was clear: vulnerable immuno-compromised people, including the elderly, were most at risk of suffering acutely, even dying, from COVID. Many people — even those who felt the masks useless, who doubted the COVID statistics, who loathed the idea of a mandate — donned one, to protect the constellation of “others.” Similarly, we require seat belts, along with a slew of other highway safety rules, to protect the “others.” Only in a dystopian world would we mask “cruelty” as “freedom.”

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email joan.retsinas@gmail.com.

From The Progressive Populist, April 15, 2023


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