More Than Just Sickness Care: What Chronically Ill Americans Like Me Fight For

During the second night of the Democrats’ first presidential debates last week, Marianne Williamson boldly redirected healthcare discussion towards the deeper causes of many sicknesses in this country:

“We have to get deeper than just these superficial fixes, as important as they are. Even if we’re just talking about the superficial fixes, ladies and gentlemen, we don’t have a health care system in the United States, we have a sickness care system in the United States. We just wait until somebody gets sick and then we talk about who is going pay for the treatment and how they’re going to be treated.

What we need to talk about is why so many Americans have unnecessary chronic illnesses, so many more, compared to other countries. It gets back into not just Big Pharma, not just health insurance companies, but it has to do with chemical policies, it has to do with environmental policies, it has to do with food, it has to do with drug policies, and it has to do with environment policies.”

Read More: Health Care, Marianne Williamson 2020

Since the debate, internet and media chatter has mostly focused on the superficial aspects of Marianne’s personality, career history, viability as a presidential candidate, and spirituality, but ignored the deeper issues she raised. Nevertheless, regardless of how we feel about her or her presidential campaign, these are critical issues that need to be discussed.

Right now in the United States, heart disease, cancer, and diabetes are leading causes of our death. These are conditions which not only deserve to be met with quality medical treatment when we develop them, but which all can be prevented by treating health as a field that’s broader than healthcare plans and medical intervention options.

By the same token, these are all conditions which presently arise from the type of society we sustain—the food policies, the drug policies, and the environmental polices Marianne referred to. For instance, while we know that quality nutrition matters when it comes to both heart disease and diabetes in particular, access to quality nutrition continues to elude people living in poverty, so much so that economic instability is an indicator for becoming diabetic. And then of course, maybe you’ve heard: the U.S. Food and Drug Administration has been finding cancer-causing weedkillers in our food for years now. Combine these high-level or widespread concerns with more specific instances like the toxic drinking water in Flint, Michigan, or the increased risk of asthma, cancer, depression, and other health problems endured by North Carolinians living near this country’s hog farms, and it becomes clear that sickness in this country is a crisis we not only need to treat but that we need to stop causing.

While some critics may place these concerns in the occulted realm of a crystal ball, no scrying or seance is required. What we’re talking about here is literally the kind of public health research you can find in peer-reviewed professional journals.

Read More: From ‘Sick Care’ to Health Care: Reengineering Prevention into the U.S. System

So Why Are People Calling This Kooky?

I think the simplest answer is that Marianne’s ideas are so far outside what’s been normalized in politics that we’re maybe a bit afraid of what that means. When presented with ideas that seem ‘outside the box,’ we’re also presented with the possibility that we contribute in some way to the maintenance of the box they transcend. The box answer to disability justice is ‘medicare for all.’ Anything beyond that requires critically listening to what disabled people and public health scholars are saying (and dis/agreeing on) about our country’s problems, and frankly, that’s a lot more work than a lot of folks are in a position to give.

Of course, internal to disabled communities and our families, there’s also a pragmatic caution here. After all, supporting fringe candidates might leave us in a position where we ultimately lose the mediocre gains we could win with more established candidates. Ending our demands at medicare-for-all ensures some success, but it’s also a compromise with what we all know about health. Looking at broader, interdisciplinary ideas about health is a risk. It draws in people who may have relationships to health and their bodies that are different than ours. It reminds us that while healthcare access may be a decidedly liberal cause, disability discriminates more along the lines of class and geography than political affiliation, and that potentially aligns us with people we really can’t stand. As someone who works with clients across political, spiritual, and other spectrums, I know with my whole heart that when all of us are in healthier relationships with our bodies and our environments, there’s less fear and scarcity to inform the interpersonal relationships we can build up from there.

Thirdly, there’s a more explicit economics present here. Most of the decision-making in this country is coming from people who have access to health insurance of some variety. For these folks, more of the problem is in what kind of treatment can be accessed and how it’s getting paid for. For everyone else—for those of us chronically below the poverty line and without insurance coverage—health is a much more dispersed experience. It’s in the food we can afford, the neighborhoods we can afford, the stress of living in these conditions, and then also in our self-image, how we pay for coverage, and what care we can afford to even access.

Talking About Impact: From Individual to Community

To give an example, I’ve experienced asthma since I was a little kid. As an uninsured adult, I can rarely afford to keep an emergency inhaler prescription filled. And if my lungs were to collapse again like they did regularly when I was growing up, there’s just no way I would be able to afford any of the available care for myself. On the one hand, my problem is healthcare access. To a lesser degree, it’s also a self-esteem issue. I’m still working on accepting the physical limitations of my body and loving myself despite not being able to ‘naturally’ do everything everyone else can.

But both of those examples also carry an unacknowledged assumption: that I’m asthmatic, i.e. that as a society we’ve accepted that some people have to be asthmatic because the environmental pollution which we know triggers asthma is more valuable than the health and social participation of people like me. In much the same way, my experience of being diabetic mirrors this. Type 2 diabetes is the acceptable cost I take on for a society that prioritizes profit for agribusiness and toxic chemicals over lives like mine.

These aren’t solely issues of healthcare plans, who gets covered, and who pays for what. They’re environmental policy. They’re urban planning. They’re food policy. They’re economic justice. And they’re what Marianne alone was talking about during the debate.

Now obviously I don’t speak for all chronically ill or disabled people in the United States. I do speak for myself as a member of those groups. And I do speak as a wellness professional helping many clients also in those groups to grapple with these same complexities that I’ve described. I speak as someone who often has to fight to have disability issues acknowledged in activist spaces. And I speak as someone who sometimes gets applauded for bringing the insight of being working class and disabled to these conversations, and who is baffled by the plain sexism being directed at a woman elevating these exact same concerns to the world’s stage.

To say it’s refreshing to hear Marianne acknowledge the integrative nature of health and the interconnectivity of public conditions which sicken and disable many of us is an understatement. No one I’ve so far encountered in the medical establishment wants to hear this stuff. And no other politician or non-disabled activist group seems to want to go that deep with us. Whether you’re on board with her campaign or not, Marianne Williamson has raised the bar. This conversation is no longer ending at what kind of healthcare plans candidates are pledging to fight for. We’re no longer stopping at what meds individuals can access or how we personally relate to our bodies. We’re talking about environmental, nutritional, and economic conditions now too.

Healthcare is a community concern. Healthcare is a broad spectrum of public issues. This is the level we need to reach and exceed if we want to actually care for one another, and if we want to truly dismantle the systemic disabling infrastructure of this country.

I hope you’ll join in with keeping us there.

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Pat Mosley (LMBT #16882) is a licensed massage therapist and life coach in Winston-Salem, North Carolina. His work is especially focused on creating permaculture in his community, which sometimes looks like providing bodywork, and other times looks like writing or designing gardens for people and bees.

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