What is Prevention

The current hub-bub regarding the latest contagious airborne disease had me receive a few queries on prevention, which in turn got me to crack open the Chinese medical textbook on Warm Pathogens (wen bing). Much of what is relayed is common sense stuff, like avoiding crowds and wearing face masks, if crowd contact is necessary. There's also discussion on quarantining and immune function. I may go into these at a later date on my other blog (http://chinesemeridiantheory.blogspot.com), which is geared much more for the clinician and those who want to get juicy with Chinese medical theory.

This discussion is much more oriented around understanding what constitutes prevention. The Warm Pathogen text's discussion on prevention basically conforms to our modern understanding of risk reduction and immune function stimulation. The evident crisis that our current healthcare system is facing has made prevention a cry issued by all, the scare around the latest cootie perhaps only bringing the questions around prevention into greater relief.

Of course, much of this centers about the hot-button issue of immunization. As one who suffered from the ravages of chicken pox at the age of three and lived to tell the tale along with hordes of similarly affected children, and as one who at the age of 28 was compelled to take an MMR vaccination in order to receive financial aid and subsequently suffered a most disagreeable reaction for about a year, I nevertheless choose to remain dumb on the issue. Certainly, no one can blame parents on either side of this contentious issue, though when we're talking about public health and the implicit obligations of living in and among people in a social contract (albeit tattered), then there are certain rights that we must abdicate for better or worse, the right to not be vaccinated being one such instance.

When mass preventative efforts are affected by governments for the good of society, we must have the government's trust. We must be given clear indications that government is acting on behalf of the common weal and is not motivated by the quest for control or profit. The government must also demonstrate that academic/private contractors are restricted from using their relationship with government to advance interests that do not conform with social principles. After all, to the extent that they are recipients of social money, they must be compelled to act accordingly.

When government becomes controlled by private interests, then clearly profit trumps regard for the social good. Profitism or bottom-linism has nothing to do with social ethics. Companies are beholden to shareholders, who expect a return on their investment. This is not to say that profitism is antithetical to benefiting society; if it does that is icing on the cake, but serving society is not the objective. Many prominent researchers including the former Editor-in-Chief of the New England Journal of Medicine have raised issue with the effects that profitism has had on shaping study results to the detriment of patients. This is not a Democrat or Republican issue, mind you. Often the change of one party for the other only means a shifting of contracts from A to B, all companies engaged more or less in the same profit-driven chicanery. We can clearly see this in effect regarding the hearings on healthcare reform, which have omitted any consideration of single payer, despite polling data that show a greater than 40% and as much as 59% opinion in favor of such a system across occupations including and especially doctors and nurses.

These far away happenings in Washington have direct implications for the individual family living in Batavia. The schedule of vaccinations which used to be only a few in the 60s and 70s has exploded, including antidotes for quite harmless conditions like chicken pox. Profit can be the only explanation for vaccination inflation because the costs and risks of some conditions for which vaccinations are issued is no greater than the common cold. On the other hand, the risk of receiving injections of numerous pathogenic factors that do not enter the body or trigger the immune system's response directly through the blood is a risk that is difficult to gauge given the numerous factors at play with each individual. Consider, for example, the numerous risks of multiple drug interactions often unknown or unpredictable in the aged population and one gets an idea of how risky cocktail inoculation is and how unpredictable this could be for an immature immune system, which even in the most extreme circumstances will not be faced with hepatitis, small pox, and whooping cough at the same time.

Prevention cannot get in the way of profitism under our present system. This means that preventative interventions must function as a gateway to further treatment. Let us take as an example the deft media campaigns that play upon feminist, quasi-feminist, and faux feminist sympathies regarding breast cancer. The message unequivocally regarding prevention is early detection, which is not the same as prevention by a long shot. Early detection means assuming a course of treatment identical to or nearly identical to a "full-blown" condition but shifting the odds of success more in the favor of the interventionists. It has nothing to do with preventing breast cancer, which would involve a more earnest addressing of environmental and behavioral factors that would undercut profitism's directives. This is not to say that early detection is a bogus message, not at all. But it is not the same as prevention.

Individuals who are less comfortable in ceding their preventative healthcare to orthodox medical profitism are left with little choice but to be more vigilant in taking account for oneself's and families health. Just as the arcane machinations of Wall Street facilitated by sloganeering like "diversification" rendered a populace sheep before wolves, so too do we play the sheep when we pay obeisance to terms like "research and development." The accountable individual must equip themselves with tools of common sense before the claptrap of medical arcania. If something doesn't seem right or make sense to you, then you've got to listen to yourself. In many cases, it is not like you can sue for damages after the fact. Remember, many of the stock brokers who dealt in fraud were not intentionally doing so and when pressed were often as confused about what they were selling as their clients. It is not much different in the healthcare field, where just like most places it is much safer to just be a part of the herd.