I have a Medicare card. It kicks in next month. I can say goodbye to extortionate insurance company premiums and micromanagement of my medical care. Good riddance.

Yet a study published 30 years ago by the RAND Corporation says that my health won’t improve. So if better health insurance won’t save me, who or what will?

Conservative columnist Ross Douthat wrote in the New York Times last week under the title What Health Insurance Doesn’t Do that recent increases in Medicaid implemented under Obamacare won’t accomplish anything other than waste a lot of money. What launched this and the reference to the 30-year old RAND study is research published in the New England Journal of Medicine that reports that people in Oregon who went on Medicaid experienced no improvement in standard health measures.

Where commentators take this is captured by the title of an article in Slate that covered the Oregon research: Bad News for Obamacare: A new study suggests universal health care makes people happier but not healthier.

How odd. I thought being happy was healthy. Evidently not. What counts for health, it turns out, is things such as serum cholesterol and glycated hemoglobin.

What this illustrates is a structural blindness in both the science and the media. The obvious conclusion to the 30-year old RAND study and the more recent Oregon study is that the medical system doesn’t know how to measure actual health and that the medical system fails to effectively treat people’s medical conditions.

Another outcome that both studies identified is that the more people have to pay for health care, the less they use it—a real shock there. Conservatives think this is really great because for them it means that we could save a pile of money by only providing catastrophic insurance because doing so would have no effect on people’s medical conditions.

This is nonsense, of course. Not because spending more and using the medical system more will make things better but because health is about having a good life, which includes things such happiness and social justice. How can you say it doesn’t? Yet the conventional understanding is that health care is the same as medical care.

Let me say it again: health is not the absence of disease as measured by a blood test and health care is not a course of medical procedures. To be simple but direct, health is happiness, it is having a good life.

Looking back to the early RAND study, almost all medical measures failed to improve as medical care became more financially accessible—almost, but not all. What improved were a collection conditions that are unmistakably associated with stress, especially chronic stress. In other words, as access to medical care got easier, life got better as measured by indicators of chronic stress.

As I’m sure you know, obesity among children is a big worry. The President’s wife has taken on the issue, cheerleading for lifestyle changes and so forth. Yet a study presented at the Pediatric Academic Societies meeting this last weekend as part of its forum on the social determinants of childhood obesity says that neighborhood characteristics have a powerful effect on childhood obesity rates. The neighborhood characteristics that had the greatest effect were the distance to parks and stores and the safety of the neighborhood.

And as I’m sure you also know, obesity among children is associated with poverty, both because of the poverty itself and the characteristics of the neighborhoods where the children live. As a matter of fact, the Pediatric Academic Societies meeting includes a forum on the health effects of childhood poverty. As a class, children suffer greater rates of poverty than any other class. Because of that poverty they are more likely to have a wide variety of both medical conditions and health impairments.

Why aren’t income and neighborhood safety health measures like blood pressure and glycated hemoglobin?

According to the studies I mentioned, single payer insurance would be no better than private insurance restricted to catastrophic coverage: the medical outcomes (mistakenly called health outcomes) are the same. I say that’s a demonstration of the ineffectiveness of current medical care, in which more is not better. I also say it’s a demonstration of our failure to accurately understand and attend to what makes us sick and what makes us healthy.

If insurance won’t save us, who or what will? Isn’t it obvious? We will.

The CDC reports that 1 in 38 children have measureable levels of lead. That’s almost 3%. Lead, as I’m sure you know, poisons nerve tissue. It also poisons the kidneys, heart and blood vessels, and reproductive organs. There is essentially no safe dose.

The shocking thing is that this is good news. When the CDC started tracking lead poisoning in children 30 years ago, the figure was 8 in 10 children with measurable levels: 80%. Elimination of lead in gasoline and paint is credited with that dramatic change. Currently, attention is focused on substandard housing with vestiges of lead-based paint.

This sunny portrait, if it can be called that, makes it look like we’re dealing with what’s left from our past. Oh, but wait: batteries used in cars and in photovoltaic energy systems use lead. So we’re still adding lead to the environment because eventually the lead has to be mined, processed, and disposed of one way or another. More importantly, the children of the people who work in the factories that produce those products have higher levels of lead in their blood than other children. On top of that, abandoned lead plants and disposal sites provide continuing exposures to those who live nearby.

To close this thought on lead exposure, substandard housing where lead-based paint thrives, working in lead factories, and proximity to abandoned lead plants are associated with low income. In other words, yet another health impairment imposed by income inequity.

There is no technical reason why this health problem can’t be solved. And yet it is not.

Take another example of a toxin that’s allegedly been eliminated from our environment: asbestos. The US imports over 1,000 metric tons of asbestos each year. How can the EPA allow this? Because the chlorine industry needs asbestos for its production process.

This isn’t a case of corruption. The EPA has the authority to make exceptions to environmental laws when the cost of preventing the use of a toxic substance has too great an effect on commercial enterprises. This is the case with the chlorine industry. For EPA, keeping the wheels of commerce in motion can outweigh the health risk from a known toxin.

Now consider an emerging toxin: nano-silver. For over a decade, concerns have been raised about nano-particles released into the environment. Nano-silver is now added to exercise clothing in order to eliminate body odor: you exercise, you sweat, God forbid you smell.

The small silver particles kill bacteria that cause smelly body parts. Little is known about the health effects on people or the environment, yet EPA gave nano-silver a so-called conditional registration so that it can be used in a growing number of products.

Is there reason for concern? Yes. Nano-silver washes out of clothes and is widely dispersed throughout the environment. Since it’s designed to kill odor-causing bacteria, a reasonable person might conclude that it also kills microorganisms in the soil, organisms necessary for the health of the soil and the plants (including, food) that grow there. A reasonable person might even conclude that these microbe killers affect our own microbiome, both on our skin and in our gut and impair, for example, our immune response.

Isn’t EPA supposed to protect us from this kind of potentially harmful exposure? Yes, they are. But they, like all other government agencies, are supposed to maintain social order.

There might be some kind of corruption at EPA, but that’s not the source of the problem we face. Maintaining the social order means maintaining the very relations of production that the ruling class works so hard to sustain and develop in its interest. EPA and virtually all other regulatory agencies exist to make sure the capitalist mode of production works smoothly.

When EPA hears that income inequality leads to lead poisoning, it is powerless to act because it hasn’t the authority to do anything about it—and besides, that’s not its job. If it hears that chlorine manufacturers need asbestos, EPA’s duty is to maintain the orderly production of that necessary industrial ingredient. If a clothing manufacturer wants to prevent body odor, EPA must let it until there’s proof (and not just reasonable concern) that there’s a problem,

What’s called for isn’t better information or smarter shopping. What’s called for is seizing the means of production and turning it toward the satisfaction of human not commercial needs.

But the lesson for me in all this is not just that our health is at risk because of the way we produce things. The lesson is that the mode of production and its social relations are the actual cause of illness.

I’m not speaking metaphorically. We are conditioned to think of agents such as bacteria or chemicals or traumatic events as the cause of illness. In my view, the cause of an illness is the social relations that permit or even encourage exposure to individual agents and so cannot be separated from them.

Honeybees are dying in huge numbers. As they die from what’s called Colony Collapse Disorder, two-thirds of the fruits and vegetables we eat are threatened. What’s killing the bees is industrial agriculture and industrial civilization. Their death is a harbinger of more ecological havoc to come—in this fiftieth anniversary year of Rachel Carson’s Silent Spring. Continue reading →

Food is a popular subject for exposes. We are routinely treated to some discovery about how food manufacturers use processes and substances that denude food of its nutrient value or turn it into something that’s actively toxic. Continue reading →

Time magazine’s cover story last week was “Bitter Pill: Why Medical Bills Are Killing Us.” What it describes is how every sector of the so-called health care industry continues to fail miserably at preventing the continued rise in costs, soon to reach 20% of national income. Continue reading →

Sierra, the magazine of the Sierra Club, has a big spread in the current issue on wind power. In a sidebar titled “Wind Rush: Three Wind Myths,” James Walker tells us that although “naysayers” claim wind power damages health, scientists and health officials “have found no scientific evidence to support such claims.” Continue reading →

The Nation magazine has an ad for a company that sells clean energy. In the ad, the image of a smokestack belching pollution is on one side and on the other the image of a wind turbine. On the clean energy company’s website, the effects of conventional energy production are compared to the effects of wind and solar energy. Continue reading →

Ecological diversity has a complicated relationship to health and illness. On the one hand, those parts of the world that are rich in organisms are also rich in disease-causing organisms. On the other hand, as biodiversity declines, the burden of disease increases because organisms that hold pathogens and disease vectors in check are weakened. This is a serious concern because of both anthropogenic climate change and the effects of industrial agriculture. Continue reading →

It’s been known for some time that children who grow up on farms are less likely to have asthma and allergies. Although it’s been assumed that the animal and plant exposures were instrumental, no direct mechanism had been established. Last week, researchers identified the mechanism as the production of regulatory T cells. Continue reading →

A new edition of the Bioinitiative Report has just been release. When first published five years ago, fourteen leading scientists summarized what was then known about the biological effects and public health implications of non-ionizing radiation from cell phones and other wireless technologies as well as extremely low frequency radiation from sources such as power lines. Continue reading →