I don’t particularly enjoy having needles poked into my scalp and neck and shoulders and temples and I especially don’t like having them poked into my forehead just above my eyebrows. Yet I allow my neurologist to turn me into a pincushion every three months because regular botox treatments subdue my migraines, and nothing else does. I like my neurologist; I trust him, and we have a good doctor-patient relationship. On this last visit we discussed my current medications and how they’re working, and agreed that I could probably start scaling back one of them. My neurologist is at a teaching hospital; at this office visit, a doctor from China was with him. With my permission, he observed my botox procedure, and I talked to him about my medical history, especially the migrainous stroke. All in all it was a fairly typical visit.
Traveling home on the regional rail train, I encountered a poster advertisement that proclaimed:
It’s NOT ENOUGH for us to be THE BEST HOSPITAL we can be. We want to help you become…
and here I expected to read something like “the healthiest person you can be.” But what actually followed was
THE BEST CONSUMER you can be.
What does being a consumer have to do with my health care, and why does a hospital want to help me be the BEST one I can be? Well, of course, I’m being silly. Here in the good ol’ U. S. of A., health care is
treated like a commodity, just like anything everything else. I could almost hear them singing “Be – all that you can be – a consumer – of health commodities!”
I did not experience my visit with my neurologist and the care he provided as akin to a trip to the mall, but in Chester County Hospital’s eyes I suppose I was CONSUMING a botox treatment.
The problems with this commodification of health care are many, but let me just state the painfully obvious. When I went to the mall today and bought myself a spiffy new pair of ankle boots, that was consumption. I made a choice to buy a product that I didn’t really need but wanted and could use. When I went to my neurologist last Friday, it wasn’t like I woke up thinking “gee, a botox treatment would be just the thing. I believe I’ll sashay on down to Jefferson Headache Clinic and buy one!” The interaction I had with my neurologist last Friday had nothing in common with the transactions I conducted at the mall today.
Now, the folks who are getting botox designed as beauty treatments because they fear aging – those folks are consumers. Maybe CCH can help them be the best ones they can be. But you don’t choose to be ill, and being treated for illness isn’t an optional frill.
The transformation of relationships like teacher/student and doctor/patient into that of service-provider/consumer is not good for society. We should see education and health care as things that society needs to provide for its citizens. In this case, the individual is part of society, and this provision is good for individual and society alike. But a consumer is an individual all on his or her own, free to consume just exactly as much health care or education as they can afford.
If you can’t afford an iPod, you can’t have one. Oh well, you’ll live. If you can’t afford college, you can’t go. Oh well, you can always work at McDonald’s. If you can’t afford to treat your diabetes, too bad. Oh well, look on the bright side: you won’t have as long to worry about not having enough money because you’ll die younger! Too bad you didn’t plan to be born with more money. How else were you planning to be THE BEST CONSUMER you can be????