We're cattle, not cowboys
By: Kelsey Schuette
Issue date: 11/6/09 Section: Opinion
On Wednesday, Oct. 14, the Senate Finance Committee passed S. 1796, or "America's Healthy Future Act of 2009," by a vote of 14 to 9. This much-anticipated vote passed the last committee draft of healthcare reform to the floor, once again evidencing that this current healthcare reform effort has legislatively progressed farther than preceding efforts. My favorite part, however, came (as always) when Kansas Republican Sen. Pat Roberts got a hold of the microphone. "We," Sen. Roberts declared, "are riding hell for leather into a health care box canyon."
While I'm sure Roberts intended his cowboy metaphor simply to convey an overwhelming sense of doom, his figurative language unintentionally captured a major trend in the current American healthcare debate: we think we are cowboys. We talk about health and healthcare in terms of the autonomous, lone individual-"You're the decision-maker." "No one should stand between a patient and his or her doctor." "How will reform affect me?" Unfortunately for both our macho American egos and the accuracy of our policy discussions on healthcare, however, we are not the cowboys in Robert's metaphorical scenario. We are the cattle.
Health is intrinsically population-based. And I'm not just talking about the fact that the person sitting next to you on the bus can give you measles. I'm talking about how your chance of getting measles depends upon what percentage of the human population living in your vicinity has gotten their MMR vaccine. You see, epidemiologists realized that we weren't cowboys a long time ago. They even use appropriately cattle-reminiscent terms like "herd immunity" to describe how disease operates on the macro level. Funnily enough, this also happens to be the level at which public policy, such as health care reform, takes place. "America's Healthy Future Act of 2009" aims "to provide affordable, quality healthcare for all Americans." That's one heck of a herd. So why are we still talking like cowboys?
While I'm sure Roberts intended his cowboy metaphor simply to convey an overwhelming sense of doom, his figurative language unintentionally captured a major trend in the current American healthcare debate: we think we are cowboys. We talk about health and healthcare in terms of the autonomous, lone individual-"You're the decision-maker." "No one should stand between a patient and his or her doctor." "How will reform affect me?" Unfortunately for both our macho American egos and the accuracy of our policy discussions on healthcare, however, we are not the cowboys in Robert's metaphorical scenario. We are the cattle.
Health is intrinsically population-based. And I'm not just talking about the fact that the person sitting next to you on the bus can give you measles. I'm talking about how your chance of getting measles depends upon what percentage of the human population living in your vicinity has gotten their MMR vaccine. You see, epidemiologists realized that we weren't cowboys a long time ago. They even use appropriately cattle-reminiscent terms like "herd immunity" to describe how disease operates on the macro level. Funnily enough, this also happens to be the level at which public policy, such as health care reform, takes place. "America's Healthy Future Act of 2009" aims "to provide affordable, quality healthcare for all Americans." That's one heck of a herd. So why are we still talking like cowboys?
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