The Coming Healthcare Civil War
Updated: Sep 11, 2021
Healthcare is the next natural topic in civil movements. The way women, African Americans, and the economically disadvantaged (a.k.a. poor) are treated in the workplace, by the media, and by some law enforcement extends to the American healthcare system. The fact that, at time of this writing, approximately 70 percent of African American citizens remain un-vaccinated is proof of a mistrust that runs much deeper than the healthcare industry or our politicians will admit, and is much farther afield than the fallout from the Tuskegee experiments.
It is no secret that African Americans can experience sub-standard or outright negligent care in the minority-underrepresented, and economically privileged, healthcare industry. Stigma and racism pervade every part of our society, and these behaviors don't stop at the exam room door. Likewise, health issues pertaining to women are still stigmatized as hysterical ravings or in their heads. Medical schools still foster and encourage paternalistic doctor-knows-best attitudes among new doctors and regularly devalue the contributions of predominantly female nurses, further promulgating stereotypes, tropes, and behaviors that extend to their patients. Are things better than they were 70 years ago? Probably. Are they good enough? Not by a long-shot.
So, where am I going with this? I'm setting the stage for that civil war I mentioned in the title. Next up: Vaccine mandates.
Can we really expect to force a vaccine on someone who does not have a primary care doctor, reasonable access to a primary care doctor (as in, get an appointment within three months), or access to equitable care in the healthcare system? I believe the answer is, no. Some people have legitimate health concerns about getting any vaccine, and if they have never been able to adequately get help for those concerns, or have them addressed before and after getting a vaccine, they should not be forced to do anything that they feel may not be in the best interests of their health.
Sure there's Obamacare. But the ability to obtain insurance, does not magically confer the ability to receive or afford care. But vaccines are proven safe, you say? Some people actually experience real side effects from vaccines and denying that their concerns exist or dismissing their concerns as rare, does not solve their problems or address their needs. What kind of problems? Autoimmune diseases, for one. None of the current vaccines have been tested in a long list of various autoimmune diseases. Allergies. The number of people who experienced an allergic reaction that did not result in hospitalization to one of the vaccines is probably in the hundreds of thousands. Those people do not qualify for a second dose, according to CDC guidelines, and should be referred to an allergist/immunologist for ingredient allergy testing and/or discussing whether they might be able to get a different brand of the vaccine. How long does that take? They can't get a medical exemption until they can get an appointment with a specialist. Does CDC even realize that there are very few allergist immunologists who are a. accepting new patients without a referral, and b. do that kind of allergy testing? Sickle Cell Anemia patients, a condition that affects many African Americans, were excluded from the mRNA trials. They are encouraged to get the vaccine, but these assurances assume people have access to care and are currently receiving treatment.
Delta Airlines, I noticed, with their infinite medical knowledge, has decided that they won't accept allergy as a medical exemption. They just require their employees to get the other version of the vaccine. Well, get ready for lawsuits, because my allergist/immunologist and CDC told me that people who were allergic to PEG in the mRNA vaccines are probably sensitized to polysorbate 80 in the J and J vaccines, and if their reaction to one of the ingredients wasn't IgE mediated, the reaction might have been complement mediated, so it doesn't matter what brand of vaccine they get, they might still get anaphylaxis. I had a pretty serious allergic reaction to both doses of the mRNA vaccine I chose. Anyone who acts like heart racing, bronchospasm, and neck swelling and hives are in my head - well, I'd like to give them a dose of anaphylaxis administered by a pharmacy intern and see how they like it. I'd tell them they don't count - they're rare - and it's in their head. I wanted to be vaccinated, because it's important, but I wish I could have received it in a safer setting. The pharmacy intern couldn't even take my blood pressure as I felt my heart stopping.
But the virus is much more dangerous than the risk of adverse events to those rare people, you say. How do you know? It hasn't been studied in persons with a long list of debilitating autoimmune diseases. As a person with autoimmune issues, I can tell you that sometimes vaccines aggravate the autoimmune condition and getting a referral to a specialist when you need help and are being assaulted by your own immune system, can be very challenging. It takes months to get an appointment, meanwhile your immune system might kill you. It took me nine months to get referrals and appointments to specialists - I would not get the vaccine until I had these doctors ready to back me up in case the vaccine aggravated my condition.
I am not African American or economically challenged - but I can imagine if there were biases against me to begin with, I may never get help. I moved just before the pandemic, and had to start fresh with new doctors. Most healthcare practitioners have no idea how long patients wait to get appointments to see them - they don't do the scheduling. And it's not just an effect of the pandemic. It took that long to establish care the last time I moved too. If you took a pole, I would guess that a majority of people haven't actually "established" with a primary care doctor.
So, the more our government keeps pushing mandates for everyone, you can expect frustrated people with real needs and concerns to resist until someone listens. Demand equal and timely access to care. Fixing these issues before mandating, is the only humane thing to do. Warp speed that. And besides, if our government and our healthcare systems don't do something to fix inequities, they'll be forced to via civil uprisings. Me too and BLM will necessarily extend to healthcare.
Finally, I support patients' rights to record medical visits without the physician's consent. And I support the movement to increase the use of non-biased Artificial Intelligence metrics in primary care. If physicians can't get over biases, let's ensure everyone gets the care they deserve and put the computers to work.
Once again, voices of dissent are dismissed in an attempt to divide and conquer. Polarization works and we all keep falling for it instead of actually listening to each other. The nation needs marital counseling. Step one: listen. Step two: acknowledge the other's statements and feelings. Step three: Find the nugget of truth - even if you don't agree, find the part of what they are saying that rings true. You can relate to one thing they are saying. Step four: make a plan together. All sides have a voice.