I have cancer, but thanks to modern medicine, in terms of health it may be no big deal. The surgeon will use a scalpel to remove a thin layer of tissue from the floor of the mouth along with a tiny bit of the connection to the tongue. Then a laser will cauterize it, minimizing bleeding, killing microorganisms that stray from my mouth into the wound, and sealing off nerve endings, reducing soreness. The surgeon has asked me several times not refer to this as a "slice & sear". Since the odds are the cancer is encapsulated, they will send me home with painkillers and antibiotics. After a week or two, that will probably be that.

But it takes a truckload of advanced technology to make this no big deal. Before anesthesia was first invented in the 19th century, the shock and pain of the operation might have killed me (assuming a pre-anesthesia dentist or doctor could have diagnosed the problem at this early a stage). Today's anesthetics have much lower odds of killing me than ether would have. Similarly, large scale commercial production of antibiotics was an early 20th century invention. Lasers only became useful for medical procedures beyond eye surgery in the late 20th century.

People like Derrick Jensen, who want to eliminate technology, want to let me, along with billions of other people, die. Since extreme anti-tech sentiment is small — but with an intense following — it is worth engaging a bit.

One argument is the kind of treatment I'm getting is expensive. Jensen and others would argue that we can't afford modern medical treatment for everybody, and should use the resources to provide a more basic low-tech level of care. Now I can confirm that treating cancer is expensive from personal experience. I pay $600 per month for insurance. Between copayments and deductibles, treatment will cost me about $2,000. Adding what the insurance company will pay brings total social cost to between $6,000 and $8,000.

This ignores social context. The Netherlands provides as good or better quality health care than I'll get in the U.S for a bit more than half the cost in the U.S.[1]. In addition, in the Netherlands I would not have been stuck with a third of the cost all at once, but would have had it included over the years in tax bills. Out of pocket cost for me would have been well under $100. If you have something against the Netherlands, you can find a large number of nations where medical costs are lower and medical quality is higher than the U.S., mostly because they use various means to prevent their residents from insurer milking – including socialized medicine, single payer insurance, and public/private hybrids that include a large public component and tough consistent regulation of private insurance companies.

That is the beginning of an answer. But poor nations can't afford the medical costs of the Netherlands or France, even if the Netherlands and France spend much less than the U.S. for better care. Fortunately they don't need to. Worldwide PPP GDP per capita (ability per person to provide goods and services) is around $11,200 per person [2]. The ability of nations with per capita GDP at that level or less to provide decent health care to their people pretty much demonstrates that our current world economy could support decent health care for the entire world. The fact that people go without healthcare is a matter of political will, not economic ability. Examples of nations with decent healthcare and GDP in that range include Cuba and the Dominican Republic – nations with very different economic and political systems. Cuba had a 2010 PPP GDP of slightly under $10,000 per capita [2], and a life expectancy about that of the U.S.[3]. The Dominican Republic had a 2010 PPP GDP of slightly less than $9,000 [2] and a life expectancy again a fraction below that of the U.S.[3] Though, as would be expected of poor nations, good heath results are larger due to healthier lifestyle and preventative care, both nations do have adequate technology, include lasers.

Cuba suffers shortages of certain medical equipment and supplies, due largely to the U.S. sanctions against them. Although Cuba's economy is highly flawed it produces enough goods for export that it could easily afford to buy any medical goods it cannot make itself, if allowed to do so. In fact Cuba has enough high tech equipment that it earns income by treating medical tourists with them.

Dominican Republic, in spite of massive corruption and an underfunded public health system also manages to provide decent health care to most of its people. The public health system provides good preventative care and basic treatment for most common illnesses. That, combined with certain types of regulation, means health insurance to cover what the public system does not provide is available to most people in the Republic. It is far from perfect, but it shows that a poor nation which is not only corrupt, but dominated by foreign international corporations still manages to provide health care of around the same standard as the worst of the rich nations.

One last argument that Jensen in particular would make is that even if our current economy could provide decent health care for everyone a sustainable world economy would be too small to do so. But, according to Jeanette Chung and David Meltzer, our current inefficient medical system is responsible for about 7.5% of US emissions [4]. Since most of that is electricity which could be generated by wind and solar power instead of coal, and because our medical system uses energy very inefficiently in ways which detract from rather than improve health, there is no reason a decent medical system for the entire world should result in emissions of more than .5% of the world current total greenhouse gas pollution, perhaps less.

We can provide not only medical care sustainably, but all of our needs and many of our wants if we choose to. But to do this we have to understand that we have a cancer that needs to be overcome. To be a cancer survivor our species needs to stop saying: "Cancer, Schmancer as long as we're healthy."

[1] Davis, Karen and Cathy Schoen and Kristof Stremikis. 2010. Mirror, Mirror on the Wall: How the Performance of the U.S. Health Care System Compares Internationally – 2010 Update. DC: Commonwealth Fund. http://www.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2010/Jun/1400_Davis_Mirror_Mirror_on_the_wall_2010.pdf.

[2] Central Intelligence Agency. 2011. COUNTRY COMPARISON :: GDP – PER CAPITA (PPP. The World Factbook. https://www.cia.gov/library/publications/the-world-factbook/rankorder/2004rank.html Accessed 11-May-2011.

[3] International Database queried for 2010 world Life Expectancy by country. http://www.census.gov/ipc/www/idb/region.php. Accessed 11-May-2011. Note IDB database does not let you save queries. You must repeat query yourself after reaching link.

[4] Chung, Jeanette W. and David O. Meltzer. 2009. "Estimate of the Carbon Footprint of the US Health Care Sector". JAMA: 302(18):1970-1972.  

Gar W. Lipow is a temporary arrangement of atoms with strong opinions, an old 3rd generation Jewish Red, a lifelong socialist and activist. His book Solving the Climate Crisis through Social Change (Praeger, 2012) tied climate chaos to class, gender, race, and national inequality. He has written for Red Pepper, Z Magazine, Znetwork, Review of Radical Political Economics, New Politics, and Grist. Gar receives food stamps and Medicaid, but remains notoriously ungrateful to our lords and betters for the crumbs that fall from their tables. Public Email: returnablevote@gmail.com, Bluesky: @garlipow.bsky.social. Mastodon: @GarLipow Facebook: GarLipow


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