Privilege

I’ve been following the “anti-vaxxer” movement over the last few weeks. The arguments are predictably crazy – there are people who don’t trust or understand scientific research and people who see a Big Fill-In-The-Blank (Data/pharma/government) Conspiracy around every corner.

Irrationality is the dead end street of these discussions and nowhere does it glare more brightly than in the way people assess their own risk. Minuscule possibilities of an adverse reaction to a vaccine becomes more important than the significant risk of the disease itself. For example, studies of the measles vaccine show that the risk of developing encephalitis from the vaccine is 1,000 times less than the risk of developing it from the disease itself.

It seems to me that the invisible factor in this distorted risk calculation is privilege, an advantage granted to a group of people just by virtue of some characteristic. You hear about it a lot in socioeconomic and race contexts, but I think it’s the elephant in the room in many of our health care policy discussions.

Some of the most moving pleas for vaccines come from parents whose kids are immuno-compromised, usually because of the side effects of cancer treatments. The common argument is that the parents needs to do a better job of keeping their vulnerable kids away from infected people. After all, I’ve heard, it’s not my job to protect your child.

At some point during my despair over the callousness of such thoughts, it occurred to me that people who say that are speaking from a position of privilege; that is, people who’ve never received the blunt force trauma of a life-threatening medical diagnosis.

The “it can’t happen to me” argument can only exist until it happens to you.

I think this might be the crux.

Our delusions of invincibility.

As I thought this over, a local story brought me another tragic example. A local public figure, Rich Apuzzo, publicly disclosed a terminal brain cancer diagnosis as he rolled out a fundraiser campaign.

As a back story, he was a local television weather man until a few years ago when he was let go by his employer. He started his own meteorology business and became politically active in the Tea Party Movement. He has been a prolific online presence, strongly disavowing the science behind climate change and frequently batting about the dog-whistle umbrella term “socialism”  in reference to the current administration.

Here he is, 52 and facing a terrible diagnosis. He doesn’t have health insurance. Based on past discussions, I assume that part of his reluctance to get insurance has been philosophical defiance. But I am utterly shocked by the words he posted on his fundraiser page. (emphasis mine)

So I’ve gone from zero problems healthwise to terminal in under two months. Kinda scary stuff… I’m calling this episode in my life, Zero-to-Terminal in Under Two Months.

So what’s the deal?… I will tell you that I don’t feel anything. The beauty of drugs and good people around me…and that is without health coverage because I’ve been healthy for 52 years and I used to have health coverage in my previous jobs but now I’m self-employed running a weather consulting company, so what exactly would I need health insurance for when my body has been great.

And there it is. The hubris. I never thought it could happen to me.

Now he’s asking for money to help his family. Donation or not, we will all be paying for his care through our tax dollars and the cost already baked in to our health insurance premiums to recover the unrecouped cost of the uninsured.

I want Mr. Apuzzo to get great health care. I want him to get his miracle and live to meet his grandchildren. Just like I want people to raise their children as they see fit.

But to ignore that your decisions can place a burden on others or to believe that you are somehow exempt from tragedy; that’s hamartia, a tragic flaw of Greek proportions. As Shakespeare’s Cassius said:

The fault, dear Brutus, is not in our stars,
But in ourselves

 

1 thought on “Privilege”

  1. Another way to view the situation is thru lens of ‘overconfidence bias.’ Some people may think themselves better than average and thus do not buy insurance…

    In any event, the thought that people have trouble accurately assessing probabilities of remote events has been with us for some time. This thought has spawned an opposing argument to the above—that inability to accurately assess risk of extreme events drives many to buy insurance that they do not need out of ‘loss aversion.’

    Classic (Nobel winning) work here was Kahneman and Tversky’s ‘Prospect Theory.’ Seminal paper can be found here:

    http://www.princeton.edu/~kahneman/docs/Publications/prospect_theory.pdf

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