Individualism and the Fall of Public Health
How predatory businesses sabotaged America’s health
Americans are dying sooner than we should. Food and Drug Administration Commissioner Robert Califf calls the trend catastrophic, especially since youth are among the principle victims. But living shorter lives is only part of the story; we also have more injuries and illnesses than people in other high-income countries. Many explanations have been offered, but according to the Trust for America’s Health, the reason is the chronic underfunding of our system of public health.
To be sure, we have the best doctors, nurses and health care facilities in the world. We ought to; we spent some $4.7 trillion on them during the year, about $14,000 per capita. This is double what other large, wealthy countries spend. But our healthcare system is flawed, say researchers from Harvard University; it’s “rescue care,” designed just to address the patient’s immediate problem. To foster long-term health, we need more resources directed toward public health, currently allocated at only 4.4 percent of our annual healthcare budget.
It wasn’t always this way. At the turn of the twentieth century, during America’s Progressive Era, public health was a viable force. In the wake of the Industrial Revolution, business had expanded as never before, but there was also extreme poverty with masses of people living in squalid housing with poor sanitation and frequent disease epidemics. Such conditions called for reform, and America responded with a host of polices destined to transform the country. Among these were regulations to improve safety of factory workers, minimum wage laws for women, industrial accident insurance and restrictions on child labor.
For the most part, these changes were welcomed, but corporate interests opposed them, viewing them as a threat to profitability. A lot of money was at stake, and they needed an ideal powerful enough to forestall the impetus of social reform. So, they appealed to patriotism, arguing that interference in business stifled innovation and reduced productivity, things that made America great. Moreover, they claimed that protecting people only made them weaker and dependent on government, which ran counter to the American traditions of self-sufficiency and independence.
These ideas got a boost from the 1928 presidential campaign when Herbert Hoover coined the term “rugged individualism” to describe his philosophy of personal freedom rather than government intervention. Generating visions of the pioneer spirit of America during its westward expansion, the notion was highly popular and won Hoover the presidency. It also spawned individualism as a political movement based on the idea that to preserve our right of self-determination, we had to limit the power of government. This included its power to impose health and safety standards on individual businesses, which was supposedly a disruption to our system of free enterprise.
This notion was quick to gain support from several industry groups, especially those noted for undermining health. As early as 1910, the gun industry was sending out the message that guns didn’t kill people; individuals did. By mid-century, the alcohol industry followed suit, claiming that responsible drinking was the solution to alcohol-related problems, not government regulation. More recently tobacco companies used a similar approach to oppose smoke-free dining and other restrictive policies, arguing they violated smokers’ rights.
Over the years, such messages helped diminish support for public health and install individualism as a national value. Gaining momentum from the “Me” generation of the 1970s, the movement helped launch the era of globalization when business interests reigned supreme. In latter decades, when progressive ideals reemerged, opponents kept up the pressure, branding efforts to foster health and safety as coercion from the Nanny State. Things turned ugly during the COVID pandemic when public health officials were intimidated, harassed and even physically threatened for mandating prevention measures.
Adding insult to injury, politicians in many states passed laws to permanently weaken public health. Then on May 13, 2021, Rochelle Walensky, the director of the CDC, finally threw in the towel, announcing on her Twitter feed that “Your health is in your hands,” which is exactly what individualists wanted to hear. It may have taken over 100 years, but the incessant media campaigns from corporate sponsors, with support from their political surrogates, were ultimately successful, moving public health from a national priority to a matter of personal choice.
Of course, the real loser has been the American people. As the country divested in public health, we have become more subject to epidemics of disease, alcoholism, drug use, and gun violence. And while our current healthcare system does little to address these problems, its cost is projected to skyrocket in the coming years, reaching $7.2 trillion by 2031 when it will amount to about 1 in every 5 dollars spent by the American consumer.
We need to reverse course. Some experts suggest we treat public health as a matter of national security, providing it with a mandatory funding stream that would insulate it from the influence of special interest groups. But whatever we do, let’s not let them dupe us any longer with their slick media campaigns. In 2024, let’s put public health reform back on the national agenda.
Author:
Dan Skiles
Dan Skiles is an IPS associate. He has a master’s degree in clinical psychology and over 30 years of experience in alcohol and other drug prevention.
