Healthcare and race: Maxine Johnson

Check out this video:

But then watch this one for a longer interview with Maxine Johnson, the woman dragged out. Its worth watching to the end to hear her opinions on the healthcare debate.

 

Gary Younge on segregation in the US

An insightful article by the British journalist Gary Younge in the Guardian today, that touches on some of the things I was rather incoherently burbling about in my post on personal responsibility a few days ago.

It is this context that makes elements of Barack Obama’s speech to the NAACP conference problematic. Having paid homage to the heroic role of the civil rights movement and recognised the inequalities bequeathed by segregation, he started on parenting. “We’ve got to say to our children, if you’re African- American, the odds of growing up amid crime and gangs are higher,” he said. “If you live in a poor neighbourhood, you will face challenges that somebody in a wealthy suburb does not have to face. But that’s not a reason to get bad grades; that’s not a reason to cut class; that’s not a reason to give up on your education and drop out of school. No one has written your destiny for you. Your destiny is in your hands – you cannot forget that. That’s what we have to teach all of our children. No excuses. No excuses.”

The audience lapped it up. Such admonitions are commonplace at any aspirant black American dinner table, where parents tell children they will have to work twice as hard as their white counterparts to get just as far. These are the mantras with which I was raised, and may well one day repeat. But I would not like to see them elevated to national policy.

 

Personal responsibility, public embodiment

Weight and health is an issue in the US that I still, after 4 years, feel I am only slowly managing to understand. It seemed clear early on that its an issue of class and race – poor people are fat, rich people are thin. But its taken me the rest of those 4 years to try and get my head around why, like most things to do with class and race, its conceptualised and discussed as a matter of personal responsibility.

The image that comes to mind is Oprah’s publicly fought “battle” with her weight. The guilt ridden confessions where she draws herself close to her audience, admitting her own weakness and resolution to continue, amid extortions to her public to keep up the fight themselves, to not admit defeat in the face of their own urges and failings.

Similar attitudes prevail of course in the UK, but I can’t imagine something like Jamie Oliver’s Ministry of Food series being screened in the US, or taken seriously, with its bizarre discussions of things like education, literacy and work being involved in healthy eating.

Its your own fault if your fat, a failing of moral character, a lack of discipline. Nothing to do with the cost of food, the availability of food stores in places that people can reach without access to cars, family size and structure, the ability to cook (either in terms of knowing what to do or in having time to do it)… none of these things. Its about personal discipline. Nothing else.

(On a personal note, its been hard to avoid absorbing some of the way weight, food, health and body image are conceptualised, after several years living there. The message imparted by the fact I can never find clothes over a (UK) size 14 in the kind of shops that cater to my demographic is depressing. Spending an afternoon trailing around the shops trying to squeeze into yet another too small “XL” is not likely to do much to anyone’s ego I guess. Getting indignant about the fact that size 12 is considered “extra large” is only satisfying if I don’t actually need to buy a new coat, or sshirt or whatever. As a result, my annual trip back to the UK has become my excuse for a new wardrobe. Picture me gleefully skipping along the high street, giddy with possibilities, beaming at all the other normal, sized 12+ women around me who are blissfully unaware of how lucky they are! (Then apologising as they back away looking freaked out). Its a yearly reminder that I’m not an total heifer who ought to be kept out of sight in sackcloth and ashes.)

Health is a moral issue. To not be healthy, to not moderate one’s eating and regularly go to a gym, is perceived as a matter of moral failing, a sign of excess and laxity. The only alternative is that its a matter of genes, which then becomes a lost-Eden story of our modern perversion from a natural order laid out for us by mythical ancestors who needed fat genes to survive in a distant “primitive” past. (Which was no doubt red in tooth and claw.)

There is no society. Only personal responsibility. Personal choices.

And so this is the thing I still don’t understand, about health and about the US in general. Or rather, I see it – I get that the concept of “personal responsibility” is the whole point – but it still makes no sense. Its the same thing that makes the idea of free health care, or free higher education, or taxes, abhorrent – not just ridiculous, but a personal affront – even to the people who need it most. Its the underlying concept that makes the US tick, and I get that. But I don’t get it. I still don’t understand why anyone with half a brain, and eyes in their head to see, would believe it.

What got me thinking about it this morning, was the articles about the nomination of Regina Benjamin to be surgeon general. As Salon.com reports, Benjamin’s nomination has been criticised because she is “obese”.

By all accounts Surgeon General nominee Dr. Regina Benjamin is an extraordinary woman. She is an African-American family doctor who has spent most of her professional life serving the people of Bayou La Batre, a poor rural Alabama coastal community. She makes house calls, pays for patients’ medicines, works for free when there is no money. She’s had heaps of honors poured on her head , including a MacArthur genius award. She rebuilt her clinic twice, once following Hurricane Katrina and then a year later when it was destroyed by a fire.

But she’s not skinny, and therefore “She will have very limited credibility unless she loses weight”. (the links the Salon article provides to the discussions: 1, 2, 3, 4). All the things this woman has done with her life, but its the matter of not being a size 10 that makes her a failure.

Something else comes up here. Looking through the comments, she appears not as a person who is going to do things and who therefore needs particular qualifications, skills and knowledge. But as someone who will “represent” something. Her role is as a symbol, something that people should be able to identify with.

Why, she’s perfect! Looks like an average American, particularly for southern Alabama.

As such, her weight is indeed more important than her qualifications or ability to do a medical job, because her role is to be a representation of… all Americans? African-American women? Working class girl made good? Her skills (possibly her life history as a person) are not as important as her ability to symbolise something – to stand in for a mass. Its the same thread that ran through the angst ridden democratic nominations – do we need a African American or a Woman more? It comes up again and again in the discussions about politicians and public officials. What/who do they represent? Having an affair, getting a divorce, being gay – these are failings to be the mass as the mass want’s to see itself, failings of commitment to the moral ideal, failings of personal discipline. Public figures are not required to have skills or knowledge, but to embody morality. To demonstrate writ large their personal ability to control themselves, to personally overcome their disgusting bodily desires and urges, to be a representation of everything an American should be.

(Now both the Leviathan and the Protestant Work Ethic are echoing in my head, but I can do neither justice.)

Ultimately public figures all fail, just as Oprah will always fail to be skinny, and perhaps there is comfort in that too, because normal people all fail to live this imaginary moral life as well. But if failing is such a central part of the concept, then I don’t see a way to break out of it. To realise that that the problem is not personal failure, but the concept of personal responsibility being the cause of social problems.