Ignored crises and new career horizons

I’m starting this with a semi-personal story. A family member opened a bar (actually, co-opened a bar with partners and her SO). And it was a big hit and people were all excited and they designed a marvelous logo. And in a burst of enthusiasm, the folks connected with said bar (including said family member) were all psyched enough to get a group deal on tattooing the logo of the bar on parts of their respective anatomies.

You can figure out where this is headed, right?

Short story–business succeeded but things fell apart, partners got vicious, lawyers were called, love stopped. So NOW, family member has this indelible reminder of what was perhaps one of the bigger debacles of her life and wants it gone. So far it has cost some $1700 between laser techs and aestheticians (yes, that’s what they’re called) to try to excise this thing. And what she has to show for her $1700 is a smudged tattoo that looks like it was done in jail by a distracted meth addict. Original cost $25. The treatments shall continue. She hears from the techs that this is a boom-town business. Get in on the ground floor, ’cause all those Millenials are going to have second thoughts come their 40th birthday.

Okay, I know that crisis (whether it’s a bad tattoo or global warming)  creates opportunity. The comedian David Brenner used to joke that the NYC umbrella salesmen who magically appear on street corners within seconds of a downpour would be hustling on the day we had a nuclear war: “yo, got your lead lined suits here! check em out”. I know that this is a country built on ‘free enterprise’. But many years ago, people on the left started pointing out that not all expenditures are good. If you live in a high-crime area and someone smashes out your car window, that’s not necessarily a ‘plus’ for the local economy. And as Kalle Lasn, the editor of ADBUSTERS has pointed out from time to time, Capitalism is built on the idea that economic activity is good regardless of why it happened. And most of what we call ‘economic activity’ doesn’t count the externalities–the oil was worth $80 a barrel, but the net damage to the local environment was generally not factored into that price. So part of our problem with conventional economics is that, in conventional economics, the Fukushima accident will be a big win for the economy (with at least 1,300 cancer deaths, never mind all the cures). After all, every extra cancer case  is tens of thousands of dollars in medical care for surgery and drugs.  Children born with profound birth defects? It’s a hiring opportunity for clinicians and home health attendants! Lemonade out of radioactive lemons!

There seems to be plenty of this sort of opportunity in our society. If you want a growth industry, look at diabetes–twenty years hence, we’re going to be looking at several orders of magnitude more amputations, prosthetics, rehabilitation stays, heart disease and diabetes-related blindness. Get in on the ground floor! Nowhere to go but UP! And remember–many of those people will go on SS/Disability in their 40’s or 50’s as a result of these conditions. Medicaid will have to pick up most of that tab, and it won’t be small. ‘Medicaid’ is shorthand for ‘you, the taxpayer’.

Now, our official reaction to the diabetes tsunami twenty years from now is… almost non-existent. Advisories from nutritionists and food activists urging people to eschew processed foods in favor of fresh ingredients and for people in general (and children in particular) to do things like, you know, exercise, are condemned by many conservatives as just another manifestation of the nanny state.  And the big agra and processed food companies have recruited many of the PR agencies who helped the tobacco industry defend itself–one of the arguments advanced in defense of smoking was that adults in this great country should be free to smoke themselves to death, and we’re seeing the same ‘freedom of choice’ argument to defend people eating themselves to death. Thanks to these public relations experts, we actually have a debate on whether the government should be in the food safety business and whether obesity is a matter of choice and freedom. This is in sharp contrast to many other industrial countries that are also facing growing rates of diabetes and its complications and are developing aggressive policies to address it.

As usual, this is nothing new. Thirty years ago, the world faced a new disease spread through sex and blood contact called AIDS. And the US response back then was in sharp contrast to the response in Europe. Author and activist Randy Shilts chronicled the difference in his book AND THE BAND PLAYED ON. He noted that once it was clear that the virus was being spread sexually, it was CONSERVATIVE politicians in Western Europe who demanded explicit advertisement campaigns to advocate for condom use. Why did this happen in Europe, when conservative politicians in the US fought education and publicity campaigns? Because conservative politicians had their eyes on the bottom line. They knew that the disease, if left unchecked, would bankrupt their country’s national health systems. And that is why Western Europe never had the rates of transmission common in the US.

But back to diabetes. The problems that lead to diabetes aren’t hard to figure out–we’ve got a nation that can’t get out of its cars for any reason, and most children either take a bus to school or get ferried by mom and dad (in sharp contrast to practices 30 years ago). And in most of suburbia, this is almost by necessity–most suburban areas lack sidewalks and safe places to cross streets, and many community schools have banned bicycles. The American Academy of Pediatrics blames much of the childhood obesity epidemic on our built environment(note–pdf report download) aka Suburbia. But we haven’t stopped building suburbia. We’ve treated the consumption of empty calories as an American right. And people who speak out on this overmuch are people who are shunned by friends.

We haven’t addressed this onrushing problem in any substantial way. And it seems to me that the free market ‘optimism’ inherent in planning for our lassitude should goad us into action. Somebody needs to deal with what we’re going to do with ourselves when the oil gets too expensive and too many of our people are unable to ambulate.  There are ways to get healthy that are cheaper than a year’s worth of  Metformin and Zestril and test strips.

I wish the bar refugees the best of luck with those tattoos.

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