Right now I am thoroughly enjoying reading The Corner by David Simon and Ed Burns; the book The Wire was based on. It is all encompassing depiction of life in the ghetto of Baltimore. It covers everything from how the area developed into a mass of drug fiends, the inner workings of industry built up around these people, the personal stories of various participants, the children involved, all the way through to the state wide systems that fall flat in dealing with the situation. Its Dickensian in the level of detail it provides and the clarity of insight into the mind of the poor people who call it ‘home’. The whole area is fuelled by addiction. Addiction to drugs, refuting of anything but the corner lifestyle, complete rejection by people outside of it and gaining a sense of belonging from being in a place where you can exist among others in this way.
It is a big, powerful book and it has made me think a lot about culture recently. How powerful it can be. Almost any behaviour can be accepted if you are in a place where other people participate in similar kinds of behaviour. Once you realise that, you see patterns all around you. Actually, another one of my blogs covers another example of how cultures develop here: http://jonnybritton.wordpress.com/2012/03/30/monkeys/ (example 2).
In the culture of the Baltimore city ghetto, the ability for destruction is necessary in order to survive. Castigation or a less well placed position in the corner game hierarchy result from showing normal human emotions such as compassion or optimism. From theft, to fighting, from capitalising on the needs of a self-destructing addict, through to giving up of families and children. It is part of the human mind ( innate or learned I don’t know) to be able to make good relative assessments of similar things. How you adhere to the cultural norms of an society is normally fairly obvious. For the residents of people who’s lives revolve around the corner, you fit in or die. What hope of leaving there is vanishes from a young age.
So how does this relate to free health care? First of all, I will say that I am not at all familiar with the kind of free health services that a drug fiend from a Baltimore ghetto could currently expect, or any standard US citizen for that matter. But I am listening to the news and debate around Obamacare attempting to create much more readily accessible insurance for poorer families. And I think that this is a very good idea. First of all, we have it in the UK and has always served me well- taking in numerous sports related injuries along the way.
My main thought, however, is based on a book I read called The Power of Habit: Why We Do What We Do in Life and Business by Charles Duhigg. One of its stories was a real life example of a multinational corporation that was way past its best days, appointing a new CEO who came in and behaved differently than any of their past leaders. His background was also not the same as the usual corporate bod and his appointment sent company stock plummeting.
From the outset, rather than talking about metrics and future growth of the company, he spoke of improving the health and safety of the workers. There was a very high injury and death rate in the factories which had been stable for years. At first people were aghast but in time his genius became apparent.
All accidents had to be rigorously recorded and safety measures put in place to avoid them. This led to a fall in the death rate. But not only that, it led to a more secure workforce that did not fear death and it led to a much deeper understanding of what was causing the accidents in the first place which meant that a much clearer idea of operational processes was made. The company became much more efficient and profitable.
The more understanding the better. More inroads into how to fix broken neighbourhoods, the better. If doctors and health workers can record the injuries and illnesses being reported, then better processes can be put in place to reduce them. The aim is not to fix the problems of the neighbourhood but might well find ways to offer a tiny bit more healthiness. From that point, more benefits might happen.
So I am looking at the situation from a data point of view. Giving more accessible health care to poor people will mean more data and more understanding of what to offer and provide to offer better support.