Ed Yong: The only thing I would push back gently on is that this is a recent thing. I think it’s actually our default posture. I think that people do gravitate towards these biomedical solutions. There’s this sort of techno-utopian view that more research and some kind of hifalutin development is going to address problems. But in many ways, these advances are kind of sticking customs that don’t address the foundational rot that has allowed lots of marginalized groups, from Black people to Indigenous people to disabled and elderly and poor people, to be disproportionately hit. That can be solved through social interventions: things like universal health care, things like sick pay for all. It’s not rocket science. Those are measures that you could put in and that wouldn’t have to wait for something biomedical. But we look for that silver bullet because I think it’s almost easier. It absolves us of responsibility for looking deeply at the systemic underpinnings of these crises and trying to actually fix them.
I write about this in the big piece: This minuscule fraction, 2.5 percent, of America’s health-care spending is on public health. What we’re doing is we’re spending huge amounts of money to treat people who are already sick and almost no money on preventing them from falling sick in the first place, which, when you think about it, is ludicrous. The entire point of health care is to maintain health for as long as possible. And the best way to do that is through prevention. That’s what public health is. It is the world of things like sanitation, of vaccination, of testing and tracing and isolating.
Wells: But sanitation and prevention is boring. And, like, getting in a crisis and then having to solve it and the hero comes to save the day with some sort of innovation is exciting.
Yong: I mean, yes, I actually think that’s true. Public-health people lament this all the time: Public health is distinctly not sexy. And it’s especially not that when it works. I think it’s the problem. When public health works, all that you see is the miracle of a normal, healthy day. It’s only when it doesn’t work, when everything goes to pot, that you realize just what you are missing.
It’s really hard to internalize that. People take their health for granted. I don’t think it’s a stretch to say that so much of our fiction involve stories of, like, people doing stupid things and a hero comes in and saves the day. Just stop people from doing the stupid things in the first place.
Wells: But then you’re being a buzzkill.
James Hamblin: Nanny state … socialists … taking away my soda …
Yong: … strapping a seat belt on you whilst pulling that cigarette out of your mouth.
Hamblin: These are the things I was thinking about when I was sitting in a radiology reading room, reading CT scans and MRIs. I just felt like I really wasn’t helping with the problems. And then I stopped doing that, and I went and studied public health and got into writing about this stuff. And I feel like it quickly becomes political. It’s hard to advocate for these things without sounding like it’s aligning with certain political incentives, even if your actual incentive is really just to keep people healthy.