Parmet on Public Health and Individualism

Via Jason, my brilliant former Constitutional Law professor Wendy Parmet weighs in on the XDR-TB scare. Unlike most coverage, Professor Parmet brings out the big picture of how the incident fits into a larger flawed public health policy:

…It is trite but true that in America we admire individual self-sufficiency and rugged individualism. Not only do we admire this “taking care of number 1” attitude, but public health has encouraged it. Over the last several decades, public health has emphasized the role that individuals can and should play in determining their own health. Indeed, every day of week, we are bombarded with messages about how we can do this or that to take care of ourselves. Sometimes the message extends to what we can do for our families. Seldom are we told what or how we can do for unnamed others.

Even infectious disease policies perpetuate this myth of self-control. We are told to vaccinate our children to protect them. We are told to help ourselves by getting a flu shot. And the federal government provides us with information about how we should prepare to help ourselves and our family in the event of an influenza pandemic.

This “privatization” of infectious disease control is even evident in the U.S. approach to quarantine. During the SARS epidemic, governments in Canada and in Asia quickly realized that quarantines would not be effective without income protection. So laws were passed to assure that people would receive compensation while under quarantine. In the United States, in contrast, despite all the efforts that have been made at public health preparedness and public health law modernization, income replacement remains off the table (the Family and Medical Leave Act only guarantees unpaid leaves for some ill employees). Perhaps even more astonishingly, in its proposed quarantine regulations, the CDC failed to ensure that it would provide all necessary health care to those it quarantined. …