Whole (31 page)

I also want to be clear that I’m not arguing against capitalism, free markets, or profits. It’s natural for all the elements in a system to do what they can to survive and thrive. In fact, that collective motivation is the basis for the stability and resilience of the entire system. Forests can last for eons (until people cut them down) not because all the organisms in the forest are unselfish and “nice” to each other, but because each is taking care of its own business in a way that contributes to the welfare of the other elements. But the goal of the system called “forest” is to achieve maximum biomass and biodiversity, so it rewards players who contribute to that end. Trees that drop their leaves are rewarded by the richness of decomposer life that turns those leaves into nutrients, which eventually make their way back into the trees. Birds that excrete nitrogen back into the soil are rewarded by a bumper crop of worms that live in the carpet of fallen leaves that grow from the birds’ nitrogen. And so on. The problem in the case of our health-care system is not the selfish behavior of the individual elements; instead, it’s which selfish behaviors are rewarded, and which are punished, by a system whose goal is profit rather than health. This problem is not inherent to the free market, but rather the result of a market manipulated by its most powerful participants, often through collusion with a government far removed from the people it is supposed to serve.

Systems naturally reinforce themselves; if they didn’t, they wouldn’t continue. Here, the operation of our health-care system generates powerful forces that reinforce the profit motive over the health motive. It generates
equally powerful forces that keep the current system in place, allowing it to withstand all manner of scientific evidence that things could be done smarter, cheaper, and better. But systems do collapse when their resources can’t sustain their goals on an ongoing basis. Such is the case when the high costs of our disease-care system, both economic and health related, threaten to bring down our entire society.

In a system that seeks the public welfare over profits for a few, companies and individuals could still make plenty of money, just as oaks and hickories can still get mighty big in the forest. They would just do it in a fashion that can be sustained indefinitely, because the other elements of the system would flourish, too.

Before we explain how the pursuit of profit affects the health-care system, it’s important to discuss the why. Why are reductionist science, medicine, and food so much more profitable than their wholistic counterparts? After all, isn’t good health better for an economy than bad health? Healthy people make more productive workers and more avid consumers of the good things in life. And shouldn’t we be measuring our economy by how well it contributes to everyone’s well-being?

Reductionism goes hand in hand maximizing corporate profits because reductionism causes new problems as it solves existing ones. Each of those new problems, while costly for society as a whole, represents a further profit opportunity for some industry.

It’s also easier to market reductionist solutions than wholistic ones. Picture a continuum of potential solutions to any problem, with “magic” solutions on one side and “realistic” solutions on the other (as shown in
Figure 13-3
).

The magic solution, which is described as instant, easy, and foolproof, is much more appealing than a realistic solution that takes time, requires effort, and is complex to get right. You’ll notice that most consumer advertising tends to favor the magic over the realistic. From weight loss solutions and financial services, to cleaning supplies and beauty products, the closer the product is to magic, the easier it is to sell and the more appealing it is to buy. This can produce a profit windfall for the person owning the intellectual property on which the magic solution is based, and indeed, these simple reductionist solutions can be patented, and thus owned, where others cannot.

Reductionist solutions, because they are formulated to address only a limited spectrum of a problem, are much more easily described as magical than as wholistic solutions. Worried about getting a heart attack? Well, all you need to do is take a couple of omega-3 capsules a day. It takes just a few seconds, and it’s as easy as, well, popping a pill. Got diabetes? Hey, here’s an insulin injector pen with a digital timer on the cap so you never have to think about doses and timing—or improving your diet. Overweight? Drink an appetite-suppressant shake, or just get your stomach stapled so you literally can’t overeat or tolerate rich foods any more.

Magic solutions work by addressing symptoms rather than causes. Symptoms can be suppressed and managed quickly, while causes take greater effort, which often means more time to deal with. Temporarily addressing an isolated symptom is fairly simple. Causes are more complex, and require greater involvement by and responsibility from the person with the problem.

Now consider the wholistic solution to cardiovascular disease, diabetes, and extra weight: eat a WFPB diet. It works by eliminating the underlying cause, our bodies’ attempts to deal with a diet high in processed foods and animal products. And while the
effect
of WFPB may be as quick as or quicker than a pill, a shot, or surgery, it requires continual upkeep; the reductionist interventions take far less effort to implement. Changing one’s lifestyle can be challenging. It requires commitment and responsibility from the person making the change, and a willingness to be open to having new experiences and developing new habits and skills.

Our sound bite world, our hurry-up lifestyles, and our advertising-based economy all make the reductionist quick-fix a much easier sale than the long-haul, comprehensive, wholistic solution. That reductionist
solutions create the need for additional products and services (drugs and other treatments to manage the side effects of the initial solution and to suppress other symptoms of the Standard American Diet, plus emergency surgeries when the initial solution fails) is an added benefit for industrial profiteers. And all that profit means the industries that make it have a lot of extra money to throw around to ensure they can make more of it in the future. In short, they have
power.

When we think of people who abuse power, our minds go to Hollywood villains whose nefarious deeds keep entire populations cowed and craven: the banker Henry F. Potter in
It’s a Wonderful Life,
Darth Vader in
Star Wars,
Nurse Ratched in
One Flew Over the Cuckoo’s Nest,
among many others. These and other archetypal villains use violence, threats of violence, and cunning to create environments in which they benefit from power and grow it to near omnipotence. When someone uses these kinds of overt strategies, you notice. Money can be used this way, too, when you bribe a public official to look the other way as you break the law, or pay some thugs to frighten your opponents into silent submission. But there’s another kind of power that’s a lot less noticeable, which I call
subtle power:
power that operates so softly and effectively that its force and source are practically invisible.

By way of example, let’s look at why millions of American school children drink milk, rather than water, with their school lunches, something that nets the dairy industry two huge benefits: huge financial return and early education of young people about the alleged health value of consuming milk. Obviously, the dairy industry does not post armed sentries in each school to force the administration to purchase the milk, the food service workers to serve it, and the students to drink it. They don’t have to; the subtle influence they exert brings about even greater compliance than a heavy-handed use of power.

First, the dairy industry has spent a lot of money over the past sixty years lobbying the government to promote dairy as one of the cornerstones of good nutrition. When the current school administrators were children, they were indoctrinated in school that dairy was one of the “four basic
food groups.” The money the dairy industry spends to buy political influence extends to financial support for governmental agricultural policies that drastically subsidize milk production. For schools to offer the school lunch program with its subsidized foods, they must offer milk as an option. Federal authorities don’t require children to actually
drink
the milk, but they don’t need to. Local school authorities do the job. They’ve been well coached to believe that milk is needed for strong bones and teeth. The dairy lobby has also succeeded in compelling the federal government to buy billions of gallons of milk for use in other federal programs, including prisons, VA hospitals, and the military. Talk about your captive audiences!

In addition to the subtle muscle applied to our political apparatus, the dairy industry spends millions of dollars each year advertising the so-called health benefits of milk to consumers. The drumbeat has been going on for so long that we scarcely are aware that it’s paid, commercially-motivated advertising, not a public service announcement. Most of us just accept that milk is good for us. And the highly successful “Got Milk?” campaign used popular role models to convince our young people that milk makes you thin, rich, healthy, and sexy.

Dairy interests contribute generous sums of money to many health-related nonprofits as well, thereby influencing their highly effective public pronouncements about the benefits of dairy. These nonprofits have to scramble for funding, so there’s pressure not to upset large repeat donors. They also pay for academic activity that passes for “research,” producing studies that start by assuming milk’s benefits and then find increasingly creative and dishonest ways to “prove” those benefits. The mainstream media, to the extent that they are funded by “Got Milk?” and other dairy industry ads, conveniently ignores, underreports, and casts doubt upon the myriad studies that show that milk and other dairy products emphatically don’t “do a body good.” As newspapers and TV news struggle to stay afloat in the age of digital media, they also are susceptible to the dairy industry’s subtle pressure to favor its side of the story.

So those school administrators have every reason to buy lots of milk. It’s inexpensive (thanks to those government subsidies) and it’s easy to procure with minimal paperwork (because the federal government has made milk the default beverage). Thanks to health education and advertising, students expect it, parents demand it, and it sells; milk brings in profits that pay salaries, whereas water from the water fountain is free. Just
in case students haven’t been brainwashed into viewing milk as a health food by thousands of images of celebrities with milk mustaches, the dairy industry “fortifies” school milk with sweeteners and appetizing chocolate and strawberry flavors to encourage children to drink up.

Similar subtle power operates everywhere: when people buy low-fat milk (because less fat is always healthier), reject the breakfast bagel in favor of two eggs and four slices of bacon (because carbs are bad for you), and choose their breakfast cereal based on its fortification with eleven vitamins and minerals (because it’s the best way to get the nutrients you need). These choices feel self-generated, but in fact are heavily influenced by millions of dollars of spending by the dairy, egg, pig, and processed foods industries, respectively.

This confluence of power, by the way, is also responsible for the phenomenon of vegetarians constantly having to answer the question, “Where do you get your protein?”—as if protein were something that exists in animal products alone. It’s also what gets us to agree to invasive medical procedures that earn the medical industry more money rather than improve our diets. Whenever you see large masses of people making what look like “free choices” against their best interests, you can bet that subtle power is at work in the background.

As you can see, money itself is a lever of subtle power. In a healthcare system like ours, where profit is the ultimate goal, money is the most powerful force available, allowing those who have it to influence, almost invisibly, government policy, the media, popular culture, and the conversations that take place in the privacy of our own homes and minds.

Scientists are more likely to receive research funding and lucrative corporate contracts for research that can produce the next pill, supplement, superfood, or hospital treatment, so that research is more likely to get done. Media outlets are punished with the withdrawal of advertising for reporting unfavorably on advertisers’ products, making them less likely to do so; journalists know their salaries depend on that revenue. Politicians who pass legislation and write statutes favorable to certain kinds of commerce are rewarded with campaign donations from industry groups who benefit from these laws and statutes. Nowhere in this process can you see violence or even green-stained fingerprints. No one called up those scientists, journalists, and politicians and threatened them; no one blackmailed them or offered them a bribe to do something they didn’t
want to. But behavior that supports the current paradigm is rewarded, and behavior that does not is disincentivized. These carrots and sticks are mostly silent, seldom pointed to, and never discussed.