Open Anthro Vol 2-1 The Social Life of Health
Volume 2, Number 1
The Social Life of Health, Illness, Medicine and Health Care: Anthropological Views
On March 23, 2010, US President Barack Obama signed into law The Patient Protection and Affordable Care Act, Public Law 111–148. The brouhaha around health care reform had been brewing for years, and would not end the day the President signed PPACA into law, 906 pages of legislation passed by the US Congress. Some observers might argue the real battle had begun that day. Others would see it as déjà-vu all over again since two decades earlier, oppositional forces converged to defeat the 1993-1994 Health Security Act, the Clinton Health Care Plan. Indeed, efforts at national healthcare reform went back even further, by at least seventy years.
In the days following the signing of the 2010 bill, the latest battle over health care reform began to rage on Capitol Hill. The matter was even brought to and decided upon by the Supreme Court, and key requirements of the law were deemed constitutional. The federal government could move forward to implement the Reconciliation Act and the Affordable Care Act, requiring every American to have health insurance.
As the day grew closer for health insurance enrollment to begin, the battle became fierce, with a budget standoff rooted in the politics of health care reform that resulted in a (partial) government shutdown that lasted sixteen days in October 2013. The matter of reform proceeded, though quite slowly since the federal website on which applicants were to enroll, was a mess. Before long, things got a bit better—the website saw improvement, more people were able to enroll, and by the close of 2013, over 2 million Americans, a small fraction of the uninsured, became owners of newly minted health insurance policies.
The whole mess—the fights, the threats, the web crashes—was successful in capturing the public’s attention. Maybe it succeeded in distracting them too. What were the terms of the battle, and who set those terms? As one among the public, I found myself wondering about the discourse that has dominated the airwaves, talk shows, newspapers, and Internet: what is being left out, what is silenced? In times like this, I feel the need to step back, take a deep breath, and get some distance. I also know that anthropology can help with that. The discipline provides a way of looking at things from other angles, a necessary respite when the familiar becomes so intense, it blinds.
I set out to prepare this edition of Open Anthropology with a focus on the anthropology of health, illness, medicine, and health care for two reasons. First, the topic is certainly timely and fulfills the mission of Open Anthropology to bring the discipline into the public conversation about critical social issues and contemporary policy debates. Second, I offer a selection of articles that help defamiliarize the “normal,” that make strange the familiar, a process that can lead to new insights, understandings, and positions. In the title of this edition, the phrase “the social life of” precedes the words “health,” “illness,” “medicine,” and “health care.” I chose this phrase to capture the idea that each of these “things” is situated in a set of social relations and dynamics that are neither natural nor inevitable (anthropologists use the word “contingent” to capture the idea that everything has a history and a context), and that are understood by people in terms of ideas, beliefs, and the meanings people attach to them.
It is always a challenge to pick among the hundreds of thousands of pages in the full AAA journal collection to feature in any particular edition of Open Anthropology. There is so much rich material to choose from across time, subdiscipline, interests and affinities. The American Anthropological Association is comprised of over forty sections and interest groups, including Society for Medical Anthropology (SMA), which itself supports ten interest groups. Between section websites and the 20+ journals, there is an enormous amount of AAA information that can be accessed on a range of topics and issues.
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