Health care, bigotry, and civil rights
Friday, October 19 2012
I realized a few nights ago that I am a bigot. That’s a hard thing to think of oneself, but let me explain.
I was in line at a pharmacy — buying medicine for my cat — when a man took position behind me. He had a cough, a heavy, phlegmy cough, and I could hear his lungs rumbling when he breathed.
‘Dude, please don’t stand so close behind me,’ I thought. I was disgusted. I worried he would cough mucus all over the back of my neck. I didn’t want whatever he had.
I wrote about Norbert Elias in a previous post: he’s the sociologist who argued that what counts as civil behavior is determined largely by rules of the ruling classes and elites. The reason we don’t pee and poop in public, the reason we cover our mouths when we cough, the reason we shake hands, wear the clothes we do, have sex in private, use forks and knives is ultimately due to courtly practices in late medieval Europe. Weird, right? But these rules are fundamental to society — they’re more deeply ingrained in us than most of our laws. You might have no problem with jaywalking or driving 10 minutes over the speed limit, but you’re probably appalled to see someone poop in public. So pervasive, so profound that we even feel visceral disgust. You would judge that person; you would condemn him as someone barbaric, uncivilized. You might not like to see someone robbed, but that crime probably wouldn’t seem revolting.
If you’re a sick person, these norms work against you. I am not saying that people should be allowed to poop in public; but I am saying that if you are a person in a public place, and you have an urgent need to poop, the norm that says you have to find a bathroom suddenly seems uncomfortably oppressive.
If you’re a elderly gentleman with a cough, the norm that you don’t cough in public makes your life harder. You can’t help it, your lung are tearing apart, and you just want to hack up all the stuff and get rid of it, but you have to go to the pharmacy for your medicine. And that one guy in line in front of you keeps giving you dirty looks, judging you for something you don’t want and can’t control. Guy doesn’t know anything about you or your life or what you’ve been through, but thinks he’s in a position to condemn you. And you know that guy is an asshole, but he’s also something worse — a bigot. He is judging you for your illness, and that is bigotry as much as judging a person for their race, sexual orientation, gender, or any other contingent fact about them.
That was me — the bigot. I didn’t realize it, not for a few days. In my defense, I was in a really bad mood that day. And probably the coughing man didn’t think through all of this. But I did, later. And I realized I was wrong to give him that dirty look. I should have said something to him, talked to him, asked him how he was doing. But I didn’t.
Through norms that condemn ‘sick’ behavior as impolite, our society makes public life difficult for sick people. To bring those people back into society, we can erode those norms. We can make it okay to poop or pee in public, to cough in public, spit bits of bloody lung wherever you want to, dribble pus on sidewalks and subways. But we won’t — and, I will admit, probably shouldn’t.
But that means we have an injustice to resolve. Blaming people for things they can’t control is bigotry; denying those people admission to public life is a gross injustice. The way we correct that injustice is through healthcare, and that puts health care squarely in the category of remedies we call ‘civil rights’.
Health care is a civil right in part because we sick people need it to participate fully in public life. Bigots may argue otherwise, but it is precisely their prejudice that make health care so essential to our civic participation.
I am sorry to have been among them — even for a moment.
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