The natural world is full of individuals. No single tree is the same as any other tree. No single pebble is the same as any other pebble. No single river is the same as any other river. No single storm is the same as any other storm. And of course no single man or woman is the same as any other man or woman.
But when trees become logs, and pebbles become aggregate, and rivers become drinking water, and men and women become employees in companies, their individuality becomes a liability. All industries want their trees to be the same size, and their aggregate to have the same consistency, and their water to have the same purity, and their employees to share the same skills. Industry wants its raw materials to be of a uniform quality in every possible respect.
And so when people enter organisations of one sort or other, they very often must wear uniforms which carry insignia of their rank on them. All concerned must conform to certain minimum standards, because the organisation works best if there are the same sort of people doing the same things using the same materials.
And it’s the same in hospitals in which humans themselves become the raw materials which are being fed into them for treatment or processing. Hospitals will want their patients to be as far as possible as uniformly the same, in the exact same way as timber yards want their logs to be of the same size and of the same quality.
And so what’s called Public Health may simply be part of an attempt to ensure that patients entering hospitals have the same conveniently uniform characteristics. For the more individual that people are, the more different and diverse they are, the more difficult they will be to treat.
They will, for example, want them to not be too fat, particularly if they to undergo surgery of any sort. I’ve only spent a single night in a hospital, but when I was examined prior to admission, the surgeon who was to operate on me declared, as soon as he saw how thin I was: “We’re not going to have any trouble with you.” Which almost certainly meant that some “overweight” people were sometimes very troublesome to operate on. And it also meant they were really only “overweight” from the point of view of the hospital.
Nor will hospitals want their patients to be habitual drinkers. For no doubt drunken patients can be very problematic. And they also may generate waste in the form of bottles and cans and glasses. So drinking will be strongly disapproved, purely for the convenience of the hospital.
And if fat people present problems for hospitals, smokers present a different problem. Smokers are messy people, blowing smoke everywhere, and filling ashtrays with ash and butts. There are extra cleaning costs associated with smokers. And this is probably why smokers are increasingly excluded not just from inside hospitals, but even from the grounds surrounding them, once again purely for the convenience of the hospital.
It would also be most convenient for hospitals if all their patients ate the same food, that could be cheaply and easily prepared, in minimal quantities. And since vegetables are usually cheaper than meat, it would not be surprising if hospitals would prefer their patients to be vegetarians rather than meat-eaters, for a vegetarian diet is likely to be both cheaper and easier to provide. Once again, this will be purely for the convenience of the hospital.
So as Public Health organisations set out to create a low-fat, alcohol-free, smoke-free, vegetarian society outside the hospital gates, it is not doing so in order to improve anyone’s health, but instead to ensure that patients of a uniform kind arrive at the hospital for processing. It’s a purely bureaucratic, managerial decision by hospitals to disallow smoking: it simply saves them money, offloading the costs (in trudging to the hospital gates for a cigarette) onto the patients.
In this manner, the medical profession ceases to conform to their patients, accepting all comers, and instead the patients must conform to the hospitals and doctors who treat them. Increasingly inhospitable hospitals don’t want “problem patients”, and will pick and choose who they will treat.
The same sort of reasoning probably applied to the “hospitality” industry when it welcomed smoking bans. After smoking was banned, pubs were going to be a lot easier to clean. What doesn’t seem to have been foreseen is that they would also have a lot fewer customers.
And perhaps the same applies with hospitals, whose patients are their customers, as fewer and fewer smokers and drinkers and fat people have any wish to ever be admitted into any of them, now that they have become equally unwelcoming. As a result, it is almost certainly the case that there are growing numbers of smokers and drinkers and fat people who have undiagnosed and untreated conditions of one sort or other simply because they have no wish to become captives inside an increasingly intolerant medical system. In fact if smokers and drinkers and fat people actually do die younger than other people, this may be the complete explanation for it. In this manner the rise of bullying and browbeating Public Health organisations will almost certainly result in a real decline in public health, if it has not already done so. And this real decline in public health is likely to be precipitate if the undiagnosed and untreated conditions include influenza or bubonic plague or Ebola.