How Suffering Drives Politics

National Journal
Sam Baker
Add to Briefcase
See more stories about...
Sam Baker
June 18, 2014, 4 p.m.

Someone is al­ways in pain, and there’s al­ways someone else who thinks they’re fak­ing it. That ten­sion, ac­cord­ing to Keith Wail­oo, tells us a lot about the past half-cen­tury of do­mest­ic polit­ics. Wail­oo’s new book, Pain: A Polit­ic­al His­tory (Johns Hop­kins Uni­versity Press, 2014), uses suf­fer­ing — wheth­er it’s phys­ic­al pain or some oth­er form of an­guish — as a vehicle for un­der­stand­ing dec­ades of so­ci­et­al change.

(Keith Negley)As the coun­try grappled with the linger­ing wounds of GIs who had re­turned from World War II, Pres­id­ent Eis­en­hower was un­der pres­sure to cre­ate a dis­ab­il­ity be­ne­fit with­in what was then the Vet­er­ans Ad­min­is­tra­tion sys­tem. But he met steep res­ist­ance from doc­tors — the people you’d think would be most in­ves­ted in caring for the wounded. The Amer­ic­an Med­ic­al As­so­ci­ation ac­cused Eis­en­hower of “plant­ing the seeds of so­cial­ism” — a charge that has been leveled at every politi­cian who has sub­sequently at­temp­ted to ex­pand health be­ne­fits, from Medi­care to Obama­care. Many of the AMA’s mem­bers also ar­gued that dis­ab­il­ity wasn’t a real thing, that it would simply be a mag­net for lazy and disin­genu­ous vet­er­ans in search of a handout. This po­s­i­tion seems ab­surd now, but in the days when the AMA was fight­ing VA be­ne­fits, med­ic­al treat­ment of pain was poorly un­der­stood. Doc­tors of­ten truly be­lieved that their pa­tients simply needed to toughen up, and lo­botom­ies were a shock­ingly well-ac­cep­ted tool for pain re­lief.

Along with the cul­tur­al re­volu­tion of the mid-1960s and the rise of in­di­vidu­al­ism, a new and rad­ic­al the­ory of medi­cine emerged: Doc­tors came to see pain as unique to each per­son, and they em­braced treat­ments that were more tailored to each pa­tient. These cul­tur­al shifts con­sti­tute the most fas­cin­at­ing part of Wail­oo’s book. The chan­ging un­der­stand­ing of pain led the phar­ma­ceut­ic­al in­dustry to flood the mar­ket with new products (even as crit­ics ques­tioned wheth­er com­pan­ies were in­vent­ing ail­ments just to cure them); it also laid the ground­work for polit­ic­al change. Wail­oo ar­gues that the polit­ics of so­cial-wel­fare pro­grams gen­er­ally track slightly be­hind cul­tur­al at­ti­tudes to­ward people in pain. In oth­er words, the broad­er cul­tur­al lib­er­al­iz­a­tion sur­round­ing pain helped to make pro­grams like Medi­caid and Medi­care pos­sible.

As the heady days of the ‘60s and ‘70s came to an end, so did that era’s view of pain. Pres­id­ent Re­agan presided over a massive purge of wel­fare, dis­ab­il­ity, and Medi­caid rolls, cast­ing the pro­grams as mag­nets for fraud and “learned help­less­ness,” as well as a bur­den to tax­pay­ers.

Re­agan also helped ease reg­u­la­tions on the phar­ma­ceut­ic­al in­dustry — a move that fit with his gen­er­al skep­ti­cism of reg­u­la­tion and that over­lapped, even­tu­ally, with AIDS act­iv­ists’ push for faster ap­prov­al of new drugs. But the pen­du­lum later swung back to­ward reg­u­la­tion, amid wide­spread ab­use of drugs like Oxy­Con­tin and ser­i­ous safety prob­lems that led the Food and Drug Ad­min­is­tra­tion to pull block­buster products like Vi­oxx, a pain med­ic­a­tion, off the mar­ket.

The polit­ic­al his­tory of pain is largely a ques­tion of pri­or­it­ies. In the ‘50s and ‘60s, the fo­cus was on the phys­ic­al pain of sick people — first vet­er­ans, then the dis­abled, seni­ors, and the poor. Un­der Re­agan, the fo­cus shif­ted to the “pain” of tax­pay­ers who fun­ded wel­fare fraud, even as an­ti­abor­tion con­ser­vat­ives sim­ul­tan­eously came up with a new front in the pain wars — fetal pain. In short, Wail­oo ar­gues, pain is an ef­fect­ive polit­ic­al is­sue. It just de­pends on whose pain you’re talk­ing about.

What We're Following See More »
19 FACE-TO-FACE MEETINGS
Latest Count: 12 Trump Campaign Staffers Had Contact with Russians
1 days ago
THE LATEST
AT ISSUE: COMEY FIRING, SESSIONS’S RECUSAL
Mueller Seeks Documents from DOJ
4 days ago
THE LATEST

Special counsel Robert Mueller "is now demanding documents from the department overseeing his investigation." A source tells ABC News that "Mueller's investigators are keen to obtain emails related to the firing of FBI Director James Comey and the earlier decision of Attorney General Jeff Sessions to recuse himself from the entire matter."

Source:
MULVANEY SAYS PROVISION ISN’T A DEALBREAKER
Trump May Be OK with Dropping Mandate Repeal
4 days ago
THE LATEST

"President Donald Trump would not insist on including repeal of an Obama-era health insurance mandate in a bill intended to enact the biggest overhaul of the tax code since the 1980s, a senior White House aide said on Sunday. The version of tax legislation put forward by Senate Republican leaders would remove a requirement in former President Barack Obama’s signature healthcare law that taxes Americans who decline to buy health insurance."

Source:
FRANKEN JUST THE BEGINNING?
Media Devoting More Resources to Lawmakers’ Sexual Misconduct
4 days ago
THE LATEST

"Members of Congress with histories of mistreating women should be extremely nervous. Major outlets, including CNN, are dedicating substantial newsroom resources to investigating sexual harassment allegations against numerous lawmakers. A Republican source told me he's gotten calls from well-known D.C. reporters who are gathering stories about sleazy members."

Source:
STARTS LEGAL FUND FOR WH STAFF
Trump to Begin Covering His Own Legal Bills
6 days ago
THE DETAILS
×
×

Welcome to National Journal!

You are currently accessing National Journal from IP access. Please login to access this feature. If you have any questions, please contact your Dedicated Advisor.

Login