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Healthcare and politics are intertwined. Political polarisation and instability affect healthcare standards like many other fields of consideration like economic inequality. Navarro et. al. (2006) proposed a model for how politics affects healthcare while acknowledging the effects of social inequities, as portrayed in Table 1. Navarro also finds a correlation between pro-redistributive governmental policies and healthcare indicators like infant mortality, and life expectancy.
Illustration by The Geostrata
A closer look is required to analyse healthcare outcomes and increasingly varying perspectives on the ways to approach healthcare coverage and different medicinal systems. Healthcare as an industry and health as a commodity have become increasingly prominent in the globalised world, especially in the United States, defined by its lack of universal healthcare. Modern and traditional medicinal systems, including Allopathy and Ayurveda, serve as pertinent examples to note the alienation from one and flocking to the other during times of increased distrust.
POLITICAL POLARISATION AND HEALTHCARE
Political polarisation is defined by competition over cooperation, unwillingness to moderate, and a view of one’s political opinions and its related conflict being larger than individuals and their relations with others. Andreas Schedler (2003) analyses that modern-day constituents of political polarisation are not by clear anti-democratic forces but an ambiguous breakdown of trust in democratic institutions caused due to questioning of the democratic character of mainstream political actors.
Infographic by The Geostrata
Political polarisation will similarly affect healthcare outcomes. When these mainstream political actors have enjoyed relative stability over the past decades, notions of public health of these states come to be associated with this distrust. Public health initiatives of the government are usually backed by modern research and science. With this association of public health initiatives with the mainstream democratic actor’s government authorisation, there is, of course, a breakdown of trust in these initiatives.
There has been a rise in right wing governments in recent years. Right wing governments are usually against redistribution of wealth. A libertarian streak is also prominent in countries like the United States. President Donald Trump has nominated Robert F. Kennedy as his Secretary of Health and Human Services. Kennedy was Trump’s competitor during the 2024 Presidential elections before dropping out to support Trump.
Kennedy has displayed vaccine skepticism to the extent of believing the widely discredited theory of vaccines causing autism. However, some of Kennedy’s arguments have allegedly found support across the political aisle with progressive firebrands like Senator Bernie Sanders (I-VT) and Senator John Fetterman (D-PA) for their overlap of interests against adulteration of food with chemicals, and other harmful additives. Del Ponte et. al. (2023) showcases the widening partisan divide in the United States over trust in the public health system.
There is a need to establish a bridge between political polarisation and ideological extremism to assess its links with health outcomes. Political ideology has been defined as “a set of beliefs about the proper order of society and how it can be achieved”. Political polarisation is also the widening gap between the various sets of ideological positions, most notably, left/liberal and right/conservative positions.
Political polarisation is also more likely to lead to worse mental and physical health for ideological extremists. An ideologically extreme person is likely to be skeptical of the governmental empirical programs designed to promote healthy living, and instead would focus on unverified sources.
Instead of believing in established medical practices, ideological extremists on either side of the spectrum are prone to disinformation. This polarisation shifts resarch based medicine from the center it occupies for the average voter, and opens up a variety of alternative medicine options.
However, there is a dichotomy that exists here. The alternative medicine system preferred by a certain ideological extreme will be singular. Hence, the number of voices that this ideological extremist is listening to actually decreases. Although at first glance political polarisation may seem to open up greater pathways of approaching healthcare; it leads to worse outcomes.
POLARISATION DUE TO PROFITEERING
However, skepticism is also sometimes justified. Increasing profits of healthcare, and insurance conglomerates and public anger over it resulted in the assassination of UnitedHealthcare CEO Brian Thompson.
Prioritising profit over medicine is a considerable accusation that is levelled against the healthcare ‘industry’. The healthcare system in the United States has been systematically subservient to the demands of corporate capital vis-à-vis corporate power, and financialisation (Perry and Bernasek, 2024).
The opioid epidemic in the United States is a clear example of undue corporate interests influencing medical practitioners’ decisions to prescribe harmful medicines. The alienating aspect of this undue corporate influence, and mismatch between resources spent and the commodification of health likely leads to flocking to alternative medicine systems, therefore, setting the stage for a clash.
During the COVID-19 pandemic, lack of cures for this disease led to flocking of Indian consumers to Baba Ramdev’s self-proclaimed and non-evidential cure ‘Coronil’. Baba Ramdev is a man who possessed considerable trust for his healthcare opinions among a vast section of Indians who practice Yoga, and alternative indigenous medicinal systems like Ayurveda.
However, the Delhi High Court found Ramdev and his associates guilty of promoting false statements regarding its cures to obesity, heart disease, and diabetes, etc. Ramdev’s Coronil was also certified by the Indian government under its AYUSH scheme as a supporting measure.
When allopathic medicine was not able to reach the masses due to lack of a cure, proponents of alternative medicine like Ramdev, engaged in profiteering. Therefore, profiteering in the present capitalist system is not only limited to modern practitioners as is evidenced by Baba Ramdev’s actions for his alternative medicines during the pandemic.
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The combination of governmental fiat in polarised times and commodification of healthcare has led to some unpopularity of allopathic medicine. However, a similar fate might befall alternative medicine systems if they are similarly popularised and commodified.
RISK-BENEFIT ANALYSIS - DISCOURSE ANALYSIS
A risk-benefit analysis is necessary for the individual before approaching alternative medicine. For mild diseases, complementary and alternative medicine may do more good than harm because the individual runs the risk of being over-diagnosed in the allopathic paradigm.
Life-threatening diseases however warrant greater reliance on empirical systems like allopathic medicine. Making an informed choice after consideration of all voices on the spectrum is a way to combat political polarisation.
However, all voices do not command the speaker-phone to spread their views. Discourse analysis is required to deconstruct the commanding views on healthcare, while also ensuring better healthcare outcomes for all. Positioning of a certain medical system at the center is practically unavoidable since governmental initiatives cannot be completely broad-based in the face of lack of evidential research in complementary and alternative medicine.
However, periodic questioning over the centering of allopathic medicine is something that does not warrant tamping down. For example, homosexuality was pathologised in the West for long, and imperial discourse led to spread of these narratives to traditionally supportive societies like India. This pathologisation in the West led to the rise of conversion therapy, and it even made its way to alternative medicine with claims of being able to cure homosexuality with a variety of herbs, and powders by some Ayurvedic practitioners.
Hence, there are some inherent problems in this risk-benefit analysis regarding healthcare that rise up when postmodernist ideas are brought to the fore which are not to be combated, but acknowledged.
Political polarisation causes differences in healthcare outcomes for differing positions; while ideological extremists are most negatively affected due to narrowing down the voices of reason. As political polarisation grows and trust in democratic institutions weakens, many people are losing faith in research-based allopathic medicine.
This has led to a rise in alternative treatments, and a preference for ‘natural’ remedies. However, both medicinal systems are prone to corporate commodification of healthcare leading to increased distrust of the public and want for newer systems that are somehow cures. Undue corporate influence also lead to disasters like the opioid epidemic.
A risk-benefit analysis is required to dissect what is suitable for the individual on the basis of severity of illness. Yet, prioritisation of allopathic medicine is more likely due to its empirical foundations and ease of associated governmental action. Hence, it is established that commodification and political polarisation fuels distrust in a medicinal system; leading to the rise of alternative medicine.
BY PRANAV
TEAM GEOSTRATA
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