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Current Affairs

A Magazine of Politics and Culture

How a For-Profit Healthcare System Generates Mistrust of Medicine

Why is there so much distrust, mis- and disinformation, and conspiracy theory about medicine in the U.S.? Blame a system that nobody can trust to have their best interests at heart.

A classic of the medical horror genre, Coma (1978) begins with an unfortunate but seemingly random tragedy: a young woman is left braindead after a routine dilation and curettage. Her good friend, Dr. Susan Wheeler, is bereft—and increasingly suspicious of her supervisor and fellow doctors after a second healthy young patient succumbs to a coma in the hospital following a minor knee surgery. The comatose patients are being transferred to a remote long-term care facility known as the Jefferson Institute, which Susan secretly investigates after sneaking away from an official tour of the site. She discovers—to the sound of a swelling string accompaniment—that the Institute is, in fact, a front for the international organ black market. Turns out the fictional Boston Memorial Hospital has been using carbon monoxide to induce comas in patients whose tissue matches potential buyers, then harvesting their organs for the highest bidders. Susan manages to thwart the sick plot, but loses her appendix along the way—luckily, that’s one of the few organs you can live without. 

Organ theft is perhaps the most pronouncedly global motif in medical folklore, appearing in rumors and legends from Lima to Las Vegas, New York to New Delhi.1 Rumors of babies “adopted” from Latin America actually winding up as organ donors became front-page news in the international press during the late 1980s, and were paralleled across the globe in the 1990s, as Bulgarian parents yielding their babies to foreign adoption agencies asked prospective parents to sign a contract promising, “I will not permit my child to be an organ donor nor allow the child to give organs or be a part of any medical experiment.” Meanwhile, on the other side of the Iron Curtain, rumormongers warned travelers to avoid seductive women in far-off lands, lest they wake up the next morning short a kidney with professional surgical incisions in their backs—a laughable tale that caused an entirely serious rumor panic in Germany, and led to the issuance of official travel guidance warning jetsetters to leave their blood type cards at home.

These stories, just some of the many organ theft tales collected by the French folklorist Véronique Campion-Vincent, are compelling at first glance, but on second thought simply too good to be true. Certain details (seductive women, neatly stitched surgical cuts) stand out in stark relief, while those that one might use for factual verification (timestamps, the identities of perpetrators and victims) are overshadowed by sex and drugs and rock and roll. Urban legends (or, rather, contemporary legends) are odd and coincidental— yet just specific enough, and told with such vehemence, that you might be inclined to suspend your disbelief. After all, the essence of urban legends is that they legitimize our anxieties. Organ theft stories take many different forms, but all employ shock value to make a similar point: that the maleficent coexists with the mundane, that peril goes hand in hand with progress. Contemporary legends invite voyeurism, the folkloric equivalent of the car accident you can’t help but ogle on the interstate. 

But while contemporary legends keep pace with modern technology and abreast of modern concerns, they often seem to seriously misattribute the threats of the world they reflect. After all, organ theft functionally does not exist, but illicit organ sale certainly does—to the tune of $1.7 billion per year—because it represents a quick source of cash throughout the Global South: the bogeyman is not some sexy blonde with sedatives and a scalpel, but a cutthroat global capitalism that compels people to sell their organs (in addition to their labor) in order to survive. 

But empirical accuracy is not the quality that matters most in folklore: stories about organ theft are “truer than truth,” writes Campion-Vincent. They draw out what we might call, in Internet parlance, the emotional truths in, with, and through which we live our lives. Sure, we enjoy the convenience, comfort, and care of modern life, but we cannot shake the fear that every advancement must come with new consequences, unknown and unknowable until we are living them. Organ theft stories gesture at their core toward an existential tension that haunts our interactions with modern medicine—namely, says Campion-Vincent, that “we want lives to be saved by miraculous technical performances, but at the same time … [harbor] deep fears about the intrusion of medical experts on the integrity of the individual.” They are stories that allow us to articulate “anxieties that … cannot be expressed openly in societies in which science is touted as a positive force improving human lives.” In these stories, modern medicine appears a kind of Faustian bargain: you can be cured, but at what cost?

Of course, the encroachment of the medic on the man is not the only intrusion illustrated in organ theft stories, or even the most obvious intrusion. Just as the clinic encroaches on the individual— with medical practice consigning some bodies to life and others to death—capitalism has encroached on the clinic, necessitating that all care ultimately cater to the bottom line. The bloody businessman’s world evoked in organ theft stories is not so different from the reality: where well-being comes at such a high cost that it is essentially reserved for the wealthy, and average people are forced to question exactly how much money their bodies and lives are worth to them. In this world, death may well be more attractive than debt—and even those with the money to pay their medical bills might find themselves wondering if their PCP is a friend or foe.

Taking Shots at Getting Shots

For most Americans, the rumor panic around organ theft has gone the way of the Satanic Panic—which is to say, the same way as car door ashtrays, waterbeds, and the Atari 2600. The medical landscape of today is far more sophisticated, both technologically and financially, than that of the 1980s. And the malevolence alleged in contemporary legends has grown more sophisticated as well. In the present, a different strain of biopolitics runs through medical folklore, on the loose ever since Jenny McCarthy released it from Pandora’s Box live on Oprah in 2007: the accusation that routine childhood vaccinations, such as MMR (measles, mumps, rubella), are responsible for autism. Organ theft stories imply that a system meant to care for you might turn on you if the price is right; anti-vax stories allege that mainstream medical institutions are not really about care at all.

McCarthy was referring to the claim of anti-vaccine activist Andrew Wakefield, a British physician who lost his medical license after publishing a fraudulent paper claiming a link between the MMR vaccine, autism, and childhood colitis in a 1998 edition of the prominent medical journal The Lancet.2 The fact that the paper has been discredited has, perversely, seemingly only encouraged anti-vaxxers looking for evidence that Big Pharma has something to hide—and the money to do so. A hysteria once limited to MMR has since grown to encompass a wide range of routine vaccines— from hepatitis B to HPV to the standard vitamin K shot meant to prevent lethal bleeding in newborns—and most recently absorbed COVID-19 vaccines into the fold of fear. Those resisting “the jab” claim that it is responsible for infertility, impotence, AIDS, genetic mutations, cancer, and the COVID-19 pandemic itself. Others allege that the vaccines contain fetal tissue, microchips, and/or microscopic tracking devices. An estimated 1 in 6 American adults continue to hold out against the COVID vaccine, despite the fact that the unvaccinated have been killed by the disease at a rate up to 17 times that of the unvaccinated. Of the unvaccinated, 42 percent say they just don’t trust the vaccine. 

Where there are vaccine-skeptical adults, there must be unvaccinated children. Low rates of juvenile COVID-19 vaccination have been accompanied by a simultaneous decline in childhood vaccination rates overall. This is a problem with diseases like measles, which is so contagious that it requires around 95 percent herd immunity to avoid vicious outbreaks—such as that which ripped through Orthodox Jewish communities across the Tri-State area in 2019, the worst case since 1992, and a current outbreak of 85 cases in Ohio.

Until his death in 1995, Jonas Salk, the inventor of the polio vaccine, was regularly swarmed by grateful crowds, but in the contemporary medical landscape, people seem less likely to bring down the house for vaccines than to burn down the clinic. More than two-thirds of emergency room doctors reported being assaulted at work in 2022 alone—and two-thirds attributed that violence to the COVID-19 pandemic—while a 2022 New York Times article featured pediatricians nationwide who report being accused by their vaccine-resistant patients of shilling for Big Pharma or worse. At the center of the issue are parents who, despite actively putting the lives of their children at risk, seem to think they are saving them from something worse.

Medical misinformation and the reinvigorated anti-vax movement have triggered a multi-year whodunnit in liberal media. And while there is certainly some truth to the accusations levied at individuals like Tucker Carlson—whose Tucker Carlson Tonight, the highest-rated cable show during much of the pandemic, peddled an astounding amount of medical misinformation, including a baseless comparison between vaccine mandates and “what the imperial Japanese army and the Nazis did in their medical experiments”—the blame game conveniently obscures what ought to be a key question: Why were so many Americans so easily persuaded that their doctors were in on a plot to kill them? Many stories in circulation go far beyond mere medical misinformation: they are allegations of outright medical malice.

Well, Richard Hofstadter didn’t make a career out of the paranoid style in American politics for nothing. To some degree, American scientific and medical history warrant paranoia: concerns around healthcare and vaccines, particularly in Black communities, rightly evoke a long history of scientific misguidance, malpractice, abuse, and coverups, from the brutal origins of modern gynecology to the infamous Tuskegee Syphilis Study.3 However, folkloric allegations go far beyond even these documented ills—something the folklorist Elissa Henken identifies as a pattern of “escalating danger” in contemporary legends, not only in response to modern technology, but also “changed demands of narrative, comparable to the bigger, better thrills of sex and violence required in movies and television.” Could it be that for the first time in human history, mainstream media is more transgressive than its folkloric counterpart, leaving contemporary legends to up the ante? Henken seems to think so: “In order to catch the attention of a quickly bored and blasé audience, the narrative must be heightened. Moreover, the increased penalty acts as a booster shot, re-shocking people into paying attention to the legend’s implicit warning.”

But as much as the media has transformed in the past 50 years, the material circumstances of our world have, too, and hospitals have been one of the notable beneficiaries of ongoing financialization. That makes them particularly ripe for antagonism in folklore. According to the Marxist sociologist (and sometimes-folklorist) Gary Alan Fine, using the fast-food chain Kentucky Fried Chicken—notorious for the “Kentucky fried rat” that everyone’s friend’s cousin’s girlfriend has supposedly been served—as an example, folklore about businesses tends to grow only darker and more pervasive as those businesses expand. And healthcare in America has grown to be one of the country’s biggest businesses, employing more than 20 million people, representing nearly 20 percent of the GDP, and raking in billions annually. 

The problem is not—or at least not entirely—that there is money to be made in misinformation. The problem is that misinformation evidences something that many Americans correctly perceive in the healthcare industry: that it, too, is about making money. 

Private Equity Does Its Thing—Surprise!

In a decade overwrought with tales of HIV-infected needles in movie theater seats, Satanists at prom, and pedophiles at daycare, the actual evil was, as is so often the case, already inside the house—or, rather, hospital. The process that would make healthcare into one of the biggest industries in the United States, with earnings totaling $558 billion in 2021, was already underway in the years when organ theft tales raised hackles worldwide. It heralded an ideological shift in the very notion of what healthcare is: while the first half of the 20th century was dominated by a perception of healthcare as a community issue—and many medical services were provided by religious and charitable institutions—the 1960s introduced the notion of healthcare as a commodity. The financialization of American healthcare was characterized by two simultaneous trends in care, write Eileen Appelbaum and Rosemary Batt in a working paper for the Center for Economic Policy and Research: on the one hand, the gradual adoption in healthcare settings of financial strategies meant to maximize revenues, and on the other hand, the growing presence and power of bona fide financial actors in the healthcare sector. 

Financialization was set in motion, somewhat ironically, by the establishment of Medicare and Medicaid, which were accompanied by generous government subsidies, in 1965. But the government was especially kind to for-profit hospitals with their reimbursements—and what was 9 percent of hospitals in the early 1980s would become 24 percent by 2019, including more than 50 percent of hospitals in Nevada and Texas. The effects of financialization played out not just in broad strokes, but on the level of the individual hospital, shaping the care received by individual patients. The “prospective payment” system, introduced in 1983, incentivized hospitals to cut costs and pocket the difference by reducing the length of patient stays, outsourcing long-term care to other facilities, and reducing nurse-to-patient ratios. Meanwhile, the administrative demands of Medicare resulted in an influx of officials with business degrees into hospitals, where they eventually ascended into leadership roles previously held by physicians. Such administrators “have financial expertise, not healthcare expertise,” write Appelbaum and Batt. “They are not bound by the Hippocratic Oath that doctors take.”

As the well of Medicare money dried up in the 1990s, both for-profit and nonprofit hospitals turned, with the full blessing of the IRS, toward venture capital. Private equity firms swooped in to buy up ever greater numbers of hospitals and nursing homes, reaching peak feeding frenzy in 2010 as they anticipated high revenues under the Affordable Care Act. But when the revenues didn’t materialize, the firms began to sell their hospitals, and buy discrete specialty clinics instead, which splintered local healthcare networks along the way.

Conspiracy theories about vaccines and other medical procedures are perhaps the inevitable output of a for-profit healthcare system where people perceive themselves not as patients, but as cash cows. High (and ever-higher) medical costs drive questions about the intentions of healthcare providers, which then spiral outward into full-blown conspiracy theories, a process that Marxist theorist Fredric Jameson describes as logical “slippage” born of the difficulty of articulating the inner workings of the complex systems that characterize late capitalism. And the intricacies of the for-profit healthcare system provide a site ripe for that slippage, in part because the profits of that system are partly contingent on people not understanding its intricacies, so that they can be charged the highest rates for the largest possible number of procedures. (Appelbaum and Batt note that for-profit hospitals have been forced to pay out millions in settlements for unnecessary procedures.)

Digital Debtlore

Perhaps you’ve heard this one:

A man with a pair of crooked glasses wants to get them adjusted so they sit correctly on his nose. However, to be seen by the local ophthalmology clinic, he must “first be referred there by the general clinic, and for that to happen, he must “first undergo a complete physical examination. Unfortunately, during the rectal portion of the examination, the examining intern comes across a strange mass and subsequently refers the man to the general surgery clinic for a proctoscopy, during which a benign polyp is removed. The removal is successful, but a protoscope-wielding gastroenterology intern accidentally punctures the man’s colon in the process, and the man ultimately “finds himself in intensive care for several weeks with a nasty case of peritonitis. What was supposed to be a totally routine examination ends with a long hospital stay and a hefty bill—and I hear the man never did manage to get his crooked glasses fixed.

This story was collected by the folklorist Jan Harold Brunvand from an Arizonan doctor in 1986, one of a canon of stories featuring the rapid accrual of hospital bills while a patient tries desperately to extricate himself from the web of hospital bureaucracy. That something as banal as medical debt—far less exciting than black markets and biopolitics—should have made its way into folklore ought to come as no surprise: folklore is, a1er all, inextricably derivative of the world from which it derives—and the average American is carting around about $90,460 worth of debt, an average of $2,424 medical. That debt explicitly figures into the thought process of many Americans evaluating their medical care options—often as the deciding factor. A 2022 study found that about 2 in 5 Americans had passed on medical care in the last year because of the cost, and that 1 in 4 had skipped a dose of medication, resorted to cutting pills in half, or else passed on refills altogether—an experience shared disproportionately by women, Black and Hispanic adults, low-income people, and the uninsured.  

But the insured struggle, too. In 2020, the average monthly cost of health insurance was $456 for individuals and $1,152 for families—and even with insurance, an accident can still come with a price tag in the thousands, because the average annual deductible in 2020 was $4,364 for individuals and $8,439 for families. In 2022, nearly half of insured Americans were worried about their ability to afford that yearly deductible. Hence, it should come as no surprise that Americans commonly skip out on ambulance rides and specialized treatments to cut costs.

Even with the scrimping and saving, an estimated 41 percent of American adults have medical and dental debt, whether owed to the provider, a collections agency, a bank, a line of credit, a family member, or a friend—and 25 percent of American adults say that they are overdue on payments or just can’t pay. Those with large debt burdens report elevated levels of stress—and with elevated levels of stress come physical issues like ulcers, insomnia, back pain, migraines, digestive tract problems, and heightened diastolic blood pressure. These conditions, in turn, require ever more medical intervention, with mounting costs, theoretically until death, at which point your estate takes over. It is understandably hard to trust that such a system has your best interests at heart. 

Of course, there is a vast world of cheaper alternatives, though, ironically, their greatest acolytes tend to be Gwyneth Paltrow-types (read: wealthy) among us: herbal tinctures, raw milk, bone broth, essential oils, and a wide array of supposedly “traditional” practices like coffee enemas, colloidal silver supplements, activated charcoal cleanses, and vaginal steaming—all for far less per session than a visit with a medical specialist would cost you. A quick Google search for “chiropractors near me” turned up appointments for as little as $30. A kit for at-home colonic irrigation costs a mere $19.99 on Amazon. And trusting that the body will simply heal itself is free. 

But there are real physical dangers to these choices. Much of alternative medicine is poorly regulated. In some states, the extent of regulation is basically that practitioners must inform their clients that they are not licensed physicians before setting about their work, whatever that may be. And alternative practitioners are certainly no less interested in profits than their mainstream counterparts. But the real danger lies not in this positive freedom—that is, freedom of choice—but in the associated negative freedom: the right to refuse care (although for many, the refusal of care is not a political statement but purely an economic decision). On Reddit, posters in r/ShitMomGroupsSay traffic in some of the saddest circulating examples of parents cutting costs: seeking essential oils that can quell a psychotic break, or tips for the unassisted home birth of a breech baby (a complication of delivery in which the baby is not coming out headfirst as expected).

“I really need advice,” writes one mother in a screenshot from a Facebook group for mothers. “My almost 10-month-old is sitting on her own but not using protective reactions to catch herself if she starts to fall over. … We’re not [vaccinating] and also couldn’t afford to keep paying insurance that was never being used so I just figured we’d be fine without. … I’m scared to take her [to the pediatrician] since we haven’t been and I’d be paying out of pocket.” 

When the issue of cost isn’t mentioned explicitly, it is often implied indirectly, through critiques of medical practice that resemble the story of the man with the crooked glasses—a figure who is harmed by the experience of routine examination, his health actually made worse by the hospital, and his original complaint left all-the-while unaddressed. “I’d love feedback from anyone with experience of a newborn with rapid breath rate that lasted over one week,” writes one recent homebirther. “We don’t see a pediatrician, and [baby girl] seems to be normal and healthy. I fear that if I bring her in, they’d send me to emergency and admit [her] to the hospital for days for a million unnecessary tests and medications.”

Follow-up posts to Reddit indicate that some mothers in these Facebook groups lose their children: child protection services come, or the babies die.

Holistic Healthcare as Protest

Whether overt or unacknowledged, the financialization of healthcare is a force that drives countless people into risky treatments such as these. From a thousand feet up, the dynamic seems lifted straight from Foucault’s writings on biopolitics: the state’s refusal to guarantee healthcare functionally disallows life for the poorest among us, forcing dependency on contrived medical traditions to cure diseases for which medication is abundantly available, if unaffordable.4

So, what of those who can afford mainstream medical care but eschew it nonetheless? When mom group posters don’t confess to or imply a lack of insurance or an inability to take on debt, they often reference other dehumanizing aspects of the examination and treatment experience that are exacerbated by the financialization of the healthcare system. The for-profit nature of healthcare has seemingly impeded the affective quality of care, as hospitals continue to downsize and cut corners to maximize profits, and doctors rush to attend to huge amounts of patients. Our very language reflects our growing alienation: commercial terms like “provider” have arisen to rival the traditional notion of the “physician,” while “patient” has been displaced by “consumer.”

The notion of holistic medicine emerged in the 1980s, right around the same time that the financialization of healthcare was beginning to really heat up. For James Gordon, a major proponent of holistic approaches, the crux is the restoration of relationships between patients and physicians, and the reconstitution of patients as “active partners in health care rather than passive recipients.” Crucially, holistic practitioners take their time with patients. Gordon explains that holistic healers “want to know how the people who come to them live and feel, what they eat and smoke and how much they exercise, what kind of stress they have at work and at home, whether they are satisfied with their achievements and their relationships to other people.”

Of course, not all proponents of holistic approaches are Harvard Medical School-educated doctors like Gordon and his co-editors— just as many are, surely, quacks, and certainly all of them, as in mainstream medicine, are interested in money.5 The political economist Robert Crawford, an early chronicler of holism, describes the individualized care touted by holistic medicine as itself an extension of the widespread “privatization of the struggle for generalized well-being” which runs as contrary to the ideals of community health as corporate healthcare.

What emerges is a peculiar tension: the holistic is at once an alternative to mainstream medicine and a product of the same ideology that has produced contemporary mainstream medicine—namely, a sense of health as a commodity for which an individual consumer must pay. At the same time, many of these consumers are clearly seeking in alternative therapies something that they are not getting from massive health conglomerates: namely, the “patient” experience, care administered humanely, with an effort made to reduce the traumatic experiences that so often go hand in hand with routine medical procedures.6 

These tensions are borne out in digital discourse, perhaps most succinctly in this post to Facebook by a woman seeking pediatric care recommendations. “Looking for a pediatrician … [who] happens to actually listen to the parents when they say something [is] up and not just brush them off,” she writes. “After all, we are the professionals when it comes to our kids. And my ‘mom gut’ saved my son’s life as an infant so I’m gonna go ahead and keep listening to it.” In her description of herself, she is an apex consumer, seeking out a particular type of service; at the same time, she is a mother wanting to be treated as a highly invested agent equal to the doctor charged with her son’s care. Hers is an extremely individualized pursuit of care—she proclaims herself the “professional” where her son is concerned, making no mention of the village once thought necessary to raise a child—and yet she is also made vulnerable by that individuality: her concerns go disregarded by her pediatrician, the only other person responsible for her son’s well-being.

Misinformation is Material

For three illustrious weeks in the spring of 2022, the so-called Disinformation Governance Board, helmed by Biden-appointee Nina Jankowicz, embarked on the project of advising the Department of Homeland Security about misinformation. However, the bungled rollout of the advisory board made it an easy target for misinformation in its own right—much of which rather viciously targeted Jankowicz—and the DHS was ultimately forced to close shop in August after a prolonged “pause” pending review. While the Board was to be mostly preoccupied with things like providing “best practice” guidance, the Right quickly proclaimed it an “Orwellian” agent of censorship and surveillance wielded against free-thinking American citizens. The real problem, however, was its sheer technocratic mundanity: its positioning of the government as the end-all-be-all “arbiter of truth”—what Intelligencer’s Benjamin Hart aptly called “doomed from the get-go”—and even the bald premise that truth can be quantified and enforced in some way.

Truth is not the issue; trust is. Too much liberal handwringing has been expended on the thought that people have renounced truth, and far too little discourse devoted to the lived experiences that shape how people evaluate what is true and not true, real and not real. A series of Deloitte focus groups—forgive me—found that in communities of color, 36 percent of respondents reported skipping or avoiding care because they did not like how they were treated by their healthcare providers. NORC at the University of Chicago found that about the same percentage of doctors don’t trust the people in charge of their healthcare organizations, people who, as discussed earlier, tend to have financial, not clinical, backgrounds. And among people who express a lack of trust in their doctors, nearly 75 percent of them express grievances that are clearly bound up with the time burdens financialization has created among doctors: too little time with care providers, a sense that doctors don’t know them as people, a sense that physicians are too financially motivated, and so on.

Liberal “solutions” targeting medical misinformation—like our ill-fated friend the Disinformation Governance Board—are bound to fail because eradicating misinformation does little to mitigate the social factors that make it so appealing in the first place. A true solution for misinformation must strike at the material source driving conspiracy theories. In many medical conspiracy theories, the original sin is the corporatization of American healthcare into a system wherein some level of dehumanization and a subsequent massive debt burden are par for the course. 

While liberals fondly imagine a future wherein humans evolve past their emotions into beings willing to accept the status quo because of its monopoly on truth, a select segment of the alt right dreams of an arguably even worse future, wherein the practice of medicine evolves past the need for people. An offshoot of the QAnon crew is devoted to the promise of sci-fi-inspired “Med Beds” that can supposedly cure terminal diseases and will render the price-gouging pharmaceuticals industry obsolete.7 In this fantasy, “care” as a billable item is eradicated altogether—as though individual physicians were the least trustworthy part of modern medicine. Ironically, doctors are one of the few actors in the healthcare industry that people say they trust.

If MedBed technology ever did arrive, it would undoubtedly be received with the same skepticism that the COVID vaccine has encountered. Whether “we” are true-blue QAnon loyalists or true-blue ActBlue Democrats, we might hope that further technological progress will fix the problems of our troubled present, but progress is so often a pharmakon: at once the problem, cure, and scapegoat. Med Beds will not restore trust in science, just as Twitter censorship ex post facto won’t restore trust in the COVID-19 vaccine.

But what might restore trust—and perhaps even a shared sense of truth—is a return to something like the healthcare ideology of yore: the notion of health as communal, an effort we are all in together—and the creation of a system that, in tangible ways, actually reflects that ideology. It was not enough during the pandemic to speak of communal responsibility in a country that regularly fails, in so many ways, so many of its citizens. It was not enough to speak of “herd immunity” in the thick of a healthcare ideology that asks—with only rare exceptions—each person to foot the bill for their own well-being. Care must be either communal or consumer; it cannot be both. And the one inevitably comes at the expense of the other.

As early as 1980, Crawford knew this, and though he was pointing a finger at the burgeoning self-care and holistic sectors, mainstream medicine is guilty of the same sin: treating health and healthcare as a consumer good, which creates “a non-political, and therefore, ultimately ineffective conception and strategy of health promotion.” Healthcare-as-commodity has proven ineffective at keeping people healthy. The U.S. spends more on healthcare per capita than any other major industrialized nation, but only about 12 percent of Americans are metabolically healthy. A broken system cannot cure its sick citizenry; and medical misinformation is a symptom, not the source, of the problem.

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  1. By medical folklore, I don’t mean a particular genre of folklore, but rather the broad canon of folkloric material wherein medicine is a motif. This includes a medley of jokes, mis- and disinformation, old wives’ tales, conspiracy theories, rumors, personal experience narratives, and urban legends—all of which compound, build upon, and reinforce one another in the production of a culture of medical skepticism. 

  2. A subsequent investigation by journalist Brian Deer revealed that Wakefield had bogus data, no ethical approval, and a $43 million conflict of interest, leading The Lancet to retract the study in 2010. But it was twelve years too late, and Wakefield’s claims had by then taken on a life of their own, seemingly unhindered by the many early-aughts studies that failed to find any causal link between the MMR vaccine and autism. 

  3. Black people continue to face discrimination in the mainstream medical system, from doctors refusing to prescribe appropriate painkillers to doctors failing to identify life-threatening conditions. Given all the good reasons for distrust, it should come as no surprise COVID-19 vaccination rates in the Black community have lagged behind other demographic groups. 

  4. The plight of diabetic Americans is a classic example: at least 1 million Americans every year are forced to ration lifesaving insulin, and an estimated one-third of diabetics rely on herbs, dietary supplements, and mind-body therapies in addition to, or in lieu of, mainstream treatment. Such a figure is roughly in keeping with the 20 percent of American adults who, in 2017, reported replacing some mainstream medical treatment with an alternative therapy (though surely not all of them are turning to alternative medicine because of financial concerns). 

  5. At least 26 deaths have been connected to chiropractic adjustments, mainly due to torn arteries—acquired during aggressive neck adjustments—causing strokes. (One study found that as many as 707 strokes were related to chiropractic care between 2001 and 2011.)  

  6. Even a routine examination may be, in an immediate, visceral sense, unpleasant and upsetting, leading some individuals, ultimately, to the medical fetish community, where the performance of helplessness and submission allows individuals to reclaim agency from real medical institutions. As described by folklorist London Brickley, individuals engaged in medical fetishism “invoke the inequality of power and agency for patients’ bodies, which are only able to reclaim power in a medical scenario when it is transformed through medical play.” This play constitutes just one mode of experiential interpretation. Individuals may seek to make sense of the perplexing experience of the examination—seemingly banal, yet potentially deeply unnerving—in any number of ways. 

  7. The rise of the QAnon conspiracy was, interestingly, accompanied by a resurgent surety that the National Economic Security and Recovery Act, better known as NESARA—a failed ’90s-era Congressional proposal to, among other things, replace the income tax with a national sales tax and to reinstate bimetallic currency—has either been passed in secret or is soon to pass. Interestingly, in the conspiracy version of NESARA, all personal debts—including medical—are to be canceled as well. 

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