The Unseen Dead: Virginia Tech and Health Policy

My heart breaks for the 33 people who died Monday. It also breaks for the estimated 50 Americans who died on the same day as a result of inadequate health coverage. Most of them had families who loved them, too. Where is their candlelight vigil? Where are their Presidential eulogies, or their exhaustive television coverage?

Instead of receiving their moment of silence, these invisible dead face an eternity of silence.

Lack of health insurance results in the deaths of 18,000 Americans each year, according to studies compiled by the National Academies' Institute of Medicine. That equates to 49 or 50 deaths every day. As the Institute has documented, deaths result from late identification of curable cancer and other conditions, and from inadequate treatment for a range of illnesses that include renal disease and other chronic conditions.

Many of those who die as a result of inadequate health care are older, in contrast to the young lives so full of promise that were cut down this week. But not all. The United States has the worst infant mortality of any industrialized country in the world except Latvia. The shadow of death falls disproportionately on African-Americans, whose infant mortality rate is 2.5 times that of non-hispanic whites.

Lack of insurance coverage isn't the only factor causing these tragic numbers. Education and other social factors play a part, too. It's shocking that a government which so actively promotes what it calls the "right to life for the unborn" is so indifferent to the wave of death that is taking down the newly-born in some communities.

The infant mortality epidemic is almost Biblical in the scope of its horror, yet too many of those who profess to read the Bible are indifferent to it. I'm thinking of people like Jerry Falwell, who rushed to send an email to potential contributors that said: "We want to honor the victims in Monday's brutal slayings and to pray for the families of the young people who were killed. It is our responsibility as Christians to offer our heartfelt prayers and our support."

Falwell's email makes reference to I Peter 5:7, which says "cast all your care upon Him, for He cares for you." But this friend to Presidents and Senators makes no mention of the verses that precede it, which include these words: ""God opposes the proud, but gives grace to the humble." The proud and powerful figures he consorts with support policies that enrich the already-wealthy, while leaving the disadvantaged without the health care they desperately need.

Others, too, have rushed to fill the vacuum left by horror with their own self-serving actions. Katie Couric and CNN have lavished themselves with attention, using this tragedy as a backdrop for their posturing. The President who so carefully concealed soldiers' flag-draped coffins rushed to present himself to the public using Virginia Tech as a backdrop.

Where are the kleig lights for these other Americans - the ones struck down by economic forces? Where are the CNN specials? Why haven't we seen Brian Williams standing in front of a community hospital telling America about this ongoing tragedy?

Our nation's policy toward mental health deserves attention in light of the Virginia Tech horror, too. We live in the only industrialized nation in the world where mental health problems are treated as less "real" than so-called physical disorders, so insukrers commonly restrict or deny coverage for mental health treatment.

Insurers are able to take advantage of our society's Puritanical belief that mental illness is a 'failure of will,' or that it's 'all in your imagination.' That's a false duality. Some mental illnesses are clearly organic, like schizophrenia, while physical complaints such as non-specific back pain are often more psychological than physical. Mind and body form one whole, and it makes no sense clinically to behave as if they can be separated.

Our Manichean belief in this false separation has created a crisis in untreated mental illness, even among those who have health insurance. (Barbara Ehrenreich has more on mental health here.)

As every suicide teaches us, mental illness can be fatal. As Virginia Tech reminds us, it can even be fatal to those who don't suffer from it. We should be learning similar lessons from alcohol-related driving accidents, or the vast majority of workplace accidents that occur as a result of psychological factors.

That's why the media's lackluster coverage of health issues is so disappointing, especially in light of its ghoulish fascination with this week's tragedy. Political scientist Bernard Cohen observed over 40 years ago that, "The press may not be successful much of the time in telling people what to think, but it is stunningly successful in telling its readers what to think about."

It's a great point (although I'd argue they've also becoming increasingly skillful at telling people what to think, too.) Daniel Yankelovich expanded on Cohen's observation:

In an era of information overload, it is the media's judgment of just how important an issue is that makes the critical difference to how seriously average Americans will take it and what action they will be willing to support - especially if the action involves inconvenience, discomfort, or pain in the pocketbook.

Television this week has used the Virginia Tech tragedy to launch a round-the-clock drive for ratings, while unseen Americans suffer and die each day from inadequate health care.

Someone should light candles in their memory, too.