Health vs. Health Insurance: How Mental Silos Blind Us to What Matters Most in Healthcare.

The Drudge Report today linked to an AP story on the spread of cutaneous leishmaniasis, the incidence of which has quadrupled in the past few years.   The parasitic skin disease comes from the female phlebotomine sand fly. There is treatment, but treatment is expensive, and of course, in Afghanistan it can be dangerous to be a caregiver.

It's tragic that this disease is afflicting Afghans, and it will be even more tragic if the disease spreads.  Once again, a reminder: The public health victories of one era can be lost in a subsequent era.

And so once again, we are reminded, health itself is more important than healthcare finance.  As it happens, I am reading Rebecca Costa's new book, The Watchman's Rattle: Thinking Our Way Out of Extinction, in which the author talks about the problem of "silos"--mental walls that keep us from thinking outside of our lane.  More often than not, these silos are self-imposed, and yet even though they are "voluntary," they can be paralyzing, intellectually.

And that's what has happened to the US in the healthcare debate.  We have "healthcare finance" in one silo, and that's been the hot silo for decades.  And in the other silo, we have Serious Medicine, which has been much neglected over the same period.   There is little interchange between the two.

Yet a look at this boy's face should tell us which is is the ultimately more important silo.