THE BLURT BULLY PULPIT: Rupa & The April Fishes
Nov 10, 2009
In which a physician/musician contemplates health care.
BY RUPA
Our album Este Mundo is poised for release at a very interesting moment--there are surges of change rumbling under the weight of archaic fearful stifling structures. As a doctor and a musician, I have the great fortune of watching up close how people are reacting to change in two big money-making industries in the US. Fear of change and arguing with reality seem to be big themes as both the music industry and health care industry are wrestling with how to adapt to the realities each face. You can witness the resistance to change in town hall debates around the US where the new health care plan has been debated. There is overwhelming fear of change, of ensuring access to health care for people in the US.
We are the only developed nation with no assured access of health care for its population. And we spend more dollars per capita on our health, in alternative medicine and conventional medicine. We are hemorrhaging dollars at our emergency rooms across the country as people come in extremis far advanced in their diseases, instead of earlier when the disease could be more manageable as an outpatient. To me, this issue is not political. It is not about socialism or capitalism. It is about human rights and making the choice about the kind of society we want to live in.
Currently, we pay more money as taxpayers for more expensive care when people arrive advanced in disease processes to the ER, requiring ICU care, surgery or extreme measures to keep them alive. They arrive to us at death's door. I have seen many people who do not have insurance come in at the last moment, almost needing amputation, with diseases far gone. If there was a clinic they could have walked into, it would have prevented the extreme and expensive care we must give them when they come in at the last most critical moment. As physicians, we are obligated to treat anyone in the ER and everyone comes in. Everyone. We are paying for their care with our tax dollars and soaring insurance premiums. Why not do it in a more responsible, forward-thinking way? Instead of covering our costs from huge skyrocketing ER expenses, why not spread the funds around ensuring people could get care earlier so their diseases don't advance to the point of tragedy as often? We pay for it anyway. That's the reality. The question is HOW we want to pay for it. With foresight or chasing figures? And I believe it would be less expensive and more humane to give people easy access to health care early on.
And then our leadership fails us. Obama shocked me when he said that his health plan would cover everyone, but not undocumented people. Again, everyone comes to the ER. I have seen that the greatest democracy is the human body, our fragile and resilient existence. Regardless of nationality, gender, sexuality, religion, social status--all these ideas that supposedly divide us--as a physician, you see on a daily basis that everyone lives, breathes, gets sick and dies. Something that has greatly shaped my music and the content of our upcoming album has been meeting people with advanced diseases who come to the hospital late because of fear of deportation. To me, it is unacceptable that anyone feels so alienated from their own bodies that they avoid getting help when they know they desperately need it, especially in a country with such vast resources--enough resources to carry on endless wars in foreign lands. We don't live in a country where resources are not available--we just chose to allocate them in terrible ways. And most of the undocumented people who I have met came here to work, and they do hard work, work that most US citizens don't like to do. They pick the vegetables that end up on our plates. They clean the kitchens and bus our tables. They rebuild hurricane-devastated American cities. To see this laboring group of people then neglected by a health plan to me seems criminal and an obvious denial of reality.
And there is an overwhelming epidemic of ignoring reality--by our media, by our leadership. We have an estimated 12 million undocumented people living in the US. Most of them have come for work and if you open your eyes and look behind the scenes you'll find that the base of the US economy is upheld by the sweat of people who come here clandestinely to work hard and earn a better life for themselves and their families. This is a labor force with no protected rights--not even the right to be healthy. We have not strayed too far from our roots of slavery, only now it's more insidious because it is unnamed, unidentified and undocumented. If we are going to profit off the labor of a group of people, it would be nice if we could ensure their safety, dignity and health. This would require a radical change--actually contending with reality. Not the idea of the United States of America but the reality. This would require radical change.
But we are living in a world where change is met with fear. Look at the record industry responding to the reality it faces--data that is freely exchangeable. One day, records will not sell. We need to imagine how to make a living as artists and artist representatives. We must imagine how to make a living off our value, our living breathing value. It is interesting to release a record and hope for the ability to take care of the musicians and industry folks who weave their careful lives with my dreams. How do we adapt in response to change around us, taking in reality and imagining a more forward thinking future? How can artists grow to take up the slack? How can the industry adapt? Innovations offer opportunities and I prefer to approach them with optimism and imagination, instead of reactive fear.
This feels like a time of real possibility for deep change. And it takes simultaneous careful observation as if through a microscope with a wide vantage point as if through a telescope to move forward with clear direction. I am hopeful and see this record as a document of where we are these days, in this particular moment, surrounded by a mass global forced migration of people in search of work, at this moment when the US is rethinking its ethical core and digging up some ugly truths about our past and present, in a time where old structures are failing and giving room for something new to emerge. It is a good time to be traveling with music, meeting people around the world--thinkers, musicians, cooks, doctors, taxi drivers, hotel managers, mothers, sound engineers, day laborers, accountants, children--taking in the stories, the perspectives and trying to let the truths have their deepest resonance. It's a fascinating time to be alive in this world.
San Francisco's Rupa & the April Fishes can be found at their MySpace page: www.myspace.com/aprilfishes. Their newest album, Este Mundo, is out now on the Cumbancha label, www.cumbancha.com.
[Photo Credit: Judith Burrows]
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