Considering the Roman philosopher Cicero’s contention that a man never really puts his mind to a subject until he writes on it, I haven’t really thought much about health care since the Clinton years.

From 1992 to 1996, I wrote about it at The Herald-Times, capping my career there with a 13-part series in 1996 called Healthcare at the Crossroads, which explored the “driving forces behind health-care reforms” in Bloomington and the nation.

Until lately, about the only thought I’ve given the subject, aside from its role in society and politics, is when I enter the amount my health insurance company deducts each month into my checkbook. I’ve gone years between doctor visits and have not submitted a claim in the eight years I've been buying my own insurance.

Well, a never-ending yen for new professional challenges, combined with an up-close-and-personal encounter with mortality (nothing serious, just expensive), have convinced me it’s time to revisit the subject of health care.

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On the Trail: Autism and the Environment
A journalistic journey into autism and industrial chemicals

The economy notwithstanding, health care is the most direct threat to most Americans’ peace and security, be they on Medicare, privately insured or uninsured.


The primary catalyst behind my renewed focus on health care was personal -- a diagnosis of a torn meniscus in my right knee. Decades of talk about health care instantly became more than pundit chatter, especially when my primary care doctor uttered the phrase “knee replacement.”

"The economy notwithstanding, health care is the most direct threat to most Americans’ peace and security, be they on Medicare, privately insured or uninsured."

Since then, I have been to Indianapolis twice for two office visits with a knee specialist, one MRI and one physical therapy session, all in anticipation of “minor” surgery. It will be arthroscopic, with only two punctures and a small amount of snipping required. The risk is minimal. I should be at 100 percent in no time.

The subject of money hasn’t come up at all, aside from the do-you-have-insurance?” query on initial contact.

All of this thought about health care took me back to 1996 and the Healthcare at the Crossroads series, which mostly focused on a debate over transforming Bloomington Hospital into a for-profit institution.

"In the for-profit environment, all in-built tendencies and pressures are to limit unprofitable treatments, to create a profit and to increase return on investment," Dr. Caitlin Kelly, then Bloomington Hospital chief of staff, told me at the time. "You hope that altruism will keep people from yielding to economic pressures. But that is hopelessly impractical."

The Bloomington community prevailed in the mid-1990s, and the hospital remained nonprofit. But from what little thought I’ve given the subject these past 12 years, the economic pressures have been unrelenting.

Just this fall, I received a letter from my insurance company congratulating me for the healthy-human discount I qualified for. My monthly premium went up $75 to $345. In November 2006, it was $213.

That's a 62 percent increase in two years.


I touched on the second catalyst two weeks ago -- John McCain’s campaign pledge to find the cause of autism.

The Centers for Disease Control says “people with Autism Spectrum Disorders (ASDs) have significant impairments in social skills and communication. They often have repetitive behaviors and unusual interests. ... Symptoms of ASDs vary from person to person and range from mild to severe.”

Two studies reported in 2007 by the Centers for Disease Control put the incidence ASDs among 8-year-olds at 1 in 150. As the Indiana Resource Center for Autism notes, the incidence was estimated at 2 to 5 in 10,000 in the late 1980s.

"Two studies reported in 2007 by the Centers for Disease Control put the incidence ASDs among 8-year-olds at 1 in 150."

While disagreement exists about the accuracy of the 1980s estimates, the data triggered my long-standing interest in the impacts of toxic chemicals on human health and development. It’s been a specialty since the mid-1980s, and I’ve talked to and read some of the best minds on the subject.

My assessment is that, when it comes to toxics, American science still subscribes to the historical notion that “dilution is the solution to pollution,” the philosophy that led the United States to dump nuclear waste in the ocean in the mid-20th century, for example.

American scientists know that mercury, lead and at least 200 other industrial pollutants, including Bloomington’s contribution to planetary toxification, PCBs, can cause neurological damage of the sort that could cause developmental disorders like autism, attention-deficit hyperactivity disorder and others.

They just say that, as long as these chemicals are present in small enough quantities, they aren’t a problem. If mercury, like that emitted from Indiana coal-fired power plants, is diluted enough in the environment and the body, then it’s okay.

Well, as much as I respect my scientist friends, I have always thought they were wrong. And so do many of their peers.

As the Mount Sinai School of Medicine’s Dr. Philip Landrigan has said in numerous places and ways, the release of 10s of thousands of industrial chemicals into the environment since the end of World War II is a “massive, toxicological experiment,” with our children and our children’s children as the experimental subjects.

I have children and grandchildren. And I now have a personal stake in the health care debate. It’s more than enough to make me really put my mind to subject.

Steven Higgs can be reached at .