Introduction: Yes, your health matters--now please get in line

It's easy: if you don't have money and you need health care services, you wait.  You just wait.  Yout sit in waiting rooms, you stand in lines, you fill out forms.  Then you fill out some more forms.  And you wait.  It's all about lines, and waiting, and patience, and hoping that your number or name gets called next.  Or soon.  Or at least sometime today.

Lines.  Health care is all about standing in lines.

I have heard some people joke about health care in Mexico: Sure, they say, everyone can get health care in Mexico--as long as they don't die in line waiting to actually see a doctor.  This problem is by no means isolated to Mexico.  Far from it.  One of my first experiences with this sort of thing was back when I was 17.  I ended up with a sinus infection that managed to gravitate to my eye, resulting in something called orbital cellulitis.  It was seriously painful, and I went to the ER.  But I ended up sitting in the waiting room as the clock ticked away because the hospital could not verify my insurance.  I had insurance, but they just had to make sure before they could actually start doing the health care thing.  There was a room available, yes, and everyone knew that the situation was not good.  But what mattered most was making sure the dollars and cents were taken care of first and foremost.  So I waited.  I will never forget what one of the doctors said about my waiting room experience when the surgery was over: "Ya, that could have killed you."

My experience with health care comes from life in the United States, and fieldwork/travel to various parts of Mexico (Baja California Sur, Oaxaca, Quintana Roo).  One way or another, when you travel or end up doing fieldwork somewhere you end up having to seek medical attention.  And this provides an opportunity to learn how things work (or, sometimes, how they don't work).

I remember one time my wife and I tried to go to a public clinic in San Jose del Cabo.  It was about 95, maybe 100 degrees.  Hot.  The clinic was ridiculously packed...and there was really no place to wait.  A long line of people, no chairs to sit, and the hot sun pounding down on us all.  We stood around for a while, then finally decided we could do without seeing a doctor.  But we were lucky we weren't dealing with an emergency.  We could afford to walk away, unlike the people who were there for more serious issues.  We have experienced similar situations in other parts of Mexico--crowded waiting rooms, overworked medical staff, long days of waiting and waiting for many people.  In some cases, people aren't even sure if they will get to see a doctor that day (this is the case in a lot of rural clinics that do not have enough staff).  They just have to wait, and hope that they can eventually get some sort of attention.  I have seen the same issue in county clinics and public hospitals in the US as well.  Waiting.  Lines.  Forms.

But I need to make something clear: health care is about waiting, and standing in line, for some people.  Not for everyone.  Many people in the US, Mexico, and all around the world can get quick, good medical care.  As long as they satisfy certain requirements.  Like having the right medical insurance plan.  Or a credit card with a deep line of credit.  Or cash.  You see, it's often just a matter of money.  Just like I learned a long time ago in that hospital waiting room.  Sure, excellent health care is technically available--in the US and in Mexico--but it's a matter of getting access to that care.

So "Whose health matters?"  Well, one answer to that question is this: The people who have the dollars or pesos or Euros, that's who.  Because they're the ones who get in the door, while the rest seem to wait endlessly in the lobby of a county clinic, a rural hospital, or some ER in downtown Los Angeles.  For the people who don't have the right health insurance, or financial resources, there's the old saying: "All in good time."  Right?  Sure, as long as you have enough time to wait around until that person with the white coat and clipboard appears and finally calls your name.  In the meantime, just keep waiting.  We will be with you shortly...

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This issue is all about the politics of health care--the contradictions, promises, discrepancies and inequalities that run rampant in health caree systems in the US and abroad.  We have contributions from Tazin Karim, Jennifer Wies, Will Robertson, Anne Pfister, Lesly-Marie Buer, Gregory Williams, Monica Casper, Carla Pezzia, Emily Noonan, Sean Tango, Erik Hendrickson & Samuel Spevak, and Veronica Miranda.  Thanks everyone for sending in your essays and taking part in this project.  I hope you enjoy this issue, and more than that I hope it can help create a little conversation, or dialog--or at least make us think a little more about the politics, shortcomings, problems--and possibilities--of our health care systems.  As always, please feel free to post your comments, or email us at anthropologiesproject at gmail dot com.

Thanks,

RA


Update: Edited for clarity on 3/16/13