The scale and subtlety of our country's dependency on oil and natural gas cannot be overstated. Nowhere is this truer than in our medical system.

Petrochemicals are used to manufacture analgesics, antihistamines, antibiotics, antibacterials, rectal suppositories, cough syrups, lubricants, creams, ointments, salves, and many gels. Processed plastics made with oil are used in heart valves and other esoteric medical equipment.

Petrochemicals are used in radiological dyes and films, intravenous tubing, syringes, and oxygen masks. In all but rare instances, fossil fuels heat and cool buildings and supply electricity. Ambulances and helicopter "life flights" depend on petroleum, as do personnel who travel to and from medical workplaces in motor vehicles. Supplies and equipment are shipped -- often from overseas -- in petroleum-powered carriers. In addition there are the subtle consequences of fossil fuel reliance.

A recently retired doctor informs me, "In orthopedics we used to set fractures mostly by feel and knowing the mechanics of how the fractures were created. I doubt that many of the present orthopedists could do a good job if you took away their [energy-powered] fluoroscope or X-ray."  [DeA sez:  nonconvivial technologies create dependence on industry and on energy- and techno-elites by deskilling workers]

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The coming scarcity of fossil fuels, on top of inflationary costs in medicine (the prices of oil and natural gas are approximately four times what they were in 1999 and rising) and the expenses of treating Baby Boomers (a cohort twice the size of its predecessor), could overwhelm a medical system already in crisis.

We can avoid collapse, however, by reducing medicine's present consumption of energy and creating a health-care system that reflects our actual relationship to resources. Ironically, peak oil can be a catalyst for creating a health-care system that is cost-effective, ecologically sustainable, and congruent with a democratic social ethos.

At present we have a tiered health-care system. At the top is a Ferrari model of care that reflects our affluence, fascination with technology, and extravagance. Ferrari care has made possible the treatment of rare life-threatening diseases and expensive procedures like organ transplants, but it has also been used for esoteric and often redundant testing and vanity procedures such as botox injections. At the bottom is a jalopy model serving over 50 million un- and underinsured Americans who very often receive no treatment, defer treatment until their condition cannot be ignored, or face economic ruin when they seek adequate care.

If the two tiers persist after peak oil, they will eventually be preserved by force -- armed guards at gated medical facilities -- for the few able to pay, while the rest of Americans are relegated to the jalopy and faced with overt rationing, triage, and curtailment of medical care. Such an outcome would be an overt contravention of democratic values -- most Americans tell pollsters they believe that health care is a human right, not a privilege awarded those with higher income.

What then should we do? The best democratic option is to replace both the Ferrari and the jalopy with a Honda. [...]

The commonsensical Honda model will emphasize public health -- the prevention of disease and the promotion of health within the population as a whole -- over treatment medicine, which focuses on restoring health to chronically or acutely ill individuals.

Typically accomplished through the diffusion of information, low-cost therapies, and the promotion of healthful nutrition and lifestyle, preventive medicine allows people to avoid or postpone disease, and to stay clear of the costliest and most energy-intensive sectors of the medical system -- doctors' offices, pharmacies, and the hospital. In the Honda model, treatment medicine would continue, but its role would be brought into better balance with the vastly more cost-effective and energy-efficient mode of preventive health care.

note that the commonsense or preventive model of health care would reap far less profit for the med mafia and pharmistocracy than the current "perpetual motion" ponzi scheme of cherrypicking (care denial), iatrogenic pathologies, and price gouging.  DeAnander's Law predicts that it is always more profitable, in money terms and for the elite, to do things wrong.  but it would be far more energy efficient and far more profitable in terms of life-years saved and quality-of-life to do things right, that is, sensibly and more simply, with less centralisation and lighter tech.

The difference between theory and practise in practise ...