The post I submitted to ABC's Jake Tapper "Political Punch" has been pulled. I don't get it. My post was relevant to the topic (John McCain's health care plan), it met all the criteria for civility (far more polite than some of the blather that has been posted) and it was very much in line with other posts criticizing McCain's proposal. You can read it for yourself, below.
Can somebody explain to me why this happened?
Saturday, September 20, 2008
McCain's Flawed Health Care Plan
I just posted this on Jake Tapper's "Political Punch" blog on the ABC News website. The article is titled: "Krugman Finally Provides Some Oppo for Obama."
I just read McCain's article in Contingencies on his health care plan (thanks for the link, Jake). Although I agree in principle with some of his proposals, such as changing policies about pre-existing conditions and finding ways to provide access to health care insurance, his plan is deeply flawed.
First, his whole plan rests on reforming access in a patchwork of initiatives between health insurance providers and government programs. This is the wrong place to start. Moving chairs around the deck of the Titanic will not avert the disaster American health care is steaming toward. The foundational issue facing the United States is the health of the population. Setting national goals for improving and sustaining the health for Americans is where we have to start. For example, "Preventable diseases are prevented."
The second flaw in McCain's plan is the refundable tax credits. Although he says that these would apply to everyone, he still relies on the compliance of the health care insurers to cooperate fairly with the program. He fails to account for the fact, that despite their rhetoric of serving our health care needs, the first obligation of the insurers is still to their stockholders, and as the current financial crisis demonstrates, the unchecked acquisition of wealth by their executives.
This second flaw also seems to believe in a pie in the sky assumption that the American public will just automatically jump on board and use their credit to buy health insurance. With some 42 million uninsured currently in the nation, that seems a stretch of astronomical proportions.
The final objection I'll mention here is the issue of pre-existing conditions. You can't just ask the insurance companies to cut back on it. That's like asking a methamphetamine addict to just use it only once a week instead of every day. They'll promise, promise and promise to do it, but as soon as you leave the room... The practice of pre-existing conditions needs to be abolished by law, because the practice is a barrier to access to care, perhaps being a greater impact than out-of-reach pricing.
Check out my blog, www.rli-reallifeissues.blogspot.com for my much more detailed discussion of health care access for all Americans.
I just read McCain's article in Contingencies on his health care plan (thanks for the link, Jake). Although I agree in principle with some of his proposals, such as changing policies about pre-existing conditions and finding ways to provide access to health care insurance, his plan is deeply flawed.
First, his whole plan rests on reforming access in a patchwork of initiatives between health insurance providers and government programs. This is the wrong place to start. Moving chairs around the deck of the Titanic will not avert the disaster American health care is steaming toward. The foundational issue facing the United States is the health of the population. Setting national goals for improving and sustaining the health for Americans is where we have to start. For example, "Preventable diseases are prevented."
The second flaw in McCain's plan is the refundable tax credits. Although he says that these would apply to everyone, he still relies on the compliance of the health care insurers to cooperate fairly with the program. He fails to account for the fact, that despite their rhetoric of serving our health care needs, the first obligation of the insurers is still to their stockholders, and as the current financial crisis demonstrates, the unchecked acquisition of wealth by their executives.
This second flaw also seems to believe in a pie in the sky assumption that the American public will just automatically jump on board and use their credit to buy health insurance. With some 42 million uninsured currently in the nation, that seems a stretch of astronomical proportions.
The final objection I'll mention here is the issue of pre-existing conditions. You can't just ask the insurance companies to cut back on it. That's like asking a methamphetamine addict to just use it only once a week instead of every day. They'll promise, promise and promise to do it, but as soon as you leave the room... The practice of pre-existing conditions needs to be abolished by law, because the practice is a barrier to access to care, perhaps being a greater impact than out-of-reach pricing.
Check out my blog, www.rli-reallifeissues.blogspot.com for my much more detailed discussion of health care access for all Americans.
Friday, September 12, 2008
Health Care for All Americans, Part 3
In Parts 1 and 2, I discussed first, the assumptions needed from a medical perspective, particularly with respect to the scope of treatment plans that would lead to optimizing the health of Americans, and second, how those assumptions would create a radical transformation in the health of Americans that would work its way through all aspects of daily life. In Part 3, I now want to describe the logic that shows how the country would benefit.
We'll start using my first assumption: Preventable diseases are prevented.
We could use any number of examples, but the format of the blog does requires some brevity, rather than a detailed White Paper or journal article. I also acknowledge that the ideas I present here have all been suggested by others, but this is how I choose to organize them.
For purposes of our discussion let's call our example citizen, Larry. Larry works full time for minimum wage, does not have health insurance, and cannot afford to buy private insurance. He also does not qualify for any government health care benefits. Larry's wife also works for minimum wage, but only 24 hours per week.
As long as his health holds, Larry can work and he has no medical needs. He pays local, federal and state taxes and uses no special government services.
But let's say that Larry gets pneumonia. It is a very common viral strain, and can be treated successfully with antibiotics, and could have been avoided entirely if Larry had had a pneumonia vaccination. Now he's faced with a dilemma. At first he thinks he just has a chest cold and he can wait it out. Being a conscientious worker, he toughs it out and goes to work, but exposes his coworkers to the bug through his worsening cough.
By the weekend, Larry is really sick. Over the counter cough medicines provide almost no relief, and on top of that, his cough is becoming increasingly productive. He cannot sleep because of the cough and not being able to find a position in bed where he can breathe without effort and pain. Larry knows he needs to see a doctor, but having no insurance, he does not have a primary care physician, so he has no idea who to call. Finally his breathing becomes so difficult that his wife calls 911. Larry is taken to an emergency room by ambulance, but one on the far side of the city because the hospital closest does not like to take patients without insurance.
By the time Larry gets to an emergency room that will accept him as a patient he is nearly in respiratory arrest. The ER doctor quickly diagnoses the pneumonia, but that it is so advanced that Larry's life is in danger. She intubates him immediately and transfers him to the hospital's intensive care unit. It is four days before Larry's condition has improved enough to send him to a "step-down" unit and two more days before he can be admitted to a medical unit room, and he is discharged two days after that.
Larry is fortunate that the hospital he is at has Certified RN and MSW Care Managers. They work with him and his wife throughout the hospitalization, develop a treatment plan and a discharge plan, set Larry up with a local medical clinic that treats patients without insurance, and provide his wife with food vouchers and bus tokens so she can make the long trip back and forth to the hospital.
Despite all this, when Larry is wheeled out to the taxi to take him home, he has a hospital bill that is $250,000. Since Larry and his wife together make too much money to qualify for Medicare, that bill rests squarely on their shoulders. He has no way to pay it back. He will not be strong enough to work for at least another three weeks. He will have not earned a dollar since he got sick, and won't until he returns to work. His wife's income is not sufficient to cover all their bills, and if they pay the rent, they will not have enough money to buy food. The hospital sent home a week's supply of medications, but after that, he will have to pay for them himself, and due to the damage to his lungs, he will need regular medications for at least six months. Those prescriptions will cost over $800 per month. Through the free medical clinic he can apply for medication cost support , but that can take up to four weeks to be approved assuming he qualifies.
Now multiply this basic scenario by twenty or thirty million Larrys a year. Every year. That is health care in America.
Here's what happens. The only good news is that Larry has survived a brush with death, ironically from a completely preventable disease.
Larry and his wife now owe the hospital $250,000. They have no assets. Even though they signed a promissory note with the hospital, no one is under the illusion that he will be able to pay back more than a few thousand dollars if he is a very conscientious person.
Larry and his wife owe the ambulance service perhaps $3,000. They cannot pay it, or they will have to try to pay it off in very small amounts per year at a probably high interest rate.
Larry will lose at least a month's income, and perhaps more if his recovery is longer than expected. If he is very fortunate, his employer will hold his job until he can return. In the meantime, his wife's income is not large enough to cover their essential bills, starting with rent and food. If Larry's wife cannot get more hours from her current work, her only realistic option is to get another part time job, likely at minimum wage. Whether that will at least let them pay for their basics is not certain. It is also uncertain how flexible their landlord will be to let them catch up with their current rent.
It should be clear by now, that one simple, preventable illness has created a cascade of events that affects the economy, are extraordinarily expensive and completely unnecessary. Yet, this is the true consequence of the current American health care system.
The hospital will have to write off the $250,000. To compensate they will have to pass this loss, as well as hundreds of others per year, to their patients with insurance.
The ambulance company will have to spend a lot to try and recover their fee from Larry, and will pass those added expenses along to their other customers who can pay, either privately or with insurance. If Larry doesn't keep up with the payments, they may turn him over to collection, which will damage his credit.
Larry's employer loses productivity from a good worker. The company may have to hire temporary labor to fill Larry's absence, which will be more expensive.
Larry and his wife lose essential income, which at minimum wage is marginal to begin with, and may jeopardize their ability to even house and feed themselves.
Every day that Larry does not work means that his wages do not generate taxes, local, county and federal, as well as FICA withholdings. Multiply that by twenty or thirty million Larrys year after year and the loss is well into billions. The impact of this loss of tax revenue and productivity is staggering on the national economy.
All this from a preventable disease that could have been stopped before it was started if Larry had had access to the most basic medical care. Everybody loses. The nation is weakened through attrition in ways no external threat could impose on us. This national "epidemic" is progressive, it is close to end-stage, and we could all too easily end up with a terminal prognosis. We may reach a point that we literally will be too unhealthy to survive as a nation.
We still have a choice. Until the epidemic takes that away.
We'll start using my first assumption: Preventable diseases are prevented.
We could use any number of examples, but the format of the blog does requires some brevity, rather than a detailed White Paper or journal article. I also acknowledge that the ideas I present here have all been suggested by others, but this is how I choose to organize them.
For purposes of our discussion let's call our example citizen, Larry. Larry works full time for minimum wage, does not have health insurance, and cannot afford to buy private insurance. He also does not qualify for any government health care benefits. Larry's wife also works for minimum wage, but only 24 hours per week.
As long as his health holds, Larry can work and he has no medical needs. He pays local, federal and state taxes and uses no special government services.
But let's say that Larry gets pneumonia. It is a very common viral strain, and can be treated successfully with antibiotics, and could have been avoided entirely if Larry had had a pneumonia vaccination. Now he's faced with a dilemma. At first he thinks he just has a chest cold and he can wait it out. Being a conscientious worker, he toughs it out and goes to work, but exposes his coworkers to the bug through his worsening cough.
By the weekend, Larry is really sick. Over the counter cough medicines provide almost no relief, and on top of that, his cough is becoming increasingly productive. He cannot sleep because of the cough and not being able to find a position in bed where he can breathe without effort and pain. Larry knows he needs to see a doctor, but having no insurance, he does not have a primary care physician, so he has no idea who to call. Finally his breathing becomes so difficult that his wife calls 911. Larry is taken to an emergency room by ambulance, but one on the far side of the city because the hospital closest does not like to take patients without insurance.
By the time Larry gets to an emergency room that will accept him as a patient he is nearly in respiratory arrest. The ER doctor quickly diagnoses the pneumonia, but that it is so advanced that Larry's life is in danger. She intubates him immediately and transfers him to the hospital's intensive care unit. It is four days before Larry's condition has improved enough to send him to a "step-down" unit and two more days before he can be admitted to a medical unit room, and he is discharged two days after that.
Larry is fortunate that the hospital he is at has Certified RN and MSW Care Managers. They work with him and his wife throughout the hospitalization, develop a treatment plan and a discharge plan, set Larry up with a local medical clinic that treats patients without insurance, and provide his wife with food vouchers and bus tokens so she can make the long trip back and forth to the hospital.
Despite all this, when Larry is wheeled out to the taxi to take him home, he has a hospital bill that is $250,000. Since Larry and his wife together make too much money to qualify for Medicare, that bill rests squarely on their shoulders. He has no way to pay it back. He will not be strong enough to work for at least another three weeks. He will have not earned a dollar since he got sick, and won't until he returns to work. His wife's income is not sufficient to cover all their bills, and if they pay the rent, they will not have enough money to buy food. The hospital sent home a week's supply of medications, but after that, he will have to pay for them himself, and due to the damage to his lungs, he will need regular medications for at least six months. Those prescriptions will cost over $800 per month. Through the free medical clinic he can apply for medication cost support , but that can take up to four weeks to be approved assuming he qualifies.
Now multiply this basic scenario by twenty or thirty million Larrys a year. Every year. That is health care in America.
Here's what happens. The only good news is that Larry has survived a brush with death, ironically from a completely preventable disease.
Larry and his wife now owe the hospital $250,000. They have no assets. Even though they signed a promissory note with the hospital, no one is under the illusion that he will be able to pay back more than a few thousand dollars if he is a very conscientious person.
Larry and his wife owe the ambulance service perhaps $3,000. They cannot pay it, or they will have to try to pay it off in very small amounts per year at a probably high interest rate.
Larry will lose at least a month's income, and perhaps more if his recovery is longer than expected. If he is very fortunate, his employer will hold his job until he can return. In the meantime, his wife's income is not large enough to cover their essential bills, starting with rent and food. If Larry's wife cannot get more hours from her current work, her only realistic option is to get another part time job, likely at minimum wage. Whether that will at least let them pay for their basics is not certain. It is also uncertain how flexible their landlord will be to let them catch up with their current rent.
It should be clear by now, that one simple, preventable illness has created a cascade of events that affects the economy, are extraordinarily expensive and completely unnecessary. Yet, this is the true consequence of the current American health care system.
The hospital will have to write off the $250,000. To compensate they will have to pass this loss, as well as hundreds of others per year, to their patients with insurance.
The ambulance company will have to spend a lot to try and recover their fee from Larry, and will pass those added expenses along to their other customers who can pay, either privately or with insurance. If Larry doesn't keep up with the payments, they may turn him over to collection, which will damage his credit.
Larry's employer loses productivity from a good worker. The company may have to hire temporary labor to fill Larry's absence, which will be more expensive.
Larry and his wife lose essential income, which at minimum wage is marginal to begin with, and may jeopardize their ability to even house and feed themselves.
Every day that Larry does not work means that his wages do not generate taxes, local, county and federal, as well as FICA withholdings. Multiply that by twenty or thirty million Larrys year after year and the loss is well into billions. The impact of this loss of tax revenue and productivity is staggering on the national economy.
All this from a preventable disease that could have been stopped before it was started if Larry had had access to the most basic medical care. Everybody loses. The nation is weakened through attrition in ways no external threat could impose on us. This national "epidemic" is progressive, it is close to end-stage, and we could all too easily end up with a terminal prognosis. We may reach a point that we literally will be too unhealthy to survive as a nation.
We still have a choice. Until the epidemic takes that away.
Sunday, August 31, 2008
Galacta
I wrote this piece ten years ago. I had been listening to Saint-Saens' Organ Symphony (Sym # 3; Berlin Philharmoniker-James Levine. Deutsche Grammophon 419 617-2). The words came to me one night as I was in that stage between wakefulness and sleep. Not the kind of thing that happens to me often, but it has always seemed like the Muse melded together two of my life's passions, astronomy and music. I still like it, and it fits the "dreamer" part of what I envision for RLI.
Galacta
Verse on the "Maestoso" from Saint-Saens' Symphony #3, The Organ Symphony, Op. 78. Meter: 9.10.9.10.
I.
From life's womb our birth
beholds the stars,
Embraced by Galacta's
spiraling arms.
Her xanthic star
darkness is o'erwhelmed,
Seeds spring from
elemental dust it warms.
II.
Childhood, sustained
by this oceaned orb,
Sparks genesis of
consciousness and fire.
Galacta's ocean
vast paradise,
So we leap to the sky
atop Sol's spire.
David C. Waggoner, March 16, 1998, Copyright (C) 1998
Galacta
Verse on the "Maestoso" from Saint-Saens' Symphony #3, The Organ Symphony, Op. 78. Meter: 9.10.9.10.
I.
From life's womb our birth
beholds the stars,
Embraced by Galacta's
spiraling arms.
Her xanthic star
darkness is o'erwhelmed,
Seeds spring from
elemental dust it warms.
II.
Childhood, sustained
by this oceaned orb,
Sparks genesis of
consciousness and fire.
Galacta's ocean
vast paradise,
So we leap to the sky
atop Sol's spire.
David C. Waggoner, March 16, 1998, Copyright (C) 1998
Saturday, August 30, 2008
Health Care for All Americans: A New Paradigm. Part 2
Saturday, August 30, 2008
6:00 PM
First of all, I admit willingly that I love working through a good policy analysis. I guess that makes me a "wonk." In my dissertation research, I spent a year reading in organizational theory, specifically in the field of Organizational Ecology. It was intellectual baptism by immersion, but gave me a set of theoretical skills that provide a perspective on how policies are developed out of an organization's mission.
So with unbridled abandon I'll jump in the deep end and take on one of the major crises of the 21st Century: Health care.
Here's the question: What kind of treatment and medical care is needed so that all Americans can be healthy, or as healthy as possible?
That perhaps is not the question you expected to hear. The national conversation has focused on how much will it cost to provide all Americans with health insurance, how will the spiraling costs of health care be brought under control, will taxes have to be raised to pay for it, what will the roles of the health insurance industry, and the medical industries, and most of all the federal government be? Tough questions all around.
However, these questions are not the right place to start. Not that they aren't relevant, but just not at the outset. What, then, are the right questions? First, you have to have a clear set of assumptions:
Health care for every American would provide a treatment plan so that :
○ Preventable diseases are prevented
○ Chronic conditions that arise from preventable diseases are prevented
○ Vision, dental, prenatal care, physical and other therapies, chiropractic, etc., will be provided
○ Labor and delivery services for hospital, birthing centers, and home birth will be provided and infants needing medical attention, or neonatal intensive care services, will receive them
○ Acute diseases that cannot be prevented will generate a treatment plan that has a goal of returning the person's health to its baseline before the disease began
○ Acute diseases not preventable, that create a chronic health condition or disability, will generate a treatment plan with a goal of sustaining the person's health as close to the baseline function as possible, and provide the needed rehabilitation and social services to optimize the individual's quality of life
○ Chronic medical conditions will generate a treatment plan that optimizes the individual's quality of life. Progression of the condition (e.g. diabetes) will be treated across the life span to preserve the individual's quality of life and functionality as much as possible
○ Genetically based diseases (e.g. cystic fibrosis, MS) and conditions (e.g. Down's syndrome, birth defects) will generate a treatment plan that provides corrective treatments when possible, and gives the individual the best quality of life across the person's life span
○ Psychiatric and behavioral health disorders will have open access to care and will generate a treatment plan that balances medication regimens with the person's autonomy, is based on a viable community support programs, and provides in-patient treatment and care on the same level as all chronic medical conditions
○ Addiction disorders will generate a treatment plan that balances in-patient and out-patient services, viable community support, quality family support, as well as a vigorous public health program to actually reduce addictions, and the involvement of the various producers such as alcohol, drugs, casino companies, sex, live and internet, to reduce the number of individuals addicted to their products. Recovery treatment programs would be available to all individuals
○ Street drug addiction disorders would receive the same level of care as the other addictive disorders but might add an element of more intensive diversion programs because of the multiple health problems drug abusers create by their high risk behavior
○ Simple injuries (not life-threatening or needing rehabilitation) will be treated with follow up to enhance rapid recovery and healing as appropriate
○ Complex injuries that need rehabilitation, and might prevent the person from working will generate a treatment plan that is directed toward recovering as much of the person's functionality as possible and provide the needed therapies and rehabilitation for that recovery
○ Traumatic injuries (life-threatening, and/or life changing) will generate a treatment plan including intensive care services and is directed toward recovering as much of the person's functionality as possible and provide the needed therapies and rehabilitation for that recovery
○ Cancer treatment will be provided and the treatment plan will, as appropriate, involve assessing the person's wishes for treatment at the time of diagnosis with one's family, physician or other medical provider, and appropriate social work and RN care management and spiritual care.
○ All end-stage diseases (e.g., cancer, cardiac, pulmonary, liver, kidneys, brain and neurological, etc.), will assess the person's wishes to continue treatment when the disease has been diagnosed as terminal and less than six months to live, with the person's family, medical provider, clergy/chaplain, social worker and care manager. Resuscitation status (code status) and advance directives for life sustaining treatment wishes will be in place by this time.
○ For the dying, at any age and from any condition, palliative care to keep the individual comfortable with appropriate medications, therapies (both standard and holistic), spiritual care, along with hospice, for at home, in a hospice house, or in a hospital will be provided.
This list, though long, was not meant to be comprehensive, but to give you a sense of the many different types of diseases and conditions people experience every day--Every day! As well, everything on this list is being done now. This is the normal stuff.
If you found yourself thinking, "Yeah, but how is he going to pay for all of this?" you're still operating out of the conventional paradigm. The current paradigm is not working and the health of Americans is eroding, placing us in grave danger from a number of perspectives!
You ponder this Real:Life:Issue for a few days, and I'll be back to post Part 2. Oh, and notice the emphasis on treatment plans. That's important!
6:00 PM
First of all, I admit willingly that I love working through a good policy analysis. I guess that makes me a "wonk." In my dissertation research, I spent a year reading in organizational theory, specifically in the field of Organizational Ecology. It was intellectual baptism by immersion, but gave me a set of theoretical skills that provide a perspective on how policies are developed out of an organization's mission.
So with unbridled abandon I'll jump in the deep end and take on one of the major crises of the 21st Century: Health care.
Here's the question: What kind of treatment and medical care is needed so that all Americans can be healthy, or as healthy as possible?
That perhaps is not the question you expected to hear. The national conversation has focused on how much will it cost to provide all Americans with health insurance, how will the spiraling costs of health care be brought under control, will taxes have to be raised to pay for it, what will the roles of the health insurance industry, and the medical industries, and most of all the federal government be? Tough questions all around.
However, these questions are not the right place to start. Not that they aren't relevant, but just not at the outset. What, then, are the right questions? First, you have to have a clear set of assumptions:
Health care for every American would provide a treatment plan so that :
○ Preventable diseases are prevented
○ Chronic conditions that arise from preventable diseases are prevented
○ Vision, dental, prenatal care, physical and other therapies, chiropractic, etc., will be provided
○ Labor and delivery services for hospital, birthing centers, and home birth will be provided and infants needing medical attention, or neonatal intensive care services, will receive them
○ Acute diseases that cannot be prevented will generate a treatment plan that has a goal of returning the person's health to its baseline before the disease began
○ Acute diseases not preventable, that create a chronic health condition or disability, will generate a treatment plan with a goal of sustaining the person's health as close to the baseline function as possible, and provide the needed rehabilitation and social services to optimize the individual's quality of life
○ Chronic medical conditions will generate a treatment plan that optimizes the individual's quality of life. Progression of the condition (e.g. diabetes) will be treated across the life span to preserve the individual's quality of life and functionality as much as possible
○ Genetically based diseases (e.g. cystic fibrosis, MS) and conditions (e.g. Down's syndrome, birth defects) will generate a treatment plan that provides corrective treatments when possible, and gives the individual the best quality of life across the person's life span
○ Psychiatric and behavioral health disorders will have open access to care and will generate a treatment plan that balances medication regimens with the person's autonomy, is based on a viable community support programs, and provides in-patient treatment and care on the same level as all chronic medical conditions
○ Addiction disorders will generate a treatment plan that balances in-patient and out-patient services, viable community support, quality family support, as well as a vigorous public health program to actually reduce addictions, and the involvement of the various producers such as alcohol, drugs, casino companies, sex, live and internet, to reduce the number of individuals addicted to their products. Recovery treatment programs would be available to all individuals
○ Street drug addiction disorders would receive the same level of care as the other addictive disorders but might add an element of more intensive diversion programs because of the multiple health problems drug abusers create by their high risk behavior
○ Simple injuries (not life-threatening or needing rehabilitation) will be treated with follow up to enhance rapid recovery and healing as appropriate
○ Complex injuries that need rehabilitation, and might prevent the person from working will generate a treatment plan that is directed toward recovering as much of the person's functionality as possible and provide the needed therapies and rehabilitation for that recovery
○ Traumatic injuries (life-threatening, and/or life changing) will generate a treatment plan including intensive care services and is directed toward recovering as much of the person's functionality as possible and provide the needed therapies and rehabilitation for that recovery
○ Cancer treatment will be provided and the treatment plan will, as appropriate, involve assessing the person's wishes for treatment at the time of diagnosis with one's family, physician or other medical provider, and appropriate social work and RN care management and spiritual care.
○ All end-stage diseases (e.g., cancer, cardiac, pulmonary, liver, kidneys, brain and neurological, etc.), will assess the person's wishes to continue treatment when the disease has been diagnosed as terminal and less than six months to live, with the person's family, medical provider, clergy/chaplain, social worker and care manager. Resuscitation status (code status) and advance directives for life sustaining treatment wishes will be in place by this time.
○ For the dying, at any age and from any condition, palliative care to keep the individual comfortable with appropriate medications, therapies (both standard and holistic), spiritual care, along with hospice, for at home, in a hospice house, or in a hospital will be provided.
This list, though long, was not meant to be comprehensive, but to give you a sense of the many different types of diseases and conditions people experience every day--Every day! As well, everything on this list is being done now. This is the normal stuff.
If you found yourself thinking, "Yeah, but how is he going to pay for all of this?" you're still operating out of the conventional paradigm. The current paradigm is not working and the health of Americans is eroding, placing us in grave danger from a number of perspectives!
You ponder this Real:Life:Issue for a few days, and I'll be back to post Part 2. Oh, and notice the emphasis on treatment plans. That's important!
Wednesday, August 27, 2008
What's Coming: Health Care for All Americans--Can it really be done? Part 1
Now that I have RLI set up and online, although still under construction, the next post is going to be an analysis of what is wrong with the health care proposals put forth by both the Democrats and the Republicans. My initial assessment, after reading a report in the Wall Street Journal of a debate between two policy advisers for McCain and Obama is that both were doomed from the beginning. This convinced me that the ideas I had been experimenting with can provide a new frame of reference to decide what will actually work and result in a healthier, more productive, more satisfied population.
The typical arguments for or against universal health care always focus on what the government will have to spend, what taxes will have to be raised to finance it at any level, or providing health care to consumers, i.e., virtually the whole population, has been, from my perspective, approached from the wrong frame of reference.
What I don't understand is that current wisdom regarding health care policy theory appears to arise out of obsolete paradigms, which, granted is not that difficult to do at the pace the health care industry is evolving, but also no real excuse not to be paying close enough attention to realize they are barking up the wrong tree. Stay tuned.
The typical arguments for or against universal health care always focus on what the government will have to spend, what taxes will have to be raised to finance it at any level, or providing health care to consumers, i.e., virtually the whole population, has been, from my perspective, approached from the wrong frame of reference.
What I don't understand is that current wisdom regarding health care policy theory appears to arise out of obsolete paradigms, which, granted is not that difficult to do at the pace the health care industry is evolving, but also no real excuse not to be paying close enough attention to realize they are barking up the wrong tree. Stay tuned.
Monday, August 25, 2008
Introit
Life is a series of beginnings, middles and endings, but we only rarely get to start at the beginning. We just have to jump into the middle and start swimming. The middle I decided to jump into is the presidential campaign here in the United States. I've been reading blog postings from a bunch of different news sites. My first post expresses my thoughts about what I've been reading, and sets the tone, I hope, for Real:Life:Issues. Don't worry, there'll be lots more to come as I develop this site and gain experience for my new forum for expression here at RLI!
My Political Ad--
The announcer's voice intones:
Blogging the presidential candidates...
Imagined as a forum...
For the debate of great ideas and critical analysis of policies and promises by those seeking the highest office in the land...
Has degenerated to become mind-numbingly boring...
Inane, vapid...
Point, counterpoint...
Slam versus slam...
Sleaze versus sleaze...
Thinking, examination, honest critique...
All faded into oblivion.
Like two old boars fighting in a mudhole...
Slinging and swinging the slime they stand in...
Long forgetting the reasons they are fighting for...
And...too stupid to stop.
The Presidency of the United States...
Bring your mind as well as your voice!
This ad has been approved by Real:Life:Issues.
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