Monday, August 10, 2009

Dad in Chief

Robert Gibbs: "We can have a discussion in our democracy about where we want to go and why or why not we want to take certain steps. The president strongly believes we can do so without yelling at each other, without pushing each other, without degrading each other, and do so in a way that respects the difference in all our opinions."

As Gibbs said that, I couldn't help but feel like a fly on the wall while Obama officiates a dispute between his daughters.

It's like Obama's our dad and we, the citizens of the United States of America, are all his children. Dad knows what's best for us even if we don't. And if we'll just let him take care of us, everything will be alright.

I just wonder if that's how Obama, his staff, and the Democrats in congress really see things.

Wednesday, August 5, 2009

A Holistic Solution

They say that 46 million people are uninsured in America. I wonder if that means there are 46 million people who wouldn’t have any access to healthcare if they needed it. Or does that simply mean that there are 46 million people who don’t have any visible means of paying for healthcare should they need it.

I had a long talk with Ania yesterday about the rise of anti-depressant use in this country. There was an article out and we had both read it. 75 million people, I think, was the number.

I wonder if the current “cost per capita” of the US health care system takes the cost of prescription medication into account and if among prescriptions medications anti-depressants are included. I’ve suspected for years that we over-medicate here in America. I wonder if we’re over-medicating—and over-diagnosing.

Maybe a healthcare overhaul means something completely different than how it’s paid for. Maybe the focus should be on defining healthcare and reforming some of our basic assumptions. Maybe holistic medicine shouldn’t be synonymous with new age quackery and should be a legitimate medical approach whereby the whole person is considered in his or her totality—mind, body, and spirit. And lifestyle would be inseparable from that.

The other day I was driving with my dad and I stepped hard on the gas in an effort to get ahead of somebody. My engine whined as my little Corolla sped up by about 20 miles per hour in a few seconds. My dad commented how bad that was for my engine. Same with slamming on the brakes or driving a stick-shift in the wrong gear. My point is, I think we as a nation actually have the right attitude towards preventative care and thinking about the harmful long-term harmful effects of bad behavior, but all too often, that attitude is directed towards our cars. Maybe if auto insurance covered maintenance and repairs and if our auto insurance premiums came out of our salary at work before we ever saw the money, we’d be a lot less concerned about oil changes and tune ups. We’d drive however we felt like, ignore regular maintenance, and then bring the car in for invasive surgery while we got to drive a snazzy loaner car—all paid for by insurance.

As it is, most of us set money aside for our regular auto maintenance so we can avoid the hefty repair costs that neglect would bring down upon us. But be that as it may, when our transmission finally DOES go out, if we have the money and if a new car isn’t cheaper, we reluctantly but willingly pony up the cash.

How different that seems to be from our attitude towards our own bodies. It reminds me of the Simpsons where Homer has his bypass operation. He pulls into a filling station because he hears a loud thumping noise. The attendant tells Homer it’s his heart. Relieved, Homer said he was afraid it was his transmission and drives away.

It’s comedy but I think it illustrates a point very well. He was worried when he was afraid his car was on its last leg but relieved when it was only his heart.

My point is, we as Americans KNOW how to take care of things but many of us don’t take very good care of our bodies. We eat the wrong things and we eat too much of it. We eat too often. We drive when we could walk. We don’t take enough time to relax in healthy ways. And even when we take time to focus on our physical and mental health, all too often our spiritual health is neglected entirely.

I’d say that the majority of the people in this country consider spiritual reality a reality. I’ll bet that nine out of ten people would agree with the assertion that man is a composite creature consisting of mind, body, and spirit. Medical science (and medical techniques and training) seem to recognize the first two (otherwise there wouldn’t be a distinction between mental health and physical health—all thing being physical) but not the third.

If spiritual reality is a reality in an objective sense, than it remains so whether medical science recognizes its importance or not. I suspect that much that is mistaken for and treated as mental and physical illness is, in reality, spiritual illness. Perhaps as many as half the cases of depression start out as a spiritual illness that spread out and infect the mind and then even the body. The body and mind are treated with medication while the root cause is left along to just get worse and worse.

I recognize that I’m starting to sound like a Christian Scientist or (gulp) a Scientologist here. But just because those two groups go too far doesn’t mean that they’re completely wrong. Jesus and his disciples DID drive out demons (or so the stories go). I don’t think they were JUST curing mental illness in each and every case.

And we can disbelieve in the possibility of demonic possession but if we still believe that man has a spirit—that man has a soul—than we have also to account for the ways in which the spirit or soul may interact with the body and the mind. And when we treat the whole person, we have to consider his spirit as well.

But this is getting to long. I only meant to propose that REAL healthcare reform may have a good deal less to with the costs and great deal more to do with how patients are treated.

Tuesday, August 4, 2009

What ABOUT Single Payer

Without demonizing anyone or any party, I’d like to look at Single Payer rationally. Can Single Payer possibly provide me and my family with the same care we’re used to and at a lower cost? Will potentially reduced administrative costs (that’s the theory) translate into lower out of pocket expenses? In short, can we achieve better care at less cost and, in the process, provide healthcare to people who couldn’t otherwise afford it through a federally run “Single Payer” healthcare finance system?

There are questions I must, for the moment, ignore. They are:

Is providing the financial means by which our citizens can obtain health care our governments responsibility?


By what reasonable interpretation of what existing clause or article of our constitution can we possibly infer that responsibility?

If we ignore those questions and assume, as an intellectual exercise, that it IS our federal government’s responsibility, than we are left trying to decide what is the best way, the most efficient way, the most humane way, the most moral way, the most ethical way, and the most complete way to fulfill the obligations that responsibility entails.

First of all and most primary, the POINT of healthcare needs to be decided upon. I submit that the first, the primary, and the ONLY point of healthcare is to maintain and restore health and to prolong life. It is NOT the point of healthcare to hasten death. No medical professional or facility, paid for in whole or in part out of the public fund, should ever be engaged in any process or technique by which any life is forcibly and willfully terminated.

Abortion and euthanasia, in particular, should not be paid for by any public plan or under any public option. So long as both remain legal, they could be provided by the supporters of the same to those who need and they can provide them to those who can’t afford them as a “charitable” service. And they can define charity however they please behind closed doors and out of the public square.

But charity in the context of healthcare is most readily defined as that which aims to promote good health and long life, indifferent to subjective concerns. And age, race, size, class, etc. are, as far as health care should be concerned, subjective. The objective reality that should be recognized is that all human beings, from the first to the last beat of their heart, are absolutely equal in value and in measure. No positive steps should ever be taken in a medical context to permanently stop a beating human heart.

Now, as an aside, I personally believe—and I believe it objectively true—that human life begins at conception. A humans heart beats for the first time, on average, three weeks from conception. As a matter of public policy, I believe that humanity should be recognized and protected in its totality but I also recognize that we, as a nation, are a long way from that ideal. And I don’t think we’ll be able to end THAT debate before we are pressured to end the health care debate. A public option will be on the table and will have to be decided upon with certain decisions as to what gets covered needing to be made immediately. So rather than accept a solution that, by default, may provide pregnancy termination services at ANY stage in a woman’s pregnancy, I’d like to get some parameters defined.

I think that a heart beat is a good, solid, empirically verifiable indicator of a human life that is worthy of and deserving of our protection. Promoting this distinction, rather than a more scientific or philosophical one, will put the onus on those who contend that having a heart that beats on its own is not a sufficient indicator that human life is present. They’ll have to defend their own distinction. And I content—unequivocally—that birth is not a proper distinction. It is, rather, a nonsensical distinction in the age of c-sections on demand. And neither is fetal viability a reasonable distinction since viability has become a sliding scale. How will such a distinction be maintained once the scale has slid all the way down to conception?

So, getting past that messy part of the business, we can focus on that which actually promotes health.

Is Single Payer the best option? Is it a POOR option? Will heath care be rationed? Will people have to wait in long lines for routine care? For emergency care?

Is Single Payer really something we need to be afraid of or is it merely the unknown that is causing us fear.

I admit I don’t know.