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Fixin' Healthcare

Tuesday, January 09, 2007

The Lifestyle Chronicles - Transformation Of Healthcare

There is entirely too much energy and resources wasted fixing blame when the only purpose served is punishment. When punishment is the objective, the systematic nature of problems are not well understood and the reponses are not solutions. There is no purpose served fixing blame in the US healthcare system when it has reached a state where just about everyone is a victim.

The US healthcare system is a misnomer. It is multiple systems and systems within systems. There was no intelligent design. It is generous to call it a system. If anything, it is an example of accelerated evolution with rapid mutations. Arguably, emotion prevails more than logic and misdirected business interests are more common than anyone cares to admit. Attempts at reform end up so far off target that no one wants to claim them.

Universal health insurance is a compassionate and a political response to the financial aspect of this problem. As such, it is understandable. This past summer I was involved in a minor accident and ended up in an emergency room. There was no injury but the bill was $3,500. My insurance covered it but I shudder to think of someone in a similar situation with no insurance.

Universal health insurance is an immediate necessity. But, please, do not call it healthcare reform. Many of the problems in the healthcare system will be aggravated by additional insurance coverage. And, insurance has proven to be notoriously unreliable as an instrument for reform.

Perhaps the notion of reforming healthcare should be superceded by something we could call the transformation of healthcare. The concept of transformation conveys a more accurate impression of the task. Nothing will be solved by tinkering with the current system. An entirely new approach is necessary. A good start would be to recognize that medical care is a division of healthcare and the overarching goal of healthcare is optimum health status with optimum mental, emotional and physical performance.

I do not give the current crop of Republicans credit for elevating the role of personal responsibility. It has been my understanding from childhood that a basic value of America is personal freedom and freedom of choice. There is no personal freedom without personal responsibility and there is a corresponding community responsibility. To be sure, numerous groups have tried to claim these values as their own, and American society has pushed the limits of these values to ridiculous levels. But, there they are for better or worse.

I have resisted the thought of creating systems to change or reform systems. Perhaps my inclinations are insufficient to the task of transforming healthcare. Lambrew and Podesta proposed the creation of a "Wellness Trust". It is an intriguing concept that should be created in the same act that establishes universal health insurance. I don't expect to hold my breath waiting for such enlightened action from the same crowd that claims personal responsibility and gave us Medicare Part D.

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