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Fixin' Healthcare

Sunday, September 23, 2007

Dr. Albert Schweitzer (1875-1965) and Mother Mary Teresa (1910-1997)

The lives of Dr. Albert Schweitzer and Mother Mary Teresa have been inspirations to countless people throughout the world. Their examples touched lives and stimulated people across all manner of human boundaries. Each of them stands on their own but viewed together they offer instructive insight to different routes by which service to the needy has common meaning for everyone.

The forthcoming book of Mother Teresa's letters to her superiors and confessors in the Catholic Church has brought renewed attention to her life. The publicity attracted my attention and this led to a desire to learn more about her life and what she accomplished. In the process, I began also to contemplate the life of Dr. Albert Schweitzer.

The comparisons and contrasts between the two highlight how they lived and what they accomplished. Though their paths through life were very different, they were remarkably similar in many ways. Two long lives overlapping in time that served the poor, sick and disabled. Both received considerable, high profile recognition while they were alive. In the process they inspired many people and changed lives.

Inspiration, motivation and the ability to stimulate others are subjects of endless curiosity because they are at the core of human behavior. People prize examples of inspiration and motivation that produce noble deeds and healthy, productive lives. But, the source and nature of inspiration and motivation are difficult to know. To the extent that anyone attempts to know the motivation and mind of another, there will be some aspect of guessing much that is is unknown.

Regardless of the inspiration and motivation in the mind of another, it is their deeds that inspire and stimulate those around them. Words, too, have the capability to inspire and stimulate but deeds give words credibility and heightened capability. Whether it is for verification or stimulation, people need examples throughout the course of their lives. Perhaps it is in the choice of examples where the basis for optimum mental and physical health of a society resides.

People who achieve widespread public attention hardly ever escape criticism or controversy. Close scrutiny of behavior reveals details that lead to judgments. Public figures and those who become public figures by pursuing ideas and tasks different from the accepted norm are judged frequently on what they say, what they write, what they do and what others say about them. That is not to say all such judgments are accurate or justified.

Dr. Schweitzer and Mother Teresa suffered hardships and were subjected to criticism during their lives. Both possessed the internal strength to persist in their efforts. How, then, does anyone know when to persist or change in the face of criticism? That is a timeless question. The search for timeless examples that create and sustain an ethical basis to address timeless questions is a reason to review any life.

There is much to learn from the life and work of Dr. Schweitzer and Mother Teresa. This review is undertaken to learn whether comparisons and contrasts between their lives can increase the meaning of our lives. If nothing more, the effort renews acquaintance with these remarkable people. Whatever deficiencies are noted when this effort is complete will be overcome if the reader is stimulated to pursue their own course of inquiry.

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Saturday, September 22, 2007

If You Care Enough, Send the Very Best

Indeed, it is a complex world. At times it seems there never will be found solutions to the problems that plague us. Health care, energy policy and climate change are prominent examples of issues requiring urgent attention. The complexity is a legitimate basis for indecision, as well as an excuse for inaction. Yes, there are plenty of examples of the law of unintended consequences, as well as disasters that forewarned their coming and could have been avoided. Complexity and expertise can do that to you. Yes, but, on the other hand...

Solutions to complex problems often come from technology or financial changes. People prefer that way because it usually expands the economy and they don't have to change any of their ways. Occasionally the problem is solved but most often it is covered over to resurface bigger and more imposing.

Natural disasters notwithstanding, human behavior is the most powerful force impacting health and all life on earth. It is the most powerful force because it is the most consistent. As the twig is bent, the tree grows. When overwhelming issues such as health care, energy policy and climate change are viewed as the result of human behavior, they are found to have a common bond and a central core.

Conservation and prevention are well known but they are not popular. To practice conservation and prevention means adopting a healthy lifestyle. Congress cannot win elections with the number of people who lead healthy lifestyles. So, they will continue to be indecisive about energy policy and climate change, and pour increasing amounts of money into medical care. They all remember Jimmy Carter sitting before the television cameras wearing his sweater.

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Friday, September 21, 2007

Say It Again

How often does the point have to be made that health insurance is more the problem than the solution? John Stossel outlines an accurate description of the situation. Those who are sick need appropriate medical care but far more receive medical care than need it. Sooner or later the US will be forced to develop a health care system while simultaneously downsizing medical care. That is the route to improved health status without run away costs.

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Sunday, September 16, 2007

Shopping for Healthcare

Mona Lori directed my attention to a site with the purpose to expose healthcare prices. It is a useful idea and a piece of the puzzle. I'm thinking the purpose would be better served if people paid for their healthcare and were reimbursed by the insurance company. Yes, it is impractical and it would be very unpopular, but, then, this project would have more meaning. On the other hand, the out of pocket burden is increasing, even for those with health, aka medical, insurance.

Check it out and give Mona some help with this beast.


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Friday, September 14, 2007

If Health Is The Goal, You Should Have Said So

Do we really know what makes us healthy? Gary Taubes asks the $64 question but he cannot provide the answer. Perhaps, as he suggests, the reason the question goes begging is the complex nature of biomedical research and the great difficulty drawing conclusions from the data. "[hormone replacement therapy] is a particularly glaring example of the difficulties of trying to establish reliable knowledge in any scientific field with research tools (epidemiology) that themselves may be unreliable."

Welcome to the real world and it is not limited to epidemiology. There are more biases than you can shake a stick at and the most sophisticated research tools are like stone cutting when compared to the mind numbing complexity of the human body. And, that body has to interact with the equally complex environment, which includes the society of other human beings.

There are days when it would be easy enough to conclude that biomedical research has little to do with the real world. Mr. Taubes comments on the limitations and drawbacks of clinical trials for drugs, and he is talking only about the scientific aspects of the studies. It has long since passed the point where clinical trials define the conditions of drug utilization in daily practice. In addition to the patient, the family and the doctor, there are insurance companies, Wall Street, marketing departments, newspaper editors, politicians and courts who are factors in that arena.

Should you ask your doctor if drug X is right for you? Is it the right question? Mr. Taubes asks a good question that doesn't get asked often enough. And, when it is asked, it is usually with an answer in mind. Think about it. Do we really know what makes us healthy? Also, it might be helpful to consider to whom that question should be put. I can see the usual suspects proposing health insurance as the answer.

Socio-economic status and level of education in all probability have more influence upon achieving and maintaining optimum health status than does medical care. School systems lament that they are asked to shoulder too many of society's problems but they may be the health care system as contrasted to the medical care system. One (health care) develops the conditions for optimum health (whatever they are) and the other (medical care) diagnoses and treats illness and disease.

Interestingly, the origins of the current epidemic of obesity and chronic diseases could be traced back to the time when Allan Bloom saw the beginning of "The Closing of the American Mind". Is that a stretch? Perhaps, but we should think about it. If health insurance means medical care for everyone, God help us. Of course, I'm just playing with your fears. How could anyone say the United States is a society oriented to sickness?

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Monday, September 03, 2007

Say It Isn't So

Jacob Sullum provides food for thought with comments on "the totalitarian implications of public health".

"Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity" (World Health Organization).

"Public Health is dedicated to the common attainment of the highest levels of physical, mental and social well-being and longevity consistent with available knowledge and resources at a given time and place" (Public Health Administration and Practice by John Hanlon).

Is individual freedom inconsistent with optimum health? If that is so, it is a condemnation of our society and culture that will never be corrected "with a legally enforceable duty to be well". When people want to be healthy, feel good and be more productive, they will find ways to do it. The role of public health is to provide reliable information and enable people with their individual efforts. Individual efforts are greatly enhanced by like-minded groups. Motivation and inspiration are at the core of healthy lifestyles.

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