Difference of opinion on the appropriateness of having abortion be a legal instead of illegal action has caused a time warp of passionate activism that has turned the entire issue into a impassible screaming match about right and wrong. These things are not of interest to me in my topic today. I've never really noticed that people behave according to right and wrong, regardless of what they think. People will do what they feel they want and need to do in the circumstances they are in. Even in retrospect, they rarely ask if they were right or wrong, but may ask if they were short sighted at the time of the decision. They may even believe it is wrong and do it or right and not do it. There is a great amount of debate on whether the current health care bill allows public money to be used to fund abortions. While I am not trying to say that the bill does or does not allow this, I am going to give the reasons why the bill should be interpreted according to tradition which absolutely disallows any use of public, governmental money for elective abortion.
Today is passover (Well Tuesday is passover, but this may not post until after midnight making the date Wednesday). It is the remembrance of the day that Moses led the Hebrew slaves out of Egypt to become a free nation. As we have been reminded in the news and literature of this holy week, Moses is a national icon, and for both the Founding Fathers and the Civil Rights movement, a man to revere. But in case you have forgotten, Moses existed because his mother had to hide him from a national abortion program. The Egyptians were afraid the Hebrews were going to become too strong to be kept as slaves, so one of the Pharaohs started a birth control program where the midwives had specific directions on how to maintain the balance of power by killing the male babies as they were in the birthing process. Moses' mother managed to bear him without a midwife and hide him in a basket which was sent floating down the river for a princess to find, and the rest is history as they say, which you can watch this Saturday night by tuning into The Ten Commandments.
Now a days, governments aren't quite as rankly power seeking as the reports from ancient Egypt seem to indicate they used to be, and programs for birth control are billed as human rights, so that the poor can have the potential of increasing their economic status without the interference of unwanted extra mouths to feed. It is primarily the rich who sit around and discuss these needs of the poor. Every totally destitute person I have ever met has cared only about their child, not about their economic status in life. But then, I am not in the business of urban renewal or economic stimulation. I am a nurse, and hanging onto people over possessions is a lot of what the world of healing is based on.
To prepare for this posting I read a few United Nations reports and discussions of over population and the plans that have been considered to cope with over population. These proposals made me wonder if no one had ever heard of Darwin, that they had to calculate who would survive as opposed to allowing nature to take its course, but I suppose Darwin is too brutal for consciences social scientists to accept, and trying to create a survivable world up front by controlling populations seems less cruel than having everyone "duke" it out for survival in an uncontrolled setting.
But again, I am not trying to judge or limit any one's personal opinion or scholarship about the best ways to approach our duty to love our neighbor as our self. There are many ways to fulfill this duty, and some seem extremely paradoxical.
What I think should be understood is the limitation of power that is required by the U.S. Constitution that eliminates the government from paying for abortion. Now I know that I can not quote the Constitution to prove this. But did you know that the Declaration of Independence complains about population issues? In the list of grievances, King George is blamed for trying to "prevent the population of these States: for that purpose obstructing the Laws for Naturalization of Foreigners; refusing to pass others to encourage their migrations" etc.etc. Similar to the concept of Pharaoh reducing the population by killing babies so they would not become strong enough to oppose him, the Founding Fathers accused the King of preventing their population from growing so that they would have strength in numbers.
We seem to think now that increasing numbers of people are a negative rather than a positive thing, but I am living in a city where empty buildings are a dime a dozen, so I think we should be taking another look at what nature says is a strength. But whether we get personally philosophical about the subject or not, we have to admit that our system of government was specifically set up to prevent the government from having the kind of power that Pharaoh and King George had: power to make decisions that can change the power of the people through numbers.
Now you may say that since the individual mother is the one asking for the abortion that it isn't a matter of the government making a choice, so it doesn't matter if the government pays the bill. But government is not an issue of choice, government is an issue of power. As soon as the government is providing the money, the government has power - ask any State Legislature about this one. We need to keep the tradition that keeps government money away from abortion because we don't want the government to cross that line of having power in the arena of abortion. To make abortion legal is to give power to the citizen by allowing choice. To pay for it is to pull strings around that choice. Of course the law won't be made for the purpose of pulling strings, but eventually that little bit of control will become a crack in the wall between individual choice and policy making for the greater good, and more surprising things than Pharaoh or King George could happen.
To give you an example of the kinds of things that happen when policy makers provide money for birth control, I refer you to the quarrels of the late 90's that the UN had with its birth control programs. They saw it as a human right, but poorer countries saw it as a way to control their people. In South America there were accusations that governments were using UN money for forced sterilization of poor peoples or minority groups. Of course this was bitterly disputed, and I am not interested here in who was right or wrong. The International Criminal Court considers sterilizing people against their will a crime against humanity and the quarrels are usually interpretations of "willingness." I am simply trying to show that without strong walls about certain activities (bright lines in law as we say) trouble abounds. It would be good for the Feds to avoid paying for abortions so that they don't wander into an accusation of minimizing the growth of minority groups who may be the default groups that would use such a benefit.
But even more than that, it is a principle of our "people-based" nation that the government should not have basic control over our lives. The government is given the right to pay for war and executions, but all other activities are about life and productivity, not death. We don't want the government to have any power over citizen death that is not allowed by the Constitution and all its procedural safe guards, and that means no government money for abortion.
Tuesday, March 30, 2010
Tuesday, March 23, 2010
The Lunatic is in the Hall
No doubt when I write what I know I get more interest. In conversations about my Health Care Bedlam from last week, I have been challenged to think more about the analogy. The political events since last week have fed the illustration also.
One of my co-workers wants to know who the narcissists are. My immediate response is that narcissists rarely end up in the mental health unit because they are so internally motivated and self-vision minded that they don't meet the decompensation traits that require intense treatment. I've seen them visit the unit when their daughters are there with anorexia, or their colleagues are there with suicidal ideation, but they are rarely the patients. However, after a few days thought, I did come up with a group that fits the pattern of narcissist. It is hard to put this out there, because more than any other group, I belong to this group, or I should say of the groups I have belonged to in health care, this is the one where I feel most at home. Secondly, the narcissism of this group is not dysfunctional to the group - but then, that is the goal of narcissism, to watch out for ones self. And even more, the narcissism is not even necessarily a personal choice. There are aspects of this narcissism that are legally binding and demand that this group stay to itself and not interfere or get involved with the issues of the other health care craziness.
The narcissists in the current health care crisis are the religious or private organizations that are running health care systems as a part of their reason to be. These are the church organizations, or the social club networks, or the religious structures that have a vast membership of likeminded folks who are driven by similar principles and as a part of that disciplined and directed life style have been able to expand on their social power to provide health services for themselves and others. To call the good Samaritans the narcissists for my illustration sounds like the height of ingratitude, but I am not painting the picture from the perspective of God and the final judgment, I am painting the picture from the perspective of social welfare under the current government of the United States of America. There is a vast denial among private institutions that what the government does is going to affect them because they are private and often religious, so they are standing oblivious to others and focusing on their First Amendment rights. They have an old fashioned trust in the barrier between profit and non-profit that they feel will guard them from being controlled by whatever it is that is going on in that asylum up the hill. They also have a legal obligation, as long as they are non-profit and taking government money for Medicaid, etc. to avoid any political overtures on policy. Although the most satisfying healing has historically been in the private, religious setting, the current debate on health care cannot include what really works because it must keep a separation between "church" and state. Unfortunately for these head in the sand policies, the lunatics are already loose in their halls, and the political insanity is spreading its tentacles through the wall of private institutions, attaching to the stones and rooting out the foundation from the bottom line. Narcissus died in sorrow gazing at his own reflection. As a member of a church who knows how great some of our parachurch educational and health care systems were, I see us sitting at the river wondering why we are a mere reflection of what we used to be, and not understanding before we are destroyed.
But back to Bedlam.
Last week, in spite of trying to open my eyes to the dynamics of what was happening, I totally overlooked a group of players. There have been times in the past when the whole health care debate was framed as "health insurance reform" and I did not say anything about where the health insurance companies fit in the picture. What is quite obvious is that health insurance is the magic pill that the political doctors are trying to use to cure the crazy health care patients. If everyone has health insurance (if everyone takes their medicine) then all will be fine. Health insurance will bolster the weary hospitals, health insurance will cover the costs of medicine for the drug company, health insurance will satisfy the needs of the medical equipment companies, health insurance will give the doctors what they need, health insurance will make it so the States don't have to cut on themselves anymore. The inexperienced psychiatrist who has read all about wonderful medicines that can cure things that used to cause problems tends to look for the right pill, and not look for the cause and effect dynamics to gain insight in solving problems. Obama is prescribing health insurance for the health care problems, and expects that now everything will be fine, because everybody knows that the ones with health insurance are taken care of, so if everyone has health insurance then everything will be fine. Although I haven't analyzed every possible news source, I think the health insurance companies are not exactly cheering at the thought of being the big fix. Why should they? Health insurance is a carefully crafted statistical gamble. It functions fine in a vacuum tube with tightly limited parameters, but burst that controlled setting, and suddenly they have no bases upon which to gamble, and their advantage is gone. With no advantage, they have no motivation.
The other nurses with whom I share an office have brought to my attention that the entire past weekend was an exercises in "crazymaking." Apparently this word grew up in the social psychology world to describe the confusion that occurs when people use language to demand things that are in direct contradiction to the language being used. As a linguist, I am not surprised I never noticed this term, because I believe that meaning exists before words, not as a result of them, and "crazymaking" requires words to have stand alone meanings that are only defined by the user and can be changed at the users whim. This does explain why Obama is totally ignoring the Tea Party movement. In his mind, they are "crazymaking", and do not see or understand how good things will be. Of course, to them, Obama and friends are "crazymaking" and do not see or understand how bad things will be. The crux of "crazymaking" is to divert from real issues. For example, in Hogan's Heroes, every time the guys wanted to make a diversion work so that they could control something, LeBeau would run around yelling: "Panic, everybody, panic." It doesn't matter if you want to divert from the lack of resources, the lack of equality, or the lack of choice, to behave as though ones own reality is the thing that is best for everyone else is in DIRECT contradiction to the principles of freedom. Such diversion is actually for the purpose of control, and control is not the function of our government. The function of our government is balance of power.
A comment on what makes people turn to "crazy making" indicated they were experiencing the deprivation of their right to know, right to feel, right to impact their own decisions and right of space. I've said before that time and space are the two biggest factors in recovering from crisis. The patients need time to know what is going on, time to feel what is true to themselves, time to make their decisions, and space to feel safe. If the Tea Parties look crazy, maybe it is because the policy is being handed down in a "crazymaking" manner.
Since the U.S.A. has no foundational creed or code of principles to call on for times of crisis, and each person or group must stand for his or her own principles , it is hard to cope in crisis. Ancient peoples pray in crisis, or appoint a Czar, or find some way to do things more efficiently than the processes of problem solving require. And as much as people want to claim that the Constitution is that foundational creed, it really isn't, because it guarantees individual creed, and individual right to thought, so it cannot support one primary thought that the people can all rally to in time of crisis: Except for the ultimate goal of balancing powers, which is to do the right thing, the right way.
If there is any over arching principle to drive us as citizens together, it should be that the Constitution gives us a guide in doing the right thing the right way. Sorting, pinpointing imbalance, analyzing capacities, all of the time and effort functions that slowly evolve into a new path as people pursue proper channels is the answer to our problems. Health care needs some old fashioned psychoanalysis and a reality check. The dreams have been a little too out there which we are in denial of, and the responsibilities have been vastly overlooked, but we don't want to work on it, we just want the magic pill.
Well, there is a character who always takes charge when you just want the pill to make everything better. Her name is Nurse Ratched, and once she gets in power, the pill becomes the only answer whether you like it or not.
Beware of what you have asked for. You may get it, and you may never know what happened.
One of my co-workers wants to know who the narcissists are. My immediate response is that narcissists rarely end up in the mental health unit because they are so internally motivated and self-vision minded that they don't meet the decompensation traits that require intense treatment. I've seen them visit the unit when their daughters are there with anorexia, or their colleagues are there with suicidal ideation, but they are rarely the patients. However, after a few days thought, I did come up with a group that fits the pattern of narcissist. It is hard to put this out there, because more than any other group, I belong to this group, or I should say of the groups I have belonged to in health care, this is the one where I feel most at home. Secondly, the narcissism of this group is not dysfunctional to the group - but then, that is the goal of narcissism, to watch out for ones self. And even more, the narcissism is not even necessarily a personal choice. There are aspects of this narcissism that are legally binding and demand that this group stay to itself and not interfere or get involved with the issues of the other health care craziness.
The narcissists in the current health care crisis are the religious or private organizations that are running health care systems as a part of their reason to be. These are the church organizations, or the social club networks, or the religious structures that have a vast membership of likeminded folks who are driven by similar principles and as a part of that disciplined and directed life style have been able to expand on their social power to provide health services for themselves and others. To call the good Samaritans the narcissists for my illustration sounds like the height of ingratitude, but I am not painting the picture from the perspective of God and the final judgment, I am painting the picture from the perspective of social welfare under the current government of the United States of America. There is a vast denial among private institutions that what the government does is going to affect them because they are private and often religious, so they are standing oblivious to others and focusing on their First Amendment rights. They have an old fashioned trust in the barrier between profit and non-profit that they feel will guard them from being controlled by whatever it is that is going on in that asylum up the hill. They also have a legal obligation, as long as they are non-profit and taking government money for Medicaid, etc. to avoid any political overtures on policy. Although the most satisfying healing has historically been in the private, religious setting, the current debate on health care cannot include what really works because it must keep a separation between "church" and state. Unfortunately for these head in the sand policies, the lunatics are already loose in their halls, and the political insanity is spreading its tentacles through the wall of private institutions, attaching to the stones and rooting out the foundation from the bottom line. Narcissus died in sorrow gazing at his own reflection. As a member of a church who knows how great some of our parachurch educational and health care systems were, I see us sitting at the river wondering why we are a mere reflection of what we used to be, and not understanding before we are destroyed.
But back to Bedlam.
Last week, in spite of trying to open my eyes to the dynamics of what was happening, I totally overlooked a group of players. There have been times in the past when the whole health care debate was framed as "health insurance reform" and I did not say anything about where the health insurance companies fit in the picture. What is quite obvious is that health insurance is the magic pill that the political doctors are trying to use to cure the crazy health care patients. If everyone has health insurance (if everyone takes their medicine) then all will be fine. Health insurance will bolster the weary hospitals, health insurance will cover the costs of medicine for the drug company, health insurance will satisfy the needs of the medical equipment companies, health insurance will give the doctors what they need, health insurance will make it so the States don't have to cut on themselves anymore. The inexperienced psychiatrist who has read all about wonderful medicines that can cure things that used to cause problems tends to look for the right pill, and not look for the cause and effect dynamics to gain insight in solving problems. Obama is prescribing health insurance for the health care problems, and expects that now everything will be fine, because everybody knows that the ones with health insurance are taken care of, so if everyone has health insurance then everything will be fine. Although I haven't analyzed every possible news source, I think the health insurance companies are not exactly cheering at the thought of being the big fix. Why should they? Health insurance is a carefully crafted statistical gamble. It functions fine in a vacuum tube with tightly limited parameters, but burst that controlled setting, and suddenly they have no bases upon which to gamble, and their advantage is gone. With no advantage, they have no motivation.
The other nurses with whom I share an office have brought to my attention that the entire past weekend was an exercises in "crazymaking." Apparently this word grew up in the social psychology world to describe the confusion that occurs when people use language to demand things that are in direct contradiction to the language being used. As a linguist, I am not surprised I never noticed this term, because I believe that meaning exists before words, not as a result of them, and "crazymaking" requires words to have stand alone meanings that are only defined by the user and can be changed at the users whim. This does explain why Obama is totally ignoring the Tea Party movement. In his mind, they are "crazymaking", and do not see or understand how good things will be. Of course, to them, Obama and friends are "crazymaking" and do not see or understand how bad things will be. The crux of "crazymaking" is to divert from real issues. For example, in Hogan's Heroes, every time the guys wanted to make a diversion work so that they could control something, LeBeau would run around yelling: "Panic, everybody, panic." It doesn't matter if you want to divert from the lack of resources, the lack of equality, or the lack of choice, to behave as though ones own reality is the thing that is best for everyone else is in DIRECT contradiction to the principles of freedom. Such diversion is actually for the purpose of control, and control is not the function of our government. The function of our government is balance of power.
A comment on what makes people turn to "crazy making" indicated they were experiencing the deprivation of their right to know, right to feel, right to impact their own decisions and right of space. I've said before that time and space are the two biggest factors in recovering from crisis. The patients need time to know what is going on, time to feel what is true to themselves, time to make their decisions, and space to feel safe. If the Tea Parties look crazy, maybe it is because the policy is being handed down in a "crazymaking" manner.
Since the U.S.A. has no foundational creed or code of principles to call on for times of crisis, and each person or group must stand for his or her own principles , it is hard to cope in crisis. Ancient peoples pray in crisis, or appoint a Czar, or find some way to do things more efficiently than the processes of problem solving require. And as much as people want to claim that the Constitution is that foundational creed, it really isn't, because it guarantees individual creed, and individual right to thought, so it cannot support one primary thought that the people can all rally to in time of crisis: Except for the ultimate goal of balancing powers, which is to do the right thing, the right way.
If there is any over arching principle to drive us as citizens together, it should be that the Constitution gives us a guide in doing the right thing the right way. Sorting, pinpointing imbalance, analyzing capacities, all of the time and effort functions that slowly evolve into a new path as people pursue proper channels is the answer to our problems. Health care needs some old fashioned psychoanalysis and a reality check. The dreams have been a little too out there which we are in denial of, and the responsibilities have been vastly overlooked, but we don't want to work on it, we just want the magic pill.
Well, there is a character who always takes charge when you just want the pill to make everything better. Her name is Nurse Ratched, and once she gets in power, the pill becomes the only answer whether you like it or not.
Beware of what you have asked for. You may get it, and you may never know what happened.
Tuesday, March 16, 2010
Health Care Bedlam
Bedlam means a scene of uproar. The word comes from a shortening of the name of Bethlehem Hospital in London which became one of the first "lunatic" asylums in 1547. What one doctor considered a lunatic in 1547, another doctor would probably have a more definitive diagnosis for in 2010 like schizophrenic, manic, obsessive or even Alzheimer's. I have done no study on the comparisons of people who were locked up in the 1500's to those locked up in 2010, but I suspect that they were very different.
Regardless of the practice of mental health care, the end result in the unit can be very much the same. The bringing together of all the individuals who need specialized attention to tolerate structured society still creates a scene of uproar in many cases. As a nurse who has worked in mental health patient units for over thirty years, the uproar isn't always just the pathology of the patient, it is also very much the pathology of the treatment.
Just as doctors in the 1500's were unaware of many of the chemical and social pressures that caused things they called "lunacy," mental health treatment is often still a stab in the dark at offering answers for things that may not be understood for years, or possibly ever. The main goal of the mental health unit is to provide safety to the patient and to others from the patient until a higher level of stabilization can be reached. Just the fact that getting from unstable to stable is part of the goal of a locked unit indicates how much uproar is occurring.
When I got up this morning I wasn't sure what I was going to blog on today. The president has said that all that can be said has been said about health care, and I know I have enjoyed reading the well researched comments of others today more than I have enjoyed trying to puzzle out things that are 2,000 pages long.
So today's blog is going to be a little picture of bedlam. A little allegory of the treatment that is being performed on our health care and the uproar that that has caused.
Let's make the patients in the unit, not individuals with health care needs, but the different, individually operating parts of the health care system. We have the Bipolar drug companies who lavish money on doctors, research and ads in their high moments of great discoveries, and then become suicidal when they can not charge and keep "patents" or are pressed to offer drugs at prices people can afford rather than prices that cover their lavish expenses. We have the schizophrenic doctors who live in the multiple worlds of money, charity, urgency and necessary risk prevention. They still have traditional duties such as not to harm and to provide for the poor off of the capacities of the rich yet they are losing power to control their own actions so quickly, that much of their practice has become empty attempts at appeasement to demand rather than carefully studied exploration of need and treatment. We have the deeply depressed hospitals who have given and given and given, and tried to cooperate with laws, regulations and demand and still are being emptied of their capacity to serve. We have the sociopathic medical supply companies that suck money out of health care by keeping their wares at free market competitive levels with no thought that they are pricing health care through the sky. They are the new leaches that bleed the needy through money the way doctors did in the past with leaches. We have the obsessive-compulsive Medicare and Medicaid systems who demand that things be done exactly as they want them all the time, without fail, or fault, or variation which is of course impossible, but they have to keep believing it is possible. And last but not least, we have the self mutilating States, who are so confused about what is helpful and right to do, that they have started cutting themselves up hoping to find some answers.
President Obama is the young, newly graduated psychiatrist who has studied it all in a book and is doing his best to make it match reality - but it never does. The Senate is the staff - therapists, nurses and social workers who try to show the patients what they need to do to help themselves, but the advise never quite gels because what the patient reports when locked up is not exactly revealing of what is happening at home, or in the work place, or even deep in their soul no matter what is seen on the outside. And the House is the Patients Rights Group. They are trying to make sure the patients get their rights because they are convinced that all those who have complete access to all their rights will get the best outcome.
My Bedlam is not far fetched. In fact, it is just a clearer picture of what everyone is saying when they observe that our health care system is broken. It is broken in spirit, unable to function for social productivity, and on the verge of self destruction.
The House is trying to guarantee rights, which will not empower health care. The Senate is trying to force it to do what it needs to do, which won't happen. The President is trying to understand, diagnose and treat it, but he is not competent enough for the job. Change does not occur until it is self determined. The biggest secrets to fixing crisis are giving them time and space to fix themselves.
In general, more pressure equals more crisis, less pressure equals less crisis.
I see in the great health care reform bill the same treatment pathology that repeats itself over and over in psychiatric units across the country. The patient is able to avoid facing truth and responsibility because someone will believe in their suffering enough to argue that someone else should take responsibility. The patient goes forward looking for who it is that should be responsible and never figures out that they can actually do something themselves to make things different. The therapists in my little allegory are not healing anyone, they are trying to fix things as they think they should be, and that never works.
I liked the self-determined attitude of the people who were demonstrating in D.C. today against the health care bill. They wanted to figure it out and be left alone to make a difference for themselves. I'm pretty sure that is what being an American is about. It isn't easy, but in the long run, it is the only thing that produces success.
Regardless of the practice of mental health care, the end result in the unit can be very much the same. The bringing together of all the individuals who need specialized attention to tolerate structured society still creates a scene of uproar in many cases. As a nurse who has worked in mental health patient units for over thirty years, the uproar isn't always just the pathology of the patient, it is also very much the pathology of the treatment.
Just as doctors in the 1500's were unaware of many of the chemical and social pressures that caused things they called "lunacy," mental health treatment is often still a stab in the dark at offering answers for things that may not be understood for years, or possibly ever. The main goal of the mental health unit is to provide safety to the patient and to others from the patient until a higher level of stabilization can be reached. Just the fact that getting from unstable to stable is part of the goal of a locked unit indicates how much uproar is occurring.
When I got up this morning I wasn't sure what I was going to blog on today. The president has said that all that can be said has been said about health care, and I know I have enjoyed reading the well researched comments of others today more than I have enjoyed trying to puzzle out things that are 2,000 pages long.
So today's blog is going to be a little picture of bedlam. A little allegory of the treatment that is being performed on our health care and the uproar that that has caused.
Let's make the patients in the unit, not individuals with health care needs, but the different, individually operating parts of the health care system. We have the Bipolar drug companies who lavish money on doctors, research and ads in their high moments of great discoveries, and then become suicidal when they can not charge and keep "patents" or are pressed to offer drugs at prices people can afford rather than prices that cover their lavish expenses. We have the schizophrenic doctors who live in the multiple worlds of money, charity, urgency and necessary risk prevention. They still have traditional duties such as not to harm and to provide for the poor off of the capacities of the rich yet they are losing power to control their own actions so quickly, that much of their practice has become empty attempts at appeasement to demand rather than carefully studied exploration of need and treatment. We have the deeply depressed hospitals who have given and given and given, and tried to cooperate with laws, regulations and demand and still are being emptied of their capacity to serve. We have the sociopathic medical supply companies that suck money out of health care by keeping their wares at free market competitive levels with no thought that they are pricing health care through the sky. They are the new leaches that bleed the needy through money the way doctors did in the past with leaches. We have the obsessive-compulsive Medicare and Medicaid systems who demand that things be done exactly as they want them all the time, without fail, or fault, or variation which is of course impossible, but they have to keep believing it is possible. And last but not least, we have the self mutilating States, who are so confused about what is helpful and right to do, that they have started cutting themselves up hoping to find some answers.
President Obama is the young, newly graduated psychiatrist who has studied it all in a book and is doing his best to make it match reality - but it never does. The Senate is the staff - therapists, nurses and social workers who try to show the patients what they need to do to help themselves, but the advise never quite gels because what the patient reports when locked up is not exactly revealing of what is happening at home, or in the work place, or even deep in their soul no matter what is seen on the outside. And the House is the Patients Rights Group. They are trying to make sure the patients get their rights because they are convinced that all those who have complete access to all their rights will get the best outcome.
My Bedlam is not far fetched. In fact, it is just a clearer picture of what everyone is saying when they observe that our health care system is broken. It is broken in spirit, unable to function for social productivity, and on the verge of self destruction.
The House is trying to guarantee rights, which will not empower health care. The Senate is trying to force it to do what it needs to do, which won't happen. The President is trying to understand, diagnose and treat it, but he is not competent enough for the job. Change does not occur until it is self determined. The biggest secrets to fixing crisis are giving them time and space to fix themselves.
In general, more pressure equals more crisis, less pressure equals less crisis.
I see in the great health care reform bill the same treatment pathology that repeats itself over and over in psychiatric units across the country. The patient is able to avoid facing truth and responsibility because someone will believe in their suffering enough to argue that someone else should take responsibility. The patient goes forward looking for who it is that should be responsible and never figures out that they can actually do something themselves to make things different. The therapists in my little allegory are not healing anyone, they are trying to fix things as they think they should be, and that never works.
I liked the self-determined attitude of the people who were demonstrating in D.C. today against the health care bill. They wanted to figure it out and be left alone to make a difference for themselves. I'm pretty sure that is what being an American is about. It isn't easy, but in the long run, it is the only thing that produces success.
Tuesday, March 9, 2010
Religion: A Primary Force in Health
As the daughter of medical missionaries, I grew up with religion being a strong part of health and health care. I have worked in both government and religious health institutions and I admit that I always felt the most comfortable when the work of the institution was considered a service to God as well as to the people involved. This especially helped when caring for unappreciative people (as I often do in mental health) because God appreciates the work even if the receiver does not.
I was wonderfully reminded of the style of health ideals that I grew up with when I saw a new documentary this weekend called "The Adventists." This movie by Journey Films traces the history of The Seventh Day Adventist Church and their passion for health and wellness as a part of their religion that drives them to serve others also. Probably the most famous of their hospitals is the one at Loma Linda, California. The Adventists happen to be vegetarians, and I am not trying to say here that I believe we should all do as they do, but their model of passion about life for spiritual reasons is the big boom energizer of health that has become forgotten in the rush to find profitable markets to heal the sick.
I hear plenty of talk about changing our health care from an illness based system to a preventative and wellness based system, but I hear nothing of how to make people want to discipline their lives to be healthy. Certainly the government does not have this kind of motivational power; even the things they make illegal are abundantly used by citizens.
There are some individuals who have the self fortitude to discipline themselves for the sake of their own self esteem, or so that they can live longer with their children, or be an example for their children, but this percentage of our population is dwindling as we constantly increase the numbers of obese and morbidly obese people and children in our nation. Many of my generation were raised with health habits drilled into us by our mothers, but the sway of mothers over the diet of children is also a decreasing factor as mothers work and children fend for themselves with fast food.
The stunning theme that this documentary portrays is that passionate belief in something greater than ones self has been the motivation for healthy habits that have led to our great health care systems of today. I'm not Adventist, but I recognized the fervor and group discipline in them that I experienced in my own religious upbringing.
There is a telling little exchange in the movie "Mars Attacks" where a reformed prisoner who was a prize boxer talks about wanting to live cleanly instead of do a "job" for a wealthy loan shark. The boxer talks about getting in touch with Allah and giving up pork and finding out about peace in life. After this heart felt soliloquy the loan shark says "So you gave up pork?" Clearly the loan shark couldn't understand why someone would do anything that abandoned bacon and good chops, which made him oblivious to the spiritual strides also. But the point is possibly better made by the lack of understanding than a responding empathy. Those who reach the level of self control where they can make disciplined choices that end up improving their health and lives all together, do not fit into the world of risk, profit, gain and indulgence that drives a progressive economy. They become immune to the call to consume because they have their mind on something else.
There is an interesting observation in the documentary that people do not come into the discipline of healthy living until they fail or reach the bottom of their own attempt to live as they wish. Since I work in the mental health and substance abuse field, I am well aware that most treatment is wasted until the person really wants to change. This becomes a real conundrum when it comes to preventative medicine goals, because many people simply will not comply until they are ill and have no choice but to change.
When people who have come to illness through refusing to maintain wellness want health care, they want it to fix them while they continue to live their unhealthy life style. They want the pill or the treatment that will just put things back to where they were before their body wore out with their unhealthy habits. So they want to buy fixes, they don't want to learn changes. Here is where the role of religion and group dogma rescues people in a way consumerism medicine never can. Commitment to principles is inexpensive and self empowering. Consuming treatments costs money and creates dependency. The person who adds a passion for principled life to his or her health care considerations becomes free from illness and the system. The person who keeps trying to find some fix that will keep him or her from having to change becomes poor trying each new thing and dependant on the system to keep offering options other than change.
But submission to principle is no longer a significant factor of our society. At least, it is not expected anymore although it is sometimes admired when it is seen. And I pose the question again: Where will such truly healthy disciplines come from as religion declines in the country? The most ancient religious rules of our Judeo-Christian heritage had food and cleanliness guidelines. We now know that such things led to health among the people, but we have a governmental system that cannot dictate that. We have a governmental system that presumes that people will be self controlled for reasons other than government enforcement. When we were a widely religious nation, keeping our various food and life style restrictions, this worked. Since the current trend of bodily care has turned away from spiritual things and into a philosophy of self indulgence, we have big problems.
The Adventists documentary is a good picture of how things way outside the world of science and logic actually drive the benefits we have found in science and logic - in this case, specifically in health care. If we try to re-invent these benefits in health care without having the motivating factors, we will fail, like a house without a foundation.
My blog in general is dedicated to finding the lost spirit of health care in America. In this posting I have come, though the example of the documentary, as close as ever to showing that the health care crisis is in actuality a spiritual crisis and as such can only be fixed by spiritual means.
I was wonderfully reminded of the style of health ideals that I grew up with when I saw a new documentary this weekend called "The Adventists." This movie by Journey Films traces the history of The Seventh Day Adventist Church and their passion for health and wellness as a part of their religion that drives them to serve others also. Probably the most famous of their hospitals is the one at Loma Linda, California. The Adventists happen to be vegetarians, and I am not trying to say here that I believe we should all do as they do, but their model of passion about life for spiritual reasons is the big boom energizer of health that has become forgotten in the rush to find profitable markets to heal the sick.
I hear plenty of talk about changing our health care from an illness based system to a preventative and wellness based system, but I hear nothing of how to make people want to discipline their lives to be healthy. Certainly the government does not have this kind of motivational power; even the things they make illegal are abundantly used by citizens.
There are some individuals who have the self fortitude to discipline themselves for the sake of their own self esteem, or so that they can live longer with their children, or be an example for their children, but this percentage of our population is dwindling as we constantly increase the numbers of obese and morbidly obese people and children in our nation. Many of my generation were raised with health habits drilled into us by our mothers, but the sway of mothers over the diet of children is also a decreasing factor as mothers work and children fend for themselves with fast food.
The stunning theme that this documentary portrays is that passionate belief in something greater than ones self has been the motivation for healthy habits that have led to our great health care systems of today. I'm not Adventist, but I recognized the fervor and group discipline in them that I experienced in my own religious upbringing.
There is a telling little exchange in the movie "Mars Attacks" where a reformed prisoner who was a prize boxer talks about wanting to live cleanly instead of do a "job" for a wealthy loan shark. The boxer talks about getting in touch with Allah and giving up pork and finding out about peace in life. After this heart felt soliloquy the loan shark says "So you gave up pork?" Clearly the loan shark couldn't understand why someone would do anything that abandoned bacon and good chops, which made him oblivious to the spiritual strides also. But the point is possibly better made by the lack of understanding than a responding empathy. Those who reach the level of self control where they can make disciplined choices that end up improving their health and lives all together, do not fit into the world of risk, profit, gain and indulgence that drives a progressive economy. They become immune to the call to consume because they have their mind on something else.
There is an interesting observation in the documentary that people do not come into the discipline of healthy living until they fail or reach the bottom of their own attempt to live as they wish. Since I work in the mental health and substance abuse field, I am well aware that most treatment is wasted until the person really wants to change. This becomes a real conundrum when it comes to preventative medicine goals, because many people simply will not comply until they are ill and have no choice but to change.
When people who have come to illness through refusing to maintain wellness want health care, they want it to fix them while they continue to live their unhealthy life style. They want the pill or the treatment that will just put things back to where they were before their body wore out with their unhealthy habits. So they want to buy fixes, they don't want to learn changes. Here is where the role of religion and group dogma rescues people in a way consumerism medicine never can. Commitment to principles is inexpensive and self empowering. Consuming treatments costs money and creates dependency. The person who adds a passion for principled life to his or her health care considerations becomes free from illness and the system. The person who keeps trying to find some fix that will keep him or her from having to change becomes poor trying each new thing and dependant on the system to keep offering options other than change.
But submission to principle is no longer a significant factor of our society. At least, it is not expected anymore although it is sometimes admired when it is seen. And I pose the question again: Where will such truly healthy disciplines come from as religion declines in the country? The most ancient religious rules of our Judeo-Christian heritage had food and cleanliness guidelines. We now know that such things led to health among the people, but we have a governmental system that cannot dictate that. We have a governmental system that presumes that people will be self controlled for reasons other than government enforcement. When we were a widely religious nation, keeping our various food and life style restrictions, this worked. Since the current trend of bodily care has turned away from spiritual things and into a philosophy of self indulgence, we have big problems.
The Adventists documentary is a good picture of how things way outside the world of science and logic actually drive the benefits we have found in science and logic - in this case, specifically in health care. If we try to re-invent these benefits in health care without having the motivating factors, we will fail, like a house without a foundation.
My blog in general is dedicated to finding the lost spirit of health care in America. In this posting I have come, though the example of the documentary, as close as ever to showing that the health care crisis is in actuality a spiritual crisis and as such can only be fixed by spiritual means.
Tuesday, March 2, 2010
How Capitalism provides for Social Needs
When I review the health care plan that was presented in Feb 2010: something I am in the process of doing; I will be judging it according to some very strict expectations about what is real and productive and what is not.
For example, It is real and productive to allow big tax breaks for people who contribute to non-profit hospitals such as The Shriner's to provide free care to very needy groups of health care consumers who could never afford the thing they need.
It is not real and productive to make promises that every single health gripe that anyone has will be immediately covered by the best possible care. There is not enough money or love in the world to provide that unless it is God's love. But in general, we are not allowed to count on the healing power of God for the poor or disenfranchised as an option for health care in The USA; so we must deal with lack of resources in spite of the fact that no one wants to come out and say who it is who will be on the short end of the lack of resources.
We have started thinking about health care like it is a right (noted in the 1963 article of my last blog) and since it is a right, whether or not one can pay is not to be considered. Instead, the problem is approached emphasising the need and assuming the resources for it will be provided. This is not practical. One of the major problems in health care is that it is not really a productive market upon which to exercise the economic principals of capitalism. Health care ultimately requires a contributor. Private ownership was the first contributor, charity was the second contributor, local government was the third, insurance plans were the fourth, and federal government plans were the fifth. When private ownership and charity were the economic force no speculation was involved, and services were limited to whatever was provided at the will of the provider. When insurance and local governments were involved speculation began to influence the factors of provision and services became a tug of war between expectations and resources. When the federal government became the provider it was PURPOSEFULLY set up to get more service than market price would provide and services were expected to be provided regardless of the will of the provider for recompense. Our own government defied the rules of our capitalistic system when they declared that Medicare and Medicaid would not expect to cover costs. They created a dysfunctional support that is now falling apart. Of course they did this because they were trying to address a social need. They were not saying that all health care should be given regardless of cost, they were trying to boost the cause of the disenfranchised by guaranteeing some money to those who cared for them. But breaking the rules is still breaking the rules. Doing a non-capitalistic exercise in the face of a very capitalistic system has simply made health care the dog of the day for the fleas to suck blood out of. The art of capitalism has inflicted the financial pain that health care is in because there was a source of money that was not subject to the restrictions of the market, and it attracted exploiters. Every exploiter had a good motive - look at what great gizmos and guarantees we have in our health care - but their good intentions have still paved the way to our health care hell.
So what is the proper way to handle social needs inside capitalism? The answer is non-profits. There has to be a way for people to block themselves from the ruthless realities of capitalism to have a sheltered way to manage their money for social need. And these non-profits have to have the right to govern themselves and choose the risks and coverage that they as a group want to take. In the old days we called such an organization a hospital, usually a religious hospital, that had a large doner base and people committed to the cause who productively managed the resources at hand and did not have to answer to anyone other than their own private management. Of course the advent of extreme insurance claims has broken down the barriers between non-profit right to control and public market, but that is a subject for a different day.
I am personally the third generation of people who ran and started such hospitals all around the world. These mission hospitals were started when national efforts of fund raising by churches provided the resources to set them up. But I can see clearly that such strong networks of related peoples do not exist anymore, and the social bases that supported these social institutions are just not there.
So how do we keep the economic structures pure and find the social support to run something that is not run by the government? Well, I think the Senator for North Dakota is on the right track.
The following is an excerpt from Senator Kent Conrad's website (Just Google it if you want to read it, I'm an old lady and don't have the URL handy)
Kent Conrad Promotes Co-op plans for health care reform:
"How would this be better than a government-run public plan option? The co-op plan aims to achieve the same benefits for consumers as a public option without government control of health insurance. It does so by creating private, consumer-driven, non-profit health plans. Because these plans will be owned by their members, they will focus on getting the best value for consumers, rather than maximizing plan revenues or profits. In addition, since the federal government would not be backing the cooperatives, there is no government liability or support beyond the seed money. Finally, the co-op plan uses the tools of the marketplace to address the health care reform principles of choice, quality and cost. "
I recognize this pattern. The government becomes the "church" that sets up the co-op, so in a way it is the contributor, but once the institution is set up, it is supposed to become self-sufficient - the goal of any good mission institution- and the government no longer has a fiscal responsibility for it and as such cannot dictate what will happen. The will of the group is the dictator of what will happen. Does this mean some inequality in health care will exist and some people will not have the resources? Yes. But the philosophy of capitalism is that when the rules are kept, human nature provides the best distribution of resources through capitalism because everyone has an ability to affect the outcome as opposed to faulty judgement of a few for the others. And one of the rules is that social need money must be protected from market money by non-profit status.
The Senator's co-ops will return us to the very productive pattern of health care where the provider decides what will be provided. If you want a good service, it is best to give the service provider control.
For example, It is real and productive to allow big tax breaks for people who contribute to non-profit hospitals such as The Shriner's to provide free care to very needy groups of health care consumers who could never afford the thing they need.
It is not real and productive to make promises that every single health gripe that anyone has will be immediately covered by the best possible care. There is not enough money or love in the world to provide that unless it is God's love. But in general, we are not allowed to count on the healing power of God for the poor or disenfranchised as an option for health care in The USA; so we must deal with lack of resources in spite of the fact that no one wants to come out and say who it is who will be on the short end of the lack of resources.
We have started thinking about health care like it is a right (noted in the 1963 article of my last blog) and since it is a right, whether or not one can pay is not to be considered. Instead, the problem is approached emphasising the need and assuming the resources for it will be provided. This is not practical. One of the major problems in health care is that it is not really a productive market upon which to exercise the economic principals of capitalism. Health care ultimately requires a contributor. Private ownership was the first contributor, charity was the second contributor, local government was the third, insurance plans were the fourth, and federal government plans were the fifth. When private ownership and charity were the economic force no speculation was involved, and services were limited to whatever was provided at the will of the provider. When insurance and local governments were involved speculation began to influence the factors of provision and services became a tug of war between expectations and resources. When the federal government became the provider it was PURPOSEFULLY set up to get more service than market price would provide and services were expected to be provided regardless of the will of the provider for recompense. Our own government defied the rules of our capitalistic system when they declared that Medicare and Medicaid would not expect to cover costs. They created a dysfunctional support that is now falling apart. Of course they did this because they were trying to address a social need. They were not saying that all health care should be given regardless of cost, they were trying to boost the cause of the disenfranchised by guaranteeing some money to those who cared for them. But breaking the rules is still breaking the rules. Doing a non-capitalistic exercise in the face of a very capitalistic system has simply made health care the dog of the day for the fleas to suck blood out of. The art of capitalism has inflicted the financial pain that health care is in because there was a source of money that was not subject to the restrictions of the market, and it attracted exploiters. Every exploiter had a good motive - look at what great gizmos and guarantees we have in our health care - but their good intentions have still paved the way to our health care hell.
So what is the proper way to handle social needs inside capitalism? The answer is non-profits. There has to be a way for people to block themselves from the ruthless realities of capitalism to have a sheltered way to manage their money for social need. And these non-profits have to have the right to govern themselves and choose the risks and coverage that they as a group want to take. In the old days we called such an organization a hospital, usually a religious hospital, that had a large doner base and people committed to the cause who productively managed the resources at hand and did not have to answer to anyone other than their own private management. Of course the advent of extreme insurance claims has broken down the barriers between non-profit right to control and public market, but that is a subject for a different day.
I am personally the third generation of people who ran and started such hospitals all around the world. These mission hospitals were started when national efforts of fund raising by churches provided the resources to set them up. But I can see clearly that such strong networks of related peoples do not exist anymore, and the social bases that supported these social institutions are just not there.
So how do we keep the economic structures pure and find the social support to run something that is not run by the government? Well, I think the Senator for North Dakota is on the right track.
The following is an excerpt from Senator Kent Conrad's website (Just Google it if you want to read it, I'm an old lady and don't have the URL handy)
Kent Conrad Promotes Co-op plans for health care reform:
"How would this be better than a government-run public plan option? The co-op plan aims to achieve the same benefits for consumers as a public option without government control of health insurance. It does so by creating private, consumer-driven, non-profit health plans. Because these plans will be owned by their members, they will focus on getting the best value for consumers, rather than maximizing plan revenues or profits. In addition, since the federal government would not be backing the cooperatives, there is no government liability or support beyond the seed money. Finally, the co-op plan uses the tools of the marketplace to address the health care reform principles of choice, quality and cost. "
I recognize this pattern. The government becomes the "church" that sets up the co-op, so in a way it is the contributor, but once the institution is set up, it is supposed to become self-sufficient - the goal of any good mission institution- and the government no longer has a fiscal responsibility for it and as such cannot dictate what will happen. The will of the group is the dictator of what will happen. Does this mean some inequality in health care will exist and some people will not have the resources? Yes. But the philosophy of capitalism is that when the rules are kept, human nature provides the best distribution of resources through capitalism because everyone has an ability to affect the outcome as opposed to faulty judgement of a few for the others. And one of the rules is that social need money must be protected from market money by non-profit status.
The Senator's co-ops will return us to the very productive pattern of health care where the provider decides what will be provided. If you want a good service, it is best to give the service provider control.
Subscribe to:
Posts (Atom)