The purge continues of my drafts. I started this in March of 2023 right as I was prepping for my first colonoscopy. Healthcare and health insurance companies has become the news headline of the past two weeks ever since a health care company CEO was gunned down in New York City.
Timing on this one is less than perfect since the alleged NYC United Healthcare CEO assassin was just captured in Altoona in the past few days.
In 1993 Bill Clinton was the President and had appointed the First Lady to look into fixing the nations health care crisis. The discussion at that time was around a single payer system for all and a nationalized healthcare program like the United Kingdom or Canada. To no one’s surprise that did not happen. There was much resistance to this idea from those on the inside of the health care industry— doctors, hospitals, pharmacists, insurers, nursing homes, lobbyists, politicians. Since then we have moved into a world with mega-hospital networks acquiring community based non-profit hospital systems. Doctors being assigned networks that are regional instead of just one part of a town. Physicians Assistants being asked to take on the responsibilities that doctors once managed so the care can be spread out over a much larger geographic region. Hospital systems and insurers have even united in an effort to “contain costs” and provide their own private version of socialized medicine.
Thirty years later the story sounds very much the same and as the son of an octogenarian the service issues are the same as when my grandparents were octogenarians. F U old mother Regan. By the way the Violent Femmes are now doing a special with the Milwaukee Symphony so at least culturally we have evolved.
What is health care? How do we create healthy communities? Do our neighborhoods impact our well care?
Have we designed communities for keeping people healthy or did our post WWII baby-boom communities lead to our health issues?
As I get older and start needing more recommended preventative screenings to reduce more expensive problems down the road, I had a really nice first hand view of how procedure specialization and operational efficiency work in the Commonwealth of Pennsylvania.
Why is healthcare so expensive in America?
Should healthcare be treated as a privilege or be a universal right?
How did the United States come to the idea that employer based healthcare was the way to go? What made us even think about creating a Medicare system? Why is Medicaid a state run program? Why do we have so many advertisements on TV, newspapers, magazines and internet for prescription drugs? Do you know what the FDA does? Do you know the difference between a nutritional supplement and a drug?
Was covid-19 a stress test for our health care systems or just business as usual? Do you believe that we need to design a system that provides incentives for designing we’ll communities where people can live and age in their own community where activities and connections are encouraged with farmers markets and community centers for all ages?can we design these communities in a for profit health care system?
Let me know your thoughts or your challenges.
Sometimes the 2nd opinions are good things. I learned a long time ago that surgeons- know how to heal by being cutters and carpenters. There are times that is the best answer. 20 plus years after my first ACL reconstruction, I’m grateful I made that decision to be cut and stabilized. I’ve had to pivot over the past year to manage my body so it can perform at its peak level while delaying the inevitable next level cut and joint replacement that I will eventually need. The key is making sure nothing else fails due to modifications in gait or function due to the modifications.