Health Plan Axioms
Posted Jul 18, 2009
Last Updated Jul 18, 2009
Health Plan Axioms
July 18, 2009
This was first drafted as a reply to an email. It is now somewhat modified.
Hi, Frank et al. Except for Mike, I doubt any of you know me. My connection with Mike is through his Uncle Leo, a 1949 shipmate of mine. We struck the steamer John W. Davin, tied her up, then rode the Greyhound to Upper Michigan, to help Sulo load out his summer's cut of aspen pulpwood.
Frank, regarding health care reform, as a doctor, your knowledge is informed by experience as a provider, mine by experience as a patient and a family member. But the difference goes beyond that, to a probable difference in our "wiring" so to speak.
So I'm replying to point out there are innumerable ways to look at and respond to the overall needs. That neither of us knows "the right way," and neither does anyone else.
In fact, I experience things differently at age 82 than I did at 62, 42, 22. And in actual fact, things *are* different.
Re: "we have the best medical system in the world." We have way the most expensive and perhaps most inefficient system in the world. I've explored the statistics on this on my blog site www.johndalmas.com in the entries of 11/11/2008; 10/27/2007
Regarding government involvement, and Medicare –– there are a lot of us out here who deeply appreciate Medicare despite its shortcomings. Regarding bureaucracy: consider the meaning of the word. There are bureaucracies and there are bureaucracies. There are corporate bureaucracies, academic bureaucracies, research bureaucracies, military bureaucracies, and government bureaucracies... They grow out of the need to organize complex tasks to make them more doable –– and attain whatever goals their designers may have for them. Think about that one: to "attain whatever goals their designers may have for them."
Four years ago, at my son's behest, I moved from Spokane WA to central OH –– and the umbrella bureaucracy known as Blue Cross screwed me up thoroughly, then seemed totally unable to analyze the problem. Leaving me uncovered after nearly 30 years *while still withdrawing my monthly premium.* It was no skin off their rear –– they were getting their monthly dip into my bank account –– until I ferreted out the missing connection. Then they promptly fixed it.
Glitches happen. Our systems don't –– can't –– fit the real world perfectly. There ain't no perfect. That's important to know.
We'll (the rhetorical "We," the people through its variously assigned representatives) -- We will get some kind of new health care system out of this, and then have to fix it. And fix it again. But whatever bureaucracies are involved won't be able to do the job by themselves. Because the American people are a major part of the system. And too many of us want the world to magically make everything right. As employers, families, care-givers, investors, manufacturers...whatever, we want the system to suit our personal and corporate needs *and preferences* –– and it ain't gonna do it. (1) It's not doable, and (2) anyway the world keeps changing on us. Fixing it is a never-ending job. It goes with living in The Real World.
What we're driving now is a real clunker. The world changes, and even a theoretical system needs to change with it. So we'll change the system, and new faults and old residual faults will show up, and we'll try to repair them. And they'll repair a lot more effectively if we're not too fixated, too fond of our old opinions, old political prejudices, and new enthusiasms.
What most needs to change is US. We tend to have fixed ideas of what is all right, what we're owed, what God's preferences are etc. God's preferences? What we have are personal opinions. And fears. "I don't want discomfort!" "I wanna live forever!" "I don't want it to threaten my desired sun belt retirement." And so on. Those are understandable preferences, but at best we only get some of them.
There is something to be said for Realism, keeping in mind that some of –– actually a lot of –– what we take as Reality is Supposition! And that layers of suppositions overlay the real reality, whatever that is, so we humans need to work at it the best we can. Not demanding too much, not belly-aching more than we can avoid, treating others as respectfully as we know how, and taking Responsibility. That's what Frank is undertaking to do, and what I'm working on here. It's part of our contract as tenants of the Universe.
Meanwhile how much can we expect to accomplish? I'll turn 83 this summer (2009). I've done all kinds of things, and generally enjoyed them (though hardly any of it turned out as intended). My sweetheart died a couple years ago, looking beautiful, purified, calm. For me, I'm on an oxygen feed, which is a nuisance but keeps me functional (thank you, Medicare). I did pretty well in genetic roulette (thanks, mom and dad). I have a loving family and I have friends and neighbors –– all over the world (thanks to email). Thanks to you guys, too. Come to think of it, thanks to all of us. Even the most cussed have some piece of the truth. (Well, there are a couple I'm not too sure about, but they don't need me rattling their cages.)
One of these days I'll die of something, and (I suspect) having died will review this life, then return as someone else, someone new, not remembering the details of past lives. Return to whatever messes and blessings we together make in or of the world. (If we make a mess of it, we get to live in it. Now there's a thought!) And always and forever learning.
Or not, as the case may be; don't ask me to prove it.
John Dalmas
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