Coming Attractions? The Nationalization of Healthcare without Single Payer

Here’s one scenario for the future of U.S. healthcare:

  • A national U.S. physician license to practice
  • A national private health insurance market; State regulation overridden
  • Worker access to the Federal Employee Health Plan
  • National Medicare and Medicaid programs; States are out
  • A combined Veterans and active military health care program
  • A national medical technology assessment and medical standards board
  • A national information technology systems to connect it all
  • A national voucher system and tax credits to finance it all
  • Washington, DC becomes the healthcare epicenter

I don’t like it much - primarily because it removes local input and control from healthcare — but a lot of what could make this scenario a reality is already on the ground or politically and administratively feasible. May be just a matter of time.

WHCB: China’s Doctors Continue to Experience Patient Violence

I’ve written before on the growing concern over violence between patients and medical workers in China. Now Xinhua, China’s official news agency, reports on the results of a new survey of doctors co-sponsored by the China Youth Daily and Dingxiangyuan, a Chinese online medical forum. The press analysis of this study — some cautioned may be warranted here — includes some disturbing findings.

See my entire post over at the World Health Care Blog

On the Constancy of Becoming

The older you are, the more the question “what are you becoming?” often morphs into the question “what have you become?” Something moves our vision from prospective to retrospective, as though at some point in one’s life, the future is expected to stop and the past take over. Is ‘becoming’ a cumulative process, a mathematical phenomenon with finite biological or spiritual limits, a bell curve of life, so to speak, that predictably rises and falls as the years add on?

People speak of ‘becoming more’ or ‘becoming less’, for example. Becoming ‘more’ is seemingly in tune with growth, enlightenment, Samadhi. Becoming ‘less’, on the other hand, feels entropic, a “decline into disorder,” not filing one’s potential, a failure to launch.

But — and this is popular notion — there is also a sense where ‘less’ is ‘more’ even when it comes to, well, ‘becoming’. To become ‘less’ is to throw off the unnecessary psychic baggage that burdens us, to discover our essential selves, and be One with whatever there is out to be one with: god, nature, sentient beings, your roots, your family, your planet or your cosmos. Take your pick. It appears that the One has a lot to choose from.

‘Becoming’ is also both something that can happen to us, and that we can make happen. In any case, it does not come easy. Struggle we must to become anything. Anything of value that is. And ‘becoming’ usually takes the form of a narrative, a story of a journey. To ‘become’ is usually to ‘overcome’. Things happen. We persevere. We learn. We change. The world changes. And there we are. Somebody new, even to ourselves.

Since stories have endings, maybe here is where the ‘becoming’ takes its cue to find an end point, a destination that sits on something stable, permanent, historical. But that really is not possible. Whatever one thinks about ‘becoming’, there seems to be a constancy about it no matter what direction it’s heading. We just can’t stop it. It’s a never ending challenge that is always calling out to us; “Come on” it says, “let’s get going. What’s your problem?” We can’t even give up! ‘Becoming’ is just relentless.

‘Becoming’ has no mercy. It strikes us even after we’re gone. We say “history will be the judge of that!” The problem is, history never stops judging. ‘Becoming’ continues to unfold in the memories of others even when one passes on; A legacy that shifts and changes as history ceaselessly re-frames the question of what’s important.

So, I say don’t fight it, go with the flow since it’s going to sweep us up anyway. The question is, what’s going to be our role, our bit part here. How do we become what we want to become? How do we indeed.

WHCB: China May Reveal Healthcare Reform Plan Soon

The Economist reports that the “long-awaited and much-debated reform plan is likely to be revealed at the annual session of China’s parliament, which opens on March 5th.” The report speculates on a stronger role for government and more money from the central budget.

See my entire post over at the World Health Care Blog.

WHCB: PHR Privacy Concerns: New World Privacy Forum Report

Robert Gellman, a privacy and information policy consultant based in Washington, D.C., has prepared a report for the The World Privacy Forum — a non-profit public interest research and consumer education group — on why personal health records (PHRs) could threaten privacy.

See my complete post over at the World Health Care Blog.

Hawaii is in Love with Obama

By overwhelming numbers, with an over 3 to 1 margin, Hawaii Democrats embraced Obama yesterday in caucuses across the state as their choice for President. Despite the confusion, lack of ballots, long lines and hours of frustration, the desire to support “Barry” (his Hawaii Punahou high school name) was too strong and could not be denied. All of this in the face of significant support of Clinton by Hawaii’s beloved and long time political leader, Senator Dan Inouye and many of Hawaii’s strong unions.

As Obama’s “home state”, national pundits figured correctly that Hawaii would line up behind him. But here on the ground in Honolulu, all was not too clear about what would happen. That anxiety — that indifference may lead to a Clinton victory — probably fueled the extraordinary caucus turnout for Obama. In any event, the arcane and indecipherable caucus system was simply flattened by the rush. One big winner riding on the Obama victory was Congressman Neil Abercrombie a highly visible and vocal supporter of Obama.

All, in all, it was an amazing day, one that could change the political landscape not only in Washington, but in the islands as well.

China’s Netizens Getting Riled Up

From Howard W. French at NYT

In recent months, China’s censors have tightened controls over the Internet, often blacking out sites that had no discernible political content. In the process, they have fostered a backlash, as many people who previously had little interest in politics have become active in resisting the controls.

And all of it comes at a time of increasing risk for those who choose to protest. Human rights advocates say the government has been broadening its crackdown on any signs of dissent as the Olympic Games in Beijing draw near.

Don’t Pimp My Health Care . . . Just Let Me See Under the Hood

Futurist Ian Morrison writes:

The prevailing vision of quality in American healthcare is “Pimp My Ride”. We take a really bad chassis and engine and bolt on unbelievable amounts of high technology on a frame that is tired, old and ineffective. We spend extravagantly on buildings, machines, drugs, devices, and people at West Coast Custom Healthcare. The people who own the rides are very grateful because they don’t have to pay for it in a high deductible catastrophic coverage world, once you are over your deductible and ensconced in an American hospital the sky’s the limit. It all looks great, has a fantastic sound system, and nice seats but it will break down if you try and drive it anywhere.

It seems to me that when we lose sight of health outcomes, many of us in the healthcare industry are in the unfortunate position of being accused of marketing a rather tawdry product. But since it’s so hard for the public to see what’s behind the curtain or under the medical hood, it is easy to understand why we settle for slogans and corporate conspiracies to explain problems — both of which do a tremendous injustice to providing insight into the reality of the healthcare system. It’s all about transparency and value. We still don’t get it.

The Dust Storms of China: ‘Reign of Sand’ Media Project

From the China Digital Times:

“A compelling multimedia project from Circle of Blue reports on the freshwater crisis in Inner Mongolia, where desertification threatens not only its startlingly beautiful steppes, but its nomadic residents’ way of life.”

WHCB: Google’s “Hybrid Philanthropy” to Promote Global Health

Larry Brilliant writes in Slate about Google’s work to come to terms with the direction of its philanthropic giving. Google.org, the relatively new face of this effort, will be funded with 1 percent of Google’s equity and profits in some form, as well as employee time — thus its ‘hybrid’ nature. Brilliant says Google asked three broad questions: 1) Where can Google work to help the poorest and weakest of the world? 2) Is it a big enough idea? and 3) Did Google have particular expertise for each potential project? Five initiatives were decided upon all with strong health implications.

See my entire post over at the World Health Care Blog.