The “historic health care reform” is NOT health care ‘reform.’ It is no more ‘health care reform’ than it is a replacement for cheap energy, a reversal of the decline of marine resources or a filter for polluted ground water. It is not a cure for the loss of biodiversity, continuing trade deficits, religious bigotry, state terrorism, climate change, dysfunctional settlement patterns or other serious problems too numerous to mention.
The health care ‘reform’ does not change health care research, it does not change health care education and is does not change health care economics beyond some patches, fixes – and new problems – related to how and by whom health care insurance is paid and how the benefits are distributed.
There will be some ripple effect but “health care reform” did not change the delivery of health care at the Regional scale (disaster response / shock and trauma / rare occurrences), it did not change health care delivery at the Community scales (birth to death health care) and it did nothing to improve the health care delivery at the Household scale.
Health care, like the other pressing problems facing humans, has been allowed to fester. It has been papered over because humans at the top of the Ziggurat had (PAST tense) resources to ignore or take ineffective faints at the problems – often involving throwing money at them.
As noted in prior posts by EMR, a healthy health care system will require:
Fundamental Transformation of human settlement pattern,
Fundamental Transformation of the governance structure, and
Fundamental Transformation of the economic system.
Do you want a good summary of how the later two Fundamental Transformations relate? Check out the WaPo Business Section feature for 21 March: “When Profit Outweighs Penalties.”
The three Fundamental Transformations will lead to profound shift in Consumption Patterns. However, something else is needed:
A NEW METRIC FOR CITIZEN WELL BEING – PART FIVE of TRILO-G.
What is a health related “new metric?”
Personal and Household responsibility for ones own health and the health of those in the Household.
This new metric must be backed up by a fair allocation of the costs to those who choose to ignore health risks and run up large costs – smokers, stimulant and electronic communication abusers, overeaters and the sleep and exercise deprived, ARE YOU LISTENING?
Why the focus on individual responsibility? The idea that a ‘doctor’ can ‘manage’ ones health is a tragic Myth akin to those that drive dysfunctional human settlement patterns. One of the responsibilities of being an educated citizen in contemporary society is taking personal responsibility.
Those who devote the time and effort to becoming a health care professional must be fairly compensated. The idea that everyone can afford a doctor to manage their health is a preposterous as the idea that everyone can afford a Single Household Dwelling on a five acre lot or that any Agency (or all levels of Agencies together) can afford a Mobility and Access system which allows everyone to take a vehicle trip where ever they want, when ever they want. For those who have been paying attention, that is especially true for Large, Private Vehicles.
What would a new health care delivery system look like?
In December of 1979 EMR published an essay titled “Ideas for the 80s.” One of the ideas was Telework – which by that time was already an ‘old’ idea but Telework was not yet on the screen of most. There were nine other ideas including a new Regional and Community health care delivery system that would be responsible for providing recreation and exercise facilities and activities as well as delivering health care at the Cluster, Neighborhood, Village, Community and Regional scales. There is need for research, standards, coordination and emergency response at the MegaRegional, Continental and Global scales but health care is PRIMARILY a Regional issue.
Essays such as “Ideas for the 80s” will be among the resources available on EMRs new website, coming soon.
EMR