Last month I wrote several letters to my local newspapers calling for health care reform (safe and affordable). I hit a roadblocks of misunderstanding and confusion when talking to my local lawmakers. The inconvenient truth is America has a supply side economy and supply side health care system. People don't want fix it.
Classical economic theory says things are independent matters that don’t lose value as they are divided, resources are infinite and the future is perfectly predictable. Nothing could be further from the truth. The world is full of interdependent relationships. Small incremental changes can lessen the value of badly needed systemic change, system failures happen and scare resources don’t last forever. We are not perfect but we have an obligation to do our best. We are not.
The Four I’s: the opposite of neoclassical economic theory
Interdependence – value of A depends on B.
Indivisibility- incremental change can lessen the value of action.
Irreversibility- things are not reversible without adding to cost the original action
Imperfect Foresight- we can’t foresee everything.
The problem with Bush and Congress is they apply neoclassical economic theory to almost everything. Money drives politics and it is how our health care system and Iraq got to be such a mess. No idea has ever caused so humanity so much grief as the neoclassical economic paradigm run amok. I would like to remind the laissez bon temps rollez thinkers out there before they post here: Communism was idealistic response to capitalism’s failures. Not a good debate with me. Capitalism works best when you use common sense, competion of ideas (not power) and compassion to balance things out.
Capitalism is a great system for wealth creation and improving lives but it prone to spectacular failures.
We have not been doing our best to improve the lives of fellow citizens. We have been taking the path of the least resistance on health care reform and making molehills into mountains as the systemic inequities increase the cost to society and ourselves. The system kills at random without fault or reason. Diseases exploit inequity in populations. We need to honest with ourselves and each other in we are going have any hope of change.
When you apply the Four I’s to our health care system you see how our supply side medicine goes against basic principles of epidemiology, how good health education and public health promotion programs undermine America’s laissez bon temps rollez economy. What would happen if changed our diet to include less starch, sugar and trans fat? Would we have a recession? I am certain will have one if we don't change. Do we really need more patient turnover in the nation's ERs and doctor's offices and does greater technology to make medicine better or jus more expensive?
What about prevention? Prevention saves money but provides no profit. Our ills however grease the wheels of our health economy.
I caused my State Senator Robert Dvorsky and State Representative Dave Jacoby much grief by writing letters to the editor in my local newspaper asking to them to make Iowa medicine to be safer, more affordable, health care and health information more accessible. Jacoby and Dvorsky don’t see it as their job to push reform (see Indivisibility) or don’t understand what I what. They want the medical system to reform itself. Dr. and Senator Bill Frist said in the NEMJ is take 17 years for our medical system to change paradigms. http://content.nejm.org/...
I want real reform before 2012.
The UIHC has enormous power and has a real good immunity to change. But I ask "What better place for change than the world’s largest teaching hospital?"
We have waited fifty years too long for a safe and affordable health care system. I have gotten cool receptions from my local politicians on health care issues like Metabolic Syndrome. Help me hep them understand how bad this could be. Please feel free to e-mail the Iowa Governor Culver, State of Iowa Legislative leaders and my local politicans:
The Iowa Senate
Joe Bolkcom (D) joe.bolkcom@legis.state.ia.us
Robert Dvorsky (D) robert.dvorsky@legis.state.ia.us
Mike Gronstal (D) michael.gronstal@legis.state.ia.us
John "Jack" Kibby (D) john.kibbie@legis.state.ia.us
Mary Lundby (R) mary.lundby@legis.state.ia.us
Dave Johnson (R) david.johnson@legis.state.ia.us
The Iowa House
David Jacoby (D) David.Jacoby@legis.state.ia.us
Mary Mascher (D) Mary.Mascher@legis.state.ia.us
Vicki Lensing (D) Vicki.Lensing@legis.state.ia.us
Swati Dandekar (D) Swati.Dandekar@legis.state.ia.us
House Speaker Pat Murphy (D) Pat.Murphy@legis.state.ia.us
Majority Leader Kevin McCarthy (D) Kevin.McCarthy@legis.state.ia.us
Jeff Kaufmann (R) Jeff.Kaufmann@legis.state.ia.us
Chuck Gipp (R) Chuck.Gipp@legis.state.ia.us
David Heaton (R)Dave.Heaton@legis.state.ia.us
I am frustrated. Some of the problems and solutions I point out never get a response. It could be my fault for not being clearer. I until I get action or answers I have no choice but to be a political pyromaniac and light fires on some politician’s foot.
Problem 1: Methicillin resistant Staphylococcus aureus makes up to 20 to 25% of unnecessary post-operative costs and should be largely preventable but hospitals won’t coordinate, communicate and cooperate to reduce in MRSA because giving rival hospitals infection rate records is bad for business. My answer is to make MRSA infections a mandatory state reportable disease. It is good epidemiology and only fair to patients and the community to stop MRSA from getting into care centers. Maybe have double blind the state databases where only a team of state epidemiologists look into infections.
Problem 2: Patient education needs to better, population based and not the pay for play matter it currently is. I ask people (especially my state legislators) if they know about metabolic syndrome and they have no clue. If we are to have any hope in preventing a wave of new diabetics we have to learn and act fast. See Article 27 of the UN Declaration of Human Rights.
Problem 3: Patient and medical information needs to more portable. I should be able to have my medical records on a swipe card or flash drive and carry it with me.
Problem 4: Crisis teams should be available to deal with system errors and answer family question and concerns. Medical errors kill more than car accidents. Reducing this number is a human rights imperative.
Any other ideas please post them.