Thursday, September 4, 2008

Thoughts on Health

I've been reading some good articles lately about health care, an issue about which I'm passionate. Here is a good one from NY Times columnist Paul Krugman. Krugman asserts that overall, Republicans don't see health care as an issue for most Americans. Here are some comments from his article:

Despite attempts to feign sympathy, the leaders of today’s G.O.P. fundamentally feel that Americans complaining about their economic and health care difficulties are, well, just a bunch of whiners. It’s true that elected Democrats are often too cautious — and too beholden to major donors — to be as progressive as the party’s activists would like. But even in the face of a Republican Congress, Mr. Clinton succeeded in pushing forward policies, like the State Children’s Health Insurance Program, that did a lot to help working families.
And what one sees on the other side is a total lack of empathy for and understanding of the problems working Americans face. Mr. Clinton, famously, felt our pain. Republicans, manifestly, don’t. And it’s hard to fix a problem if you don’t even think it exists.

I feel so strongly that in a country as rich as America, it is unconscionable for anyone to be without basic health care coverage. But I also know that health care isn't cheap, and I don't know if I think the government should operate health care systems. What I do know is that we are a sick country, and that health is more than just putting a band-aid on a wound.

This article in the local alternative paper provides, well, an alternative view on health care. It discusses the work and beliefs of a local physician who suggests that we take a more holistic view (and he had me at 'holistic'). He suggests that it's time to take a community-focused approach, considering environment, the media, urban development, location and proximity of open air/parks/grocery stores/etc., and how treatment of an individual affects others. Here are some thoughts:

If our primary approach is to try to fix [a health problem] after the fact through medical intervention, we can't afford to do that anymore. It's getting too expensive. It's too resource-intensive.

Is it [doctors'] main job to be effective deliverers of health-care services, or is our role to actually improve health? It it's just to deliver health-care services, certainly we need to do it more effectively and a higher quality and so forth, but it's a fairly narrow role. But if we're supposed to be seen as healers in the broader sense, then we need to engage people in the community. As health-care professionals, we bring a certain amount of the table. We then need to partner with people in the community to help develop broader health.

It is the community itself that creates the social norms. [It is important] to develop the capacity of the community to make the changes they need to affect their health, to empower the community, to develop social networks in the community. ... Helping coach kids in softball and soccer can help community health as much as just doing doctor things.

To reduce costs we have to look at prevention and the environments in which people live. ... Recognize that social connectivity is part of health, poverty is part of health. When one wants to improve health, it requires both individual and societal intervention. No man is an island.

I am thrilled to read about this approach to health. I'm a HUGE believer in the power and importance of community. My life's work is in creating and sustaining connections between seemingly disparate units - in my office, at my job site, in my thoughts - and in helping others see connections in these areas, as well. Mother Theresa said, "If we have no peace, it is because we have forgotten that we belong to each other." I believe we need to get back to the connections we have with others, as a way to solve our problems. This may seem over-simplified, but it is such a radical idea, with such life-changing consequences.

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