Saturday, March 25, 2017

Public health should guide us talking about health insurance.

Are we talking about the people’s health anywhere inside all this noise about health insurance? 
Seems all we really hear about is the money with snipes about how unfair it is for …
well different folk have different ideas of unfair.
I am not even sure we talk that much about the actual health care. 
This market based fiasco we have does not deserve the name “health care system” because we don’t have one.  We have a financial sector of medical businesses. 
Talk about a health care system might start with something like making sure we have good places to be born and to die.  In my mind both would be something like a garden with space for the families of those involved.  A health care system would include a local health clinic system.  Somewhere local where you can get your vaccines, do your checkups, be told to exercise more and eat healthier, get stitches in or out or have something looked at in case it is something worse.  Somewhere spacious, accessible, welcoming and accommodating like a library. 
How about first level health care somewhere where you talk to a neighbor who knows your name?
That would be a start for health care that we mostly have not yet made.
The first step towards becoming a healthy people is to be clear that we are not in good shape now.
Taking a look at the leading causes of death in our country, the top lists in most categories are dominated by our ability (and probably willingness) to harm ourselves and others.  We do a lot of unsafe things in our cars, in our homes and in our habits.  We seem to be good at eating poorly, driving unsafely, killing ourselves and others, neglecting our bodies and staying overweight and unfit.  The list of what kills us is very similar to the list of woes for the living. 
I would like to move this item up from the bottom and least discussed part of our health debates. 
Above health care.
Above health insurance.
Focusing on a vision of a healthier nation with our mix of peoples, we can come to a vision on how to provide it and finally how to pay for it. 
It is everyone’s job to take care of everyone else. 
A healthy society takes care of its own. 
We may not know why we are such a violent people, but we know that we are, and in many cases we know what to do about it.  We know how to intervene.  We know how to show compassion.  We know how to practice contrition, remorse, compassion and restitution. 
From road rage to domestic abuse, there are a whole number of aggressive, angry behaviors we have come to consider normal and shrug off.  When the nation to the north of us only has a tenth of our violent crime problems and the one to the south of us has to have a major drug war to inch past us in murder statistics we should not be so self-confidant.  We should be embarrassed. 
Ours is the house in the neighborhood with the scandalous fights in the night. 
We can deal with the food and exercise problems too.  There is no mystery here.  There is precedent in how we knocked down cigarette consumption where we educated the public, set a new social tone of acceptability and shut down tobacco’s massive advertising machine. Fast food needs to be next. 
What would it take to send all of our kids to schools where they were in a calm, supportive environment that welcomed them all and provided for them all?  It would take more resources.  It would especially require more people and money in the schools that are the least calm, supportive, welcoming and able to provide for each and every child. 
There are many places where vicious circles of unhealthiness can be broken and the schools are one of the best of them. 
All of this has been said so many times that it is hard not to say it with examples and contrasts at every point, as part of our never ending harsh lecturing that we arrogantly call the “health care debate”. 
Our public health, like many of our public schools, are a disappointment and a cause for humility. 
In all of our communities we have all kinds of people working hard on getting us to take better care of ourselves and each other in every way imaginable.
There is no doubt that the ethics, will and knowledge for a healthy country is here already.
The dominant trend in our society is going the other way towards short sighted sociopathic unwillingness to help others and to accommodate our differences. 
There are a lot of complicated reasons why this is the dominating group and why we don’t practice the solidarity needed for a healthy population, with an appropriate health care system paid for in some fair and reliable way. 
Most of those reasons have to do with money. 

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