Health care?

In the first chapter of Atul Gawande's new book, The Checklist Manifesto, reprinted here at NPR.org, I found this little tidbit:

On any given day in the United States alone, some ninety thousand people are admitted to intensive care. Over a year, an estimated five million Americans will be, and over a normal lifetime nearly all of us will come to know the glassed bay of an ICU from the inside.

I find this statistic both astounding and rather horrifying.
Reading a few lines further, I next found this stark sentence, "Fifty years ago, ICUs barely existed."

What is the trend revealed in these factoids? At the very least, I would say our unrestrained worship of technology. Coupled with our similarly unrestrained worship of profit, is it any wonder we strode into this health care mess in so short a period of time-- essentially, since WWII?

With the reliance upon technology comes the annoying corollary: reliance upon the technologists. We loves our gadgets-- but few people know how they work, how to build them, how to fix them. So, naturally, we are beholden to a minority class of technologists who can supply our needs; and even they are not the top of the heap. Most of the folks who know something of how our many machines and technologies work are merely product-savvy salespeople, high-level repair people (part-swappers), or well-trained and experienced industry insiders who, through long familiarity, have acquired a wide knowledge base from which to draw. Those who actually know how the stuff works, on a nuts-and-bolts (or, more likely, transistors-and-lasers) level are the true technologists, the upper-class of the technology food web: we can call them the Sci-Tech Elite. And who directs this Elite? The economic upper-upper-class-- the profit-mongers, of course! Even if the R&D is done at a major university or branch of government, the goal, somewhere along the line, is, or ultimately becomes, the production of profit for the top dogs.

This little diatribe is already going in an unintended (though interesting) direction. The point in the discussion of health care that I set out to make is that we've placed our reliance-- indeed, the greatest measure of our faith-- in the health technologists. Who are they? Through habit and social history, we equate them with our healthcare providers-- the physicians who, for a few precious minutes at a time anymore, still see us and thump our chests and look in our orifices. Though they are not the true technologists behind the modern medical mistake we call healthcare, they have become the front-men and -women, the priest-class through which we access the glorious Technology in which we have so fully vested our faith; in point of fact, I'd say they are our pimps and pushers.

Generalities, all just generalities. There are still "good" doctors out there-- those who know what health and care really mean, and do not misplace their own faith in "the machine that goes Ping!" But by and large, their traditional Hippocratic skills and instincts have been subsumed into an enormous Health Machine-- a radiometric, laser-guided, computer-controlled, digitally-enhanced, sterile, disposable, and very expensive Health Machine.

What would happen, do you think, if we were to reclaim ownership of our own health and health care, by-- for example-- practicing sensible lifestyle habits and preventive care? Would we really miss high-tech medicine? (Sure, when you're smeared across 3 lanes of superhighway and you need to be reassembled; or when your congenital heart defect finally gets the better of you and demands a valve replacement; and the like.) But really-- in most cases, how much better could we make our lives by taking charge of our own health and health care, and no longer leaving it in the hands of the technologist-profiteers?

Essential Progressive Reading List - please expand!

Those who know me know I'm not a big reader. So when I put together a must-read list, you know it's gotta be filled with important works! And since I don't read as much as I'd like to, please help me to expand this list of must-reads for the modern progressives. I reserve the right to edit!

In no particular order:


Barbara Kingsolver's Animal, Vegetable, Miracle is the novelist/story writer's first book-length non-fiction work. Part one-year memoir, part overview and critique of modern American agribusiness and food production, this delightful book chronicles her family's yearlong commitment to eat locally-grown foods-- as in foods raised by the family themselves in their home garden, or obtained from farmers they've met, usually within a small radius of their western Virginia home.

As an critique, it offers disturbing insight into industrial farming and food production-- information which is terrifically disturbing to those who, like me, already have ample reason to distrust the direction our modern, energy-intensive lifestyle has taken us. Yet, rather than sounding a shrill message of impending doom, as it could easily have done, the book is more than sufficiently balanced by the intimate, sensuous descriptions of the foods produced and consumed during a turn of the seasons. It's clearly the work of one who loves good, wholesome food, and will appeal to the like-minded. Nor is this a fairy-story of idyllic pastoralism; she does not stint in her reporting the hard work and failures encountered in the process. It is not a promotion of vegetarianism, as they family raise poultry for food and also buy local meats, but the focus on the varied output of their modest garden draws more attention to the vegetal joys of a localized lifestyle than to the environmental and ethical issues surrounding flesh-farming. In sum, this book is a beautiful paean to the joys of good food and community that results from local farming; truly a foodie's book.


The Transition Handbook, by Rob Hopkins, is essential reading for the solution-driven progressive. Hopkins is the congenial, flap-eared founder of the now-global movement (begun in the UK) to relocalize our economies and build resilient communities in the face of the twin challenges of Peak Oil and Climate Change. This is neither hippie love-note nor ammo-stocking survivalist exhortation to hunker in your bunker; it's a well-crafted guidebook and open invitation to create a lifestyle that is BETTER than what we now enjoy-- or endure, depending on your perspective! Divided into three sections entitled Head, Heart, and Mind, the Handbook acknowledges and attempts to adequately address the complex nature of large-scale societal change-- including the psychology of resistance to change. But mostly it's a guide to the process of conceiving and creating vital, interdependent, local communities that can weather the coming changes (identified in the Head section as potentially hugely cataclysmic) and indeed thrive after the Age of Cheap Oil.


Yes, I've mentioned this book previously here on sharedyes, but it bears repeating (partly because things seem neater when they come in threes!). Apollo's Fire, by Congressman Jay Inslee and Bracken Hendricks, lays out the arguments for an Apollo moonshot-scale national program to shift our economy to renewable energy sources, and explains how it's much more sensible than the alternatives. Lots of explanatory economics and current information bolster their premise-- that fossil fuels are a dead-end from which we can emerge better than ever. I often call the proposal a legislative trifecta: shifting to renewable energy sources creates jobs, helps save the environment, and reduces foreign energy dependence and its concomitant geopolitical dangers (read: Iraq War).

2010 Theme

The Year of Re-localization.

Reconciliation

No, I'm not talking about God & Sinners or you and your neurotic family-- I'm talking about the two congressional health care reform bills.

One thing I know should be present in the final bill that will be sent to the President's desk: repeal of anti-trust protection for the health insurance industry. In 1945, Congress passed the McCarran-Ferguson Act, giving the health insurance business such protections, and allowing the States to regulate such businesses without federal interference. Now that insurance is a transnational cash cow scam industry, the Feds must be allowed to step and in, and absolutely the business should be subject to the same anti-trust laws as other businesses.

See Sen. Patrick Leahy's (D-VT) proposed amendment to the health care reform bill.

The fat lady ain't sung yet, let's keep on the pressure!

Copenhagen was a bust. Surprise!

While the "negotiators" at COP15 pat themselves on the back for their accomplishments, the rest of the world recognizes that traditional political processes are ineffective when time is of the essence.

So if you weren't clear about things, it's up to the people to lead the way. Yes, that means being the change you want to see in the world. Being green has always started at home: time to put your actions where your mouth is! Reduce waste, increase energy efficiency, raise awareness, start conversations. There's plenty to talk about: Peak Oil, the recent EPA determination that CO2 poses a public health risk, foreign oil dependence, the economic opportunities represented by a national push for green energy... to name just a few.

Let's move forward!

Human v. Fossil power

In a brilliant demonstration of the energy density of our modern (fossil) fuel sources,* the BBC TV show Bang Goes the Theory set about to power all the electrical loads of a British household using a warehouseful of stationary bicycles (and their human pedalers!) fitted with generators. Although we in the U.S. can't directly view the show's UK feed, they did provide this web-ready clip for worldwide players. Simply brilliant.

*Both UK and USA generate about 20% of their grid electricity in nuclear power plants. Uranium is a kind of fossil fuel, too. In any case, it's a finite fuel source, innit?

And you thought education was in trouble!

Almost daily, in newspapers and websites across the country, there is evidence that education is not in as bad shape as we're often led to believe: I refer to the daily flood of letters to editors and blog entries decrying global climate change (most say "global warming") as a lot of hooey— and offering carefully reasoned refutations.

Clearly, our education system is turning out advanced climatologists in record numbers! If that's true, concerns over dismal national science and math education results are entirely unfounded. Climate science is math- and science-heavy stuff, so our education system must be doing something right!

As an example, here's a letter to the editor of my local paper, proving that great minds surround us. Stand down the alert! We're fine!