THE GREAT HEALTH DEBATE

HERE IN THE UNITED STATES, we seem to be on the verge of some needed changes to how health care is to be covered and who will benefit. Both the Congress and the Senate have passed bills. These now have to be reconciled and represented as final legislation. This process is different from that of some countries where the Senate serves only as a place of review of legislation passed elsewhere.

Back in April, I observed:

Seeing Michael Moore's film, 'Sicko', has a few surprises and is good back grounding. Much easier to access are the PBS FRONTLINE documentaries, Sick Around the World and Sick in America. These are readily available online (just right click on the titles to open the relevant Websites). The first reviews health insurance and health care in five capitalist countries (The United Kingdom, Japan, France, Taiwan, and Germany) and gives some idea of the variations that are possible based on the model invented by Bismark in Germany in late 19th Century.

Of the five countries mentioned, Japan is touted as being the most healthy. Interestingly, in Japan, health care was built into the constitution of Japan by the American, General Douglas MacArthur. This made the health of the people of Japan the responsibility of the Japanese government. Taiwan is unique in that, when seeking a new approach to health care, it investigated systematically health systems in other democratic nations.

There is a lot of concern about the overall cost of health care here in the US. About 17% of Gross National Product goes to providing health care and may rise to 22% over the next few years. This is roughly twice as much as in peer countries and with inferior health outcomes in several areas such as life expectancy and infant mortality. Some put this down to the fee-for-service basis of health care in the United States. However, most other countries retain this approach, such as Australia, France, Canada, and Japan while keeping health care costs lower. The report I alluded to in my September post (Accounting The Cost of Health Care in the United States, published in January 2007, by the McKinsey Global Institute) showed that costs related to diagnostic procedures, inpatient care, drugs, and multiple administrative structures contribute most to the overall cost of care. To see this report, you will have to register on their Website.

According to some polls, Americans appear to be loosing interest in health care as an issue. There is a some chance that the Republican Party may be able to rally sufficient support to defeat the final bill. If we are loosing interest, it may be because of rising disillusionment with the political process. In my April posting, I suggested you look to the lobbying around health. In September a CNN report (Health care lobbying: Political power machine) indicated some $400 million had already been spent and I have read that as much again has been spent since. The spending "leaders" are drug manufacturers, hospitals, and nursing homes. The legislators most active in opposing the present legislation seem to be those who have benefited most in campaign contributions and lobbyist support over the last year.

What could have possessed Gen. Douglas MacArthur to make health for everyone the responsibility of the Japanese legislature? However could he have conceived such a radical approach? Perhaps because, as a military leader, he knew how critical health is to the functioning of an army. Despite the many 'horror' stories we hear and read about the personal tragedies (see 'Sick in America' above) resulting from the failure of the so-called 'health system' in the US, politicians appear to be insensitive to the importance of good health services for all citizens. Unlike the President, they perhaps have been insulated from the consequences of our dysfunctional 'system' of care.

The cynic in me wants to leap to the forefront. In this year, the House of Representatives faces re-election as does one third of the Senate. Additionally, many governors face re-election. Due to the central role of TV advertising, the costs of political campaigning continue astronomical despite the ncreasing importance of the Internet in gleaning election funding. Meanwhile contributions, or the promise of contributions, from corporations can be critical to the degree when viewed as a safe source of support for those aspiring to election or re-election.

In the struggle over health reform, could we be experiencing the slow death of democracy where the 'rights' of vested interests supervene over those of ordinary citizens? If the price of peace is eternal vigilance, what then is the price of democracy?

As The Bard remarked, There is many a slip twixt the cup and the lip.

About 40 American voters read this post. If you have a concern about health reform, pass on the need for vigilance and action to some of your friends. I recommend you review the sources I have listed.

And, a Happy and Healthy New Year!

'TWAS THE NIGHT BEFORE CHRISTMAS...

WHAT WAS YOU MOST FAVORITE OF ALL CHRISTMAS EVE? Let me tell you about mine...
This is about the first Christmas eve that I can recall.

Though we could not know it, it was in the middle of the Second World War. That year (1941) our family had moved into the little town of Clare, about 80 miles north of Adelaide in South Australia. Previously we had lived on our farm but manpower shortages had forced my father to give up life as a farmer; he had rejoined the Army. So we were just my mother and my two sisters living in what seemed to be a quite grand house overlooking the town, nestled in the Clare Valley. The elder of my two brothers was in the Navy and the younger was living in Adelaide with my Grandfather, getting ready to join the Air Force. Most of the male friends of our family were off in the armed forces.

Our mother would get us off to bed around sunset. Christmas in Australia is in the middle of summer, so that would be around 9 in the evening. Then she would go around all the windows making sure the blinds were down and the curtains drawn. The air raid wardens would be patrolling the streets checking that not a ray of light escaped any window. The peaceful little town was nonetheless in the grip of war. With less than a dozen cars to be driven about, due to severe fuel rationing, the town was hushed and dark. Occasionally, there would be the sound of a train from the nearby rail station (steam locomotives in those days).

At the foot of my bed was my Christmas stocking. Hugging my dear Teddie bear and comforted by the dim light from my night lamp, I drifted off into slumber land.

But then a strange thing happened.

It seemed much later but the house had not its accustomed quiet. I awoke to the sound of low conversation from the direction of the kitchen. My mother was talking to someone! Who could it be? I got out of bed and crept towards my bedroom door. I opened it a crack to look and listen. Then I knew that the sound I could hear was the voice of my father!

He had come home unexpectedly on leave. The last passenger train up from Adelaide had brought him home. My parents seemed to be busy with the sound of things being wrapped in paper. It seemed wise to return to bed and to sleep. I felt very happy, knowing I would see my father in the morning.

When I awoke, at the foot of my bed was a large paper-wrapped object. Of course, we were not allowed to unwrap presents until after breakfast. I sat on my father's knee, his strong arms around me and the sweet smell of him all about me. Later, when the unwrapping began, I found, beneath the brown paper, a large, red tricycle! It was somewhat bigger than my proper size; so my father made wooden blocks to fit on the pedals so my feet would reach!

Such a happy Christmas morning; my father was home for a few days.

May your Christmas this year be as happy as was mine then.

YIKES...WINTER!

IT MUST BE FIVE AM, said I to myself as I awoke this morning. What was that sound I heard? None other than the sound of the snow plow going up the street. Then a brief relapse into light slumber. There it goes again...the plow going down the street.
For the past week or so, I had been pooh-poohing the weather forecasts for snow. So I did yet again yesterday. I'll believe it when I see it...those forecasters are ever the conservatives, they do not want to be caught out not forecasting snow when it finally does come. Talk about crying, "Snow" (rather than "Wolf").
Last night the weather really did mean business and four inches of the stuff lay on the driveway. So...out I went with the snow shovel. Yuck...wet snow and heavy; how I hate it! Much better when it is all light and fluffy. I am very methodical when it comes to clearing snow, dividing the driveway up into nice rectangles and shoving the snow across the drive to the side. Wet snow means smaller sections. The whole operation took me about 45 minutes and raised a fine sweat. By then the sun was up and it looked somewhat like this. I think we are due for some more tonight. However, it looks like those of you who live in Portland, Oregon, are going to get quite a bit as well and even colder than here.
Somewhat of a contrast to the pictures in my last blog. I think I am finished with the garden now. Anyway, the snow is here and I am astonished at how my energy revives now that the waiting for winter is over. What sort of winter will it be, I wonder? Some say, cold and not much snow. Others...wet and warmer than usual. Everyone has an opinion.
Its getting dark around 4:30 PM these days. Just a fortnight (two weeks) or so and the days will begin getting longer.
What to do about the onset of slight Seasonal Affective Disorder (how appropriate, the acronym...SAD). Here's my antidote: Get up early, have an hour out in the morning light before lunch, drink at least four cups of strong, black coffee, take Vitamin D, eat a little dark chocolate each day (I love that semi-sweet cooking chocolate), exercise each day if one can, drink hot chocolate, go to bed around 10 at night, and make sure to read the 'funnies' in the newspaper several times a week. Send a few jokes around the email circuit.
Anyone else have ideas?
Of course, you lucky ones who live Down Under, you have the summer. Lots of sun, long white beaches, surf, and Bar-b-Qs. How can you stand it? Well, yes, and bush fires. Let's hope not as bad as last year.
Apart from all that, be sure to have a happy holiday time and dodge the Christmas jingles (jangles?) if you can. Anyone got a good joke?