With the fast appointment, and equally sudden withdrawal of Tom Daschle as Secretary of Health and Human Services, what had been growing momentum behind long overdue health care reform was derailed, and we hope only temporarily sidetracked. Daschle, a veteran of Congress and one who had experienced many attempts at health care reform, was viewed as a very solid and informed choice for the post. Those who have read his book, know that he is an advocate for practical and doable change, recognizing that what many see as the ultimate destination, a single payer system, may require some interim steps. His plan would amalgamate existing government care programs, require that everyone be covered with affordable insurance for a basic level of health care services, and remove politics from decision making by creating a federal health board with confirmed appointees (like the Federal Reserve Board) to oversee the system.
Personally, while some of Daschle's plan characteristics have merit, I am a proponent of going for the whole enchilada now and proposing a single payer system to get rid of greedy profit motivated health insurance companies now. Why allow profit at the expense of health and life? And why spend even one more penny on marketing, advertising or competition when the money can and should go to delivering care and prevention?
Let's do what we have to do now to make the system affordable, accessible, fair, accountable, universal, portable, and responsible. By responsible, I mean a system that devotes resources to health promotion and prevention, a system that aims to promote well-being rather than just ameliorate disease after it has occurred, and a system that recognizes that responsible lifestyle change is more than half the battle in keeping people well. Health is related to happiness and happiness is related, inextricably, to doing what makes life worth living, with those we love, and in supportive communities. Beyond these basic philosophical changes, why not pay providers more for keeping their patients healthy? Rewarding them for listening to and counseling their patients about lifestyle (not just exercise and nutrition) might also be a nice addition.
Think about your idea of a good healthcare experience. I have had primary care delivered by angels and by robots. By people who listened and believed I knew my own body, and those who were so focused on arriving at a diagnosis, (or getting to their next appointment) that they cared little about my experience of illness. Incredibly, the Washington Post had an article recently about an Ethiopian-born physician who is also a novelist (Abraham Verghese) who proposes that medical schools teach their students about the importance of the life stories of their patients. This advice is, on the one hand, good news— and on the other, incredible in its acknowledgment that medical curricula are woefully out of touch. I doubt it is coincidental that my favorite primary care practitioners are physicians who were first trained as nurses, pharmacists or therapists. In fairness to medical schools, (not that any is really warranted) it is incredibly difficult to change the curriculum in a medical school, even a smidgeon.
So, what characteristics do you think make for a good health care encounter? Share them here, and perhaps a medical educator or two who believes in the importance of the humanities will stop by and take note.
DLW is an occasional blog about how people spend the time of their lives (every moment) to enable health, balance, meaning and fulfillment. As a blogspot about doing, it draws from personal stories and from studies of everyday living. It's main idea is that to be well, people must be involved fully in what they do. The activities that occupy our days help to connect us to the world, define who we are, and keep us healthy.
Great Links About What, How, Why, Where and How Often People Do Things
- Calculate your Life Expectancy
- O*Net - A terrific resource to get information about work related occupations
- Wisdom—A must see project of shared experience
- Brian R Little- About Personal Projects
- Authentic Happiness - Take the Work-Life Questionnaire
- wdydwdyd? (Why do you do what you do?)
- Calculate your weekly Time Use
- Bureau of Labor Statistics -American Time Use Survey
- ▼ February (7)
Interesting Books about Doing and Not Doing
- Bateson, Mary Catherine—Composing a Life
- Bruner, Jerome—Acts of Meaning: Four Lectures On Mind and Culture
- Christiansen, Charles & Townsend, Elizabeth—Introduction to Occupation: The Art and Science of Living
- Csíkszentmihályi, Mihaly— Flow: The Psychology of Optimal Experience
- Diener, Ed, & Biswas-Diener, Robert—Happiness: Unlocking the Mysteries of Psychological Wealth.
- Edgell, Stephen—The Sociology of Work: Continuity and Change in Paid and Unpaid Work
- Gini, Al—The Importance of Being Lazy: In Praise of Play, Leisure and Vacations
- Kabat-Zinn, Jon—Whereever You Go, There You Are
- Little, Brian; Salmela-Aro, Katerina; and Phillips, Susan D. — Personal Projects Analysis: Goals, Actions and Human Flourishing
- Matuska, K & Christiansen, C. — Life Balance -Multidisciplinary Theories and Research
- McAdams, Dan P. —The Stories We Live By: Personal Myths and the Making of the Self
- Robinson, John & Godbey, Geoffrey — Time for Life: The Surprising Ways Americans Use Their Time
- Seligman, Martin—Authentic Happiness: Using the New Positive Psychology to Realize your Potential for Lasting Fulfillment
- Tolle, Eckhart—The Power of Now