"Health" and "Care" and the lady in the library

Yesterday I met a woman. I'll call her M. She was in the library, looking stunned, looking lost, looking brave anyway. There was no one else in the library at the time but the two kids she'd brought in with her, and she and I got to talking. She'd had a terrible health scare and been in the hospital for a few days. They told her she has diabetes and if she'll lose fifty pounds, it will go away. And, I'm sure they're right. But she was on her own to do it.

Now, if you ask me, that, right there, that one lady - that's what's wrong with our system. The system we have right now is little more than a collection of autonomous individuals and financial incentives, and frankly, if financial incentives aren't really part of your life you don't have the personal power for autonomy.

Also this week, I heard a broadcast of Think Out Loud, and found out that, long before the national initiative, Oregon's been working on changing the actual system. They've got a plan ready to propose. It all sounds realistic, practical, compassionate, and fiscally responsible, and I hope hope hope they succeed at this. It will change in the nation when it begins to change state by state, I think. Godspeed, Oregon. God's blessing on you in this effort. Seriously. It needs to happen.

The Medical Home clinic in Lebanon, Oregon, is a good example of how things can work better. Dr. Rick Wopat was on the Think Out Loud broadcast, and his answers to "how does it work?" are well worth listening to.

I wish I could send M. to his clinic. (It's not even in our state. No one could send her there.) There's only so much I'm allowed to do as an employee - and I found as many resources for her as I could, and talked to her at length. What she needs in compassionate care that doesn't make her feel so alone and frightened. M. needs a behavioral therapy counselor, and a nutritionist - not one rushed, annoyed, fee-for-service doctor who's "rude" and "mean." She needs to avoid decades of expensive care by means of immediate and effective support. She needs to be seen as a person, not as a case, and if someone would work with her, she's one person who's ready to work. Now. Another few months of this kind of panic and fear and overwhelm, and she probably won't be ready anymore.

In fact, M. and I and you and everyone - we need HEALTH care ... not malady management.


Lynn S said...

But the million dollar question is this: Will Oregon's health care innovation REALLY transform the system from "malady management" to the kind of utopian health care we all wish we could have?
Everyone would love that kind of health care, but will socialized medicine garner that result?

Stephanie said...

Well ...

1. I do not ask for utopia. I ask for compassionate care that makes sense, and which takes a whole person into account, and which does this before there is a cataclysmic and expensive event.

2. The system we have now is expensive, and if that same amount of money were rearranged, it could easily cover the sort of care offered to other civilized nations. We're really good at what we do - we're just doing it stupidly.

3. And mostly, there is no "us" and "them." There is only humanity, all of whom deserve dignity and compassion. The yee-haw method of every man for himself blames all ill events on the one to whom they happened. This, to my mind, is neither realistic, mature, humanitarian, nor Christian.

False choice: Current System vs. "Socialized" Medicine

Real choice: Current System vs. a completely different arrangement that uses the dollars currently in the system in a more sensible and compassionate way

dogwooddiarist said...

Amen, Stephanie.

Missy Hempe said...

Stephanie isn't asking for Utopia, and neither are the rest of us. We also don't want completely socialized medicine. We are in a mixed-economy. No pure capitalist society has ever worked. So why not have a mixed-economy health care approach?

Douglas Bienert said...

Somewhere between Utopia and an $800 bill for a 15min doctor visit and a simple perscription for penicillin is a workable health care system.