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.