Idea for health care reform

It's a two-parter:

1. Abandon "fee for service" and its "perverse incentive" to see patients as units of income, making it lucrative to see more people instead of taking enough time with each one;

2. Get creative, look to other models, think about where the incentives go.

And this is a very interesting experiment!

Minnesota Experiment Puts Patient Health First

by David Welna

Were Gaul being paid by the number of patients he sees, as most doctors are, it might not have been worthwhile for him to sit and listen at length to his patient. But Gaul and all the other doctors at the Eagan clinic are now on salaries and feel more at liberty to consult with each other about patients.

Good ad campaign idea

After reading books like Dr. Harvey Karp's The Happiest Baby on the Block (and knowing from experience that "his" 5 S's are simply the oldest and most tried and true soothing methods), and after reading Liedloff's The Continuum Concept and piles and piles of Mothering magazines over the years ... and then knowing that the Blessed Mother wrapped the Baby of all babies in "swaddling clothes" ... well, it's not hard to figure out that it's supportable through history, experience, research, and simple observation that wearing the baby and keeping him swaddled is good for the baby.

That was always kind of my gold standard anyway - did they do this for thousands of years or just recently, once everyone could afford things like cribs? That's how I made decisions about where people slept, or when, or with whom. And that's also how I decided where and when to nurse my babies, or where and when and how to expect their attention and/or obedience. Some stuff isn't philosophical. Some stuff is as practical as the earth itself.

But this! Now, this is an ad campaign nobody's figured out yet. According to Joseph Bruchac's Sacagawea, one reason Lewis and Clark had a peaceful journey across the territories of so many native tribes was because they had a mom wearing a baby in their group. (That statue is the one I knew as a Portland child.) Who goes to war with babies in the army? Nobody does. So it was obvious that these were peaceful people. Now, that's an ad campaign for the baby-wearers! We come in peace - we're wearing our children.

Soon soon soon

School starts in less than four weeks. For me. School starts for me. Somewhere in my life, the cooling of September nights, and the reddening of the leaves, and the changing of the light began to work together and sound like the tuning of the orchestra. Here it comes, here it comes. The lights blink a bit. The people find their seats. The music is about to begin. Where's your program? Did you get a program? And I am eight years old - or twelve - or forty-nine. Apparently it's all the same in my sternum and in my dancing brain where the orchestra is tuning up. The new school year is about to begin.

Yesterday in the library, I worked on the summer reading book response sheets from the teen program. Although I was not meant to be reading them - the task was to make the records consistent so that we could gather statistics - I glanced at them from time to time, and all at once I began writing lesson plans in my head. I could think of three - five - ten things to do right off the bat that would encourage and help these young adults-in-the-making. Practicing with this skill or that ... putting the parts together ... tune and practice with each instrument, and then add them all together for a symphony of interaction with the wide world of Ideas and Notions and Dreams and Ambition. At this time of the year, I always think about getting a teaching credential at last, and getting my butt back into the classroom as a teacher. (But I know it passes. That classroom exists in a context, and the context is political, and this knowledge wakes me up in a hurry every time. I simply cannot attend faculty meetings. Period.)

As an aside ... I was not going to post this picture, but I guess I want to. Lesson plans come into my head in the fall, and so do bulletin boards and colored pencils and filing folders and all manner of creative organization. This year I got a very fun day at the library. I got to do the display for the teen writing contest. See what I did in the display cabinet? This was fun!Got a bit of my autumnal classroom urges out of my system this way.

But this is not the year I teach. Not in a school, and not in my living room. This is another year for my own learning. This year - yay! - I am a student again. Big plans, too. Introduction to Interdisciplinary Studies (3 credits), my first Human Studies core course, called Relationship to the Self (4 credits), and a bunch more PLA writing (2 credits for instruction, writing for 12-16 credits, depending on what I can get done). At least one CLEP test - maybe all three (9, 18, or 27 credits to transfer into my transcript). Classes on campus - yay! - and not just at home on the computer. Deeply investigative, questioning, life-changing classes and writing - yay! Oh, man. Find a seat. Quick! The music is about to start!

I think it's like an arch

An arch is a structure that spans a space while supporting weight (e.g. a doorway in a stone wall). Arches appeared as early as the 2nd millennium BC in Mesopotamian brick architecture, but their systematic use started with the Ancient Romans who were the first to apply the technique to a wide range of structures.^[1]

So saith Wikipedia.

And that, I think, is a good visual for the problem(s) faced by a free and principled democracy whenever it comes to questions of social justice. We have oppositional values, and we need them if we wish both to span space and to support weight. We need justice and kindness. We need generosity and everyone working. We need profit and philanthropy - not just as individuals, but as a people.

We wish to be fair, not preferring wealth and privilege over poverty or a bad start in life; but we also want each man to pull his own weight and earn what he has. We do not believe that law enforcement has a moral right to bully, intimidate, or coerce - no, not even to behave that way toward the criminal. Or maybe we do.

Maybe we do think the good guys have immunity from moral obligation.

I saw the movie Public Enemies this summer. It's not a movie to make the cogitator comfortable or happy in any way. It's also not for the squeamish (lots of brutality) or for anyone who has a problem with motion sickness. (Could we pulleaze stop all the jerky camera work and just get into the scene? Seriously. There are some fatuous film students who need to study the greats or stop studying altogether because jerking the camera around does not make the viewer enter the scene, but step back instead, trying to stand still in order to see what's going on because the story is compelling but someone keeps jiggling the floor. Geeeez Louise, that was frustrating!)

I really liked this movie - despite the jumpy camera man. It is about the famous bank robber, John Dillinger. I went to see it on the strength of Ebert's review. I agree with Ebert about most of the movie - especially this bit.

This is very disciplined film. You might not think it was possible to make a film about the most famous outlaw of the 1930s without clichés and "star chemistry" and a film class screenplay structure, but Mann does it. He is particular about the way he presents Dillinger and Billie. He sees him and her. Not them. They are never a couple. They are their needs.

But I do not agree with his conclusion that

I'm trying to understand why it is not quite a great film. I think it may be because it deprives me of some stubborn need for closure. His name was John Dillinger, and he robbed banks. But there had to be more to it than that, right?

I don't agree with that bit because I think the movie was asking a much, much larger question. Closure or the answers to how Dillinger ticked ... those aren't the point. I think this movie asked the question Charles Dickens asked. He too wanted people to notice that the underclass of criminals was joined at the hip to the law enforcement policing them. Nice people in nice houses want neither criminal nor cop in the living room - and thus it has always been. (This, I discovered during my 19th Century Lit course, is a very clear theme in Oliver Twist. But it's just as obvious in the stories of Jeeves & Wooster.)

I think this movie, and Charles Dickens, and every police corruption case and every horrifying truth of what Americans have done in the name of acquiring information for the sake of a safer citizenry - these have all asked the same question. The question is this.

At what point does the cop become a criminal? Where is the line crossed? When is it valid to do harm in order to do good? Who are the good guys when the power is used for evil?

This isn't a blog post about torture or the questionable information it obtains. And it isn't a blog post about nationally funded health care or whether or not all the things it would pay for are moral or good or healthy. This is a blog post about the need for opposing values.

If you try to build an archway with more weight on one side than the other, it collapses. If you try to build an archway without joining the sides at the top, it collapses. If you try to build an archway without 1. Keystone 2. Voussoir 3. Extrados 4. Impost 5. Intrados 6. Rise 7. Clear span and 8. Abutment, it will not stand.

And if you try to build a strong, functioning, healthy, prosperous society without kindness for the less fortunate, or without a moral sense that says, "I will not do that - not because I cannot, but because I should not," it will not stand. Not everything can be for expediency or for profit.

In the movie Public Enemies, there is a moment when the agent goes too far. He is determined to bully information out of Dillinger's girlfriend. The others in the office are horrified at his behavior ... but no one stops him. The Lucifer Effect has the right name. It masquerades as light when the moral "good" outweighs morality. When we try to pass through the archway made that way, we all get crushed in the collapse.

Oh, no I won't!

Okay, listen. I'm all for social justice and a responsible use of the resources we have in this world. I am. I think we have an order from God himself. We're supposed to govern wisely. Be good stewards. Yeah, yeah, yeah. I get it. But give up my incandescent lights??? Oh, c'MON!!!

Starting Tuesday of this week, the manufacture and import of the standard 100 watt and the frosted light bulb, which is deemed the most wasteful, will be banned in the EU countries. And over the next three years, all incandescent bulbs will be phased out completely. A similar ban is set to begin in the United States in 2012. Eleanor Beardsley quotes the EU Energy Commissioner Andris Piebalgs who has tried to reassure Europeans in his blog by telling them, "Much like the car and telephone took time to catch on, you will one day appreciate the new era of lighting."

Oh, no I won't!

I'll use the newfangled things, but I will not like them. There is a time of day that begins to come again in the autumn of the year. It's the time when there is still dinner to put on the table, but it becomes necessary to turn on the lights. It's the time of day when I light candles. And it's the time of day when incandescent light bulbs (that, admittedly, do indeed produce more heat than light) remind me of every late afternoon, waiting for the household Dad to come home. Dinner smells go with that kind of light. Taking your school mess to your room, or setting the table, or putting music on the stereo ... it's that time of day, and I have never seen any alternative to incandescent lighting that can illuminate it properly. I am not happy about this. I must have a drop or two of German blood in my veins.

Consumers in some countries, like Germany, are said to be stockpiling Thomas Edison's old-style bulbs for cost reasons, or even out of nostalgia.

I'm thinking of doing the same thing. It's like finding out that a favorite book is now gone from the library shelves - discarded - sold at a book sale, and no way to track the treasure so that I can buy it myself. Or visiting the old neighborhood only to find out that your grandpa's house has been flattened to make room for something really depressing ("like a Baby GAP" - name that movie). Sometimes progress really stinks. Especially if it's not lit properly.