Saturday, August 19, 2017

Healthcare Matters

“There was a rich man who was dressed in purple and fine linen and lived in luxury every day. At his gate was laid a beggar named Lazarus, covered with sores and longing to eat what fell from the rich man’s table. Even the dogs came and licked his sores." Luke 16

"It occurred to me that there was no difference between men ... so profound as the difference between the sick and the well."
F. Scott Fitzgerald


"Is high-quality, affordable medical care in America still a reasonable expectation for most Americans? Is it even a human right? Is it better achieved by government guarantee or by the free market?"


Healthcare has always been and will always be an important issue for most people. Sickness touches almost all of us at one time or another and when it does it raises all sorts of intertwined questions
... from personal responsibility through social welfare to divine purpose
... from lifestyle and prevention through treatment and intervention to DNR [do-not-resuscitate] orders, palliative/hospice care and the right to die.

When and Where

Tuesday, October 17,  7:00 to 8:45 pm
Friends University, William Penn Hall, Room 100 (directly west of the Fine Arts building)

Opening Question

Maintaining the quality, accessibility, and affordability of America's health care system is an ongoing challenge.  Are we sliding gradually and inevitably into a single-payer system? If the right to life exists, does that imply the right to the health care that preserves life? What does the future of health care in America look like? (Don't ask the Congress of the United States!)

Panelists

With enthusiasm and gratitude, please welcome our 4 panelists. We should all make an honest effort to review any point of view statements [POVs] and any readings they have suggested to stimulate our thoughts for the evening [any links will follow their name/bio].

Dr. Carla A. Lee, APRN-BC, is the Executive Director of La Familia Senior/Community Center and President of the Wichita-Sedgwick County Nurses Society. Professional recognitions:
First Certified ARRN, nurse practitioner and clinical nurse specialist, in Kansas
Fellow the American Academy of Nursing, American Nurses Association
Fellow of the International Biographical Association, Cambridge, England
Inducted to Ks Nurses Hall of Fame, 20l3

Dr. Mark Mosley has been an ER physician for 25 years at Wesley Medical Center in Wichita and an Associate Professor of Pediatrics and Internal Medicine at the Kansas University School of Medicine –Wichita.  He has treated the medically indigent, homeless, mentally ill, Medicaid patients, and privately insured patients at a for-profit hospital (within HCA, the largest for-profit provider in the United States) -- a very interesting mix of capitalism and government-driven social responsibility.  (Dr. Mosley was the “Top Doctor of Wichita” in 2006 and 2007.)
US Healthcare fact sheet copy.docx
US Healthcare Coverage, Cost & Quality.docx
An American Sickness—how healthcare became big business and how you can take it back. (2017) - Elizabeth Rosenthal
Ending Medical Reversal- improving outcomes, saving lives. (2015)- Vinayak Prasad & Adam Cifu

Dr. Kent Murray is a retired internal medicine physician, having been Chief of Staff at the Wichita VA for 13 years and an Associate Professor of Internal Medicine and Associate Dean for Veterans Affairs at the Kansas University School of Medicine –Wichita.  As a VA physician, he has spent most of his career in essentially “socialized medicine.”  Dr. Murray claims to have seen vast improvements in that system and understands its possible extensions.  He has "felt embarrassment that the richest country in the world has, unlike other Western industrialized nations, a largely profit-driven health care system which leaves millions under-insured or uninsured."  Believing that health care is a human right, he generally favors a single-payer system.
4 Models for Healthcare

Dr. Josh Umbehr is a certified Family Physician in Wichita who started Atlas MD, an insurance-free, direct primary care practice, wherein he is able to “shrug off the burdens and restrictions of government and insurance regulation,” so that he can focus solely on his patients and their needs.

[Many thanks to John Todd and Fr. Benedict Armitage for their help in securing the participation of our panelists.]

The Evening's Format

The first half of the evening will consist of each panelist giving an opening position statement to which we will provide a link on this page in advance [if the panelist wishes to share part or all of it with us in advance] ... although we have explicitly advised panelists that providing a position statement in advance is not required.

The second half of the evening will be dedicated to questions ... from panelists to their fellow panelists ... and from the audience to panelists ... so bring your questions as well as your answers.

And for those of you who are inclined to get some questions out in the open for consideration BEFORE the evening's meeting ... feel free ... join the liberales ... and blog your COMMENTS and REPLIES below as needed/wished to build some trains of thought for us.

Epilogue

Well done to all our symposiasts !! It was an evening of probing and testing ... of dialogue and diagnosis ... of therapies and treatments ... and of hopes and fears ... all worthy of the best traditions of doctors and nurses:

"... Into whatsoever houses I enter, I will enter to help the sick, and I will abstain from all intentional wrong-doing and harm, especially from abusing the bodies of man or woman, bond or free. ..."
from Hippocratic Oath

For those who missed this enjoyable and enlightening evening, take time to view the AV recording on Healthcare Matters from Paul Soutar at Graphic Lens ... or just go to YouTube and search for us under "New Symposium Society Healthcare Matters". It shows once again that Washington is clueless when it comes to the real people, the real issues and the real answers.

We are adding the panelists' suggested readings under their names above for you to use in continuing your own education in these important matters ... and let your voice be heard.

"Divinity Matters" is just ahead in November 2017 ... and "War Matters" is in the planning stages for February 2018. We hope you are already thinking about these important [and not unrelated] subjects ... so if you have some ideas to share ... just let us hear from you ... contact us at newsymposium@gmail.com.   Goodbye until our next meeting and stay tuned to our blogsite for further info.



Other Suggested Readings

Video
Type 2 Diabetes Is "Processed Food Disease", Dr. Robert Lustig, 2017

Short
"How the Government Ruined US Healthcare — and What Can Be Done", Alice Salles, 2017
"Medicare for All: Leaving No One Behind", Senator Bernie Sanders, 2016
"Was Friedrich Hayek a Hypocrite on Socialized Medicine?", Karl Hess, 2011
"Prevention vs. Treatment: What's the Right Balance?", Halley S. Faust and Paul T. Menzel, 2012
"Justice and Access to Health Care", Stanford Encyclopedia of Philosophy, revised 2013
"Healthcare access as a right, not a privilege: a construct of Western thought", Biomed Central, 2007

Longer
"Being Mortal: Medicine and What Matters in the End", by Atul Gawande, 2014
[PBS Frontline Report on Being Mortal]

4 comments:

  1. Right to life or to a lifestyle?

    The cry for healthcare as a right and not a privilege is growing louder in America. The argument is that the fundamental individual right to life implies a fundamental individual right to the healthcare needed to sustain that life.

    However, sustaining life is the very crux of personal decision making and responsibility which we call lifestyle. Removing the individual's responsibility to take the necessary actions to sustain one's own life opens a Pandora's box of collectivism.

    To offer a simple but current example, consider those who chose to build houses in flood zones prone to destruction by hurricanes. Now that the predictable destruction has come, should repairing or rebuilding in those same dangerous locations be subsidized by everyone else?

    Eliminating any distinction between a true disaster and predictable damage unwisely encourages speculative excess and unfairly burdens responsible actions. Somebody must make a choice or else freedom is an illusion.

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  2. What is our goal: health or healthcare?

    An important corollary arises from our assertion that the only "right" at issue here is a common right to life [non-volitional and inalienable] and not a specific right to a given lifestyle [volitional with responsibility]. That corollary is that our proper goal is not healthcare but health itself ... and this brings the issue of post facto treatment v. ex-ante prevention to the forefront.

    In so far as medical conditions and the accompanying expenses are preventable or addressable by the adoption of a certain reasonable and attainable lifestyle, it is not logical to consider their "medical treatment" as a necessary expense either for the individual or for society.

    In what he calls the next great tectonic shift unfolding in public health, Dr. Robert Lustig that an extremely large percentage of the "diseases" we currently treat and the medical expenses we incur result from an combination of (1) our physiological tendency to become addicted to certain stimuli [including certain chemical substances like sugar in our food] and (2) an ominous [even conspiratorial] alliance of government with the food industry to "process" real food into substances that we abuse and which abuse us in return.

    If Lustig is correct, then "healthcare for all" is a canard [intended or not] to distract us from the fact that current food processing practices with government support are not only ruining public health but also threatening the economy with unsustainable costs. As evidence of his point of view, consider the fact that when asked what ONE THING should be done first to address the massive public health problems facing America Lustig without hesitation answered "stop all government subsidies to food producers".

    His point is that until we take public health seriously, it is seriously misguided to even talk about public healthcare.

    Search for "Dr. Lustig: Type 2 Diabetes Is Processed Food Disease" on You Tube.

    ReplyDelete
  3. Bangs and Bucks: Efficiency

    The last failed Republican healthcare reform bill [Graham-Cassiday ] claimed that healthcare overall would improve by making "structural" changes ... reduce the amount the federal government "spends" on it, divide up and give the strings-attached, reduced amount back to the individual states and then let the individual states make the "substantive" decisions about how to spend it on healthcare. In order for this claim to be true, states would have to make healthcare more "efficient" ... to discover how to get enough increased substantive bang for each structural buck to actually increase the aggregate bang given the decreased aggregate expenditure of bucks.

    But were the Republicans really being truthful with us? If their logic is correct, why should the federal government be involved in health care at all? Indeed, why should the state governments be involved either? Why not just leave the money with the invididuals and let each one decide how much to spend on what kind of healthcare? Wouldn't that be the most efficient?

    But then again, if there is a single "best way" to deliver healthcare, wouldn't it be most efficient for the federal government to simply force everyone to pay for and use that same single-payer healthcare system ... wouldn't that deliver the biggest bang for the buck?

    And can't these same double-edged efficiency arguments be made about education, infrastructure and just about anything else the federal government does except national defense? For maximum efficiency, it appears governments [both federal and state] should either be alot smaller or alot bigger ... which is it?

    Freedom and Commonwealth: Republics

    Or are there "structural" considerations other than EFFICIENCY which might help us unravel this mystery?

    What about FREEDOM [aka inalienable rights] ... which implies the individual's authority to act in what he belives [correctly or incorrectly] to be his own benefit so long as he alone bears the full costs for his actions? And what about COMMONWEALTH ... which implies there are some resources which, by their very nature, must be held and maintained collectively by groups of invididuals [at various ascending levels of aggregation] because no single individual in the group is structurally able to bear the full costs associated with his own actions affecting such resources?

    Maybe we can rephrase the healthcare debate as follows. What part of healthcare needs to be based on FREEDOM and what part needs to be based on the COMMONWEALTH? And when the COMMONWEALTH has been thoughtfully identified as present, what is the lowest level of aggregation that can adequately provide and justly allocate the shared resource in question?

    Afterall, America is a wonderful rabble of free individuals who have freely joined together at various levels of aggregation to form small and large REPUBLICS which honor individual freedom while recognizing that some "things" are "public" [from the Latin "res publica"] and represent a "commonwealth" which brings us together. Would a return to these fundamental structural principles of human action help us resolve the questions we have about healthcare, education, infrastructure and a host of other private and public needs and resources?

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