Today I realize my position as one of the privileged class.
I’ve always been poor—in a way. I was taught by my relatives to think of myself this way. We never had much. We used things down to the last morsel of their usefulness, and often went without the “finer” things in life. We got boxes of food from the government and our church, went without Christmas toys on occasion. How is this privilege in America?
I did have plenty of intangible blessings that I am still realizing the full value of: a community that surrounded us on all sides, and let us know that we were in their prayers and that no matter what we would be fed, clothed, sheltered and educated. These were strong Mormon cultural values that guide me deeply to this day in ways I barely notice and some that I am trying desperately to shed.
My realization today that I am in fact part of the privileged class comes from a juxtaposition of two messages. I went to a lecture sponsored by AMSA (American Medical Student Association), regarding health literacy. It was a sobering reminder that nearly half the people in this country are functionally illiterate. The question asked was, how do we, as physicians, attempt to reach across the divide of our specialized 8, 9, 10+ years of higher education and $10,000 words to convey simple ways for people to follow our direction to achieve better health?
Now, an hour later, I sit and watch some college football and an IBM commercial comes on talking about the problem of water supply and the growing needs of an overburdened ecosystem. “Build a smarter planet” is the catchphrase…
Almost half the country is illiterate.
And this commercial touts a company’s ability to build a “smarter planet”?
It is this moment that I realize the special status that I have on this planet as an educated American who has a full belly and a few moments to catch a bit of football on Saturday night. I also realize the responsibility that I, and other members of my class have to managing the resources that this planet in its VAST—almost unfathomable—generosity gives to us.
We are the ones. WE have to take this power that we have been given in all the information that floats around us. Not to become cynical and apathetic about it, but use this time to reach out to see the rest of humanity and the struggles they endure just to live, and make it better, make it just.
We have arrived in our place of privilege on the backs of our ancestors who have enslaved, raped, pillaged, and very nearly used up the diversity and lush riches of this planet. Now it is time to use that position to bring some justice, equality and from those things—PEACE to the rest of the world.
And pray for those who have truly suffered, to forgive us for taking so long to do it.
A message from Rosemary.
Across the porch, she stares me down. Every time I wander out, to sit and take in the evening, chat with friends and neighbors on the swinging bench that sits outside my front door, there she is…flirting shamelessly with me. “Let’s get to know each other better” she taunts at me. After a little over a month of this behavior, I give in. Rosemary, I hear you and I do find you intriguing. Let’s see if the chemistry can become something good for me.
Rosemary possesses at least 24 antioxidants (compounds that consume free radicals) one of which is very powerful -romarinic acid. It also contains at least six compounds that prevent the breakdown of acetylcholine. Acetylcholine plays a crucial role in the transmission of impulses from one nerve fiber to another across synaptic junctions, making it potentially useful in the treatment of Alzheimer’s disease. It can be most useful in this respect in combination with other Acetylcholine promoting or containing herbs such as nettles and Royal Jelly.
Rosemary is historically known as ‘the herb of remembrance’ suggesting its anti-senility and memory-enhancing activity. I have been spending my time in a brain aging time warp (aka naturopathic medical school), therefore I have decided to start brewing up a tincture batch, it should be ready to ingest just in time for finals week!
Rosemary has a variety of properties. It is antispasmodic, a cholagogue, an emmenagogue, a stimulant, a stomachic. The stimulant action of rosemary helps promote liver function, the production of bile, and proper digestion. Use her with wild abandon in cooking meals that might be heavy or complex, she could aid in your ability to better digest the food.
Rosemary has a general tonic effect on the circulation and the nervous system, especially the vascular nerves. It is especially useful in treatment of circulatory weakness, including hypotension. Rosemary should also be considered for older people with a weak circulation or due to overwork or weakening diseases such as influenza or pneumonia. Those who have just been taken down to the mat by the swine flu might consider including more rosemary in their gravy or bone broths to get back into shape.
CAUTION: excessive amounts of rosemary taken internally can cause fatal poisoning.
Reference:
[the complete botanical prescriber 3rd edition John A. Sherman, ND.]
[ herbal vade mecum, gazmend skenderi]
Castleman M. The Healing Herbs. New York: Bantam Books, 1991, 452–56.
Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Foods, Drugs ,and Cosmetics, 2d ed. New York: John Wiley & Sons, 1996, 446–48
Rosemary possesses at least 24 antioxidants (compounds that consume free radicals) one of which is very powerful -romarinic acid. It also contains at least six compounds that prevent the breakdown of acetylcholine. Acetylcholine plays a crucial role in the transmission of impulses from one nerve fiber to another across synaptic junctions, making it potentially useful in the treatment of Alzheimer’s disease. It can be most useful in this respect in combination with other Acetylcholine promoting or containing herbs such as nettles and Royal Jelly.
Rosemary is historically known as ‘the herb of remembrance’ suggesting its anti-senility and memory-enhancing activity. I have been spending my time in a brain aging time warp (aka naturopathic medical school), therefore I have decided to start brewing up a tincture batch, it should be ready to ingest just in time for finals week!
Rosemary has a variety of properties. It is antispasmodic, a cholagogue, an emmenagogue, a stimulant, a stomachic. The stimulant action of rosemary helps promote liver function, the production of bile, and proper digestion. Use her with wild abandon in cooking meals that might be heavy or complex, she could aid in your ability to better digest the food.
Rosemary has a general tonic effect on the circulation and the nervous system, especially the vascular nerves. It is especially useful in treatment of circulatory weakness, including hypotension. Rosemary should also be considered for older people with a weak circulation or due to overwork or weakening diseases such as influenza or pneumonia. Those who have just been taken down to the mat by the swine flu might consider including more rosemary in their gravy or bone broths to get back into shape.
CAUTION: excessive amounts of rosemary taken internally can cause fatal poisoning.
Reference:
[the complete botanical prescriber 3rd edition John A. Sherman, ND.]
[ herbal vade mecum, gazmend skenderi]
Castleman M. The Healing Herbs. New York: Bantam Books, 1991, 452–56.
Leung AY, Foster S. Encyclopedia of Common Natural Ingredients Used in Foods, Drugs ,and Cosmetics, 2d ed. New York: John Wiley & Sons, 1996, 446–48
Health Care Town Hall
Due to a car accident on I-5 somewhere, Dr. Dean is an hour late. The meeting hall at PCC Cascade is slowly filling up. It’s hard to figure out who got selected to be at this meeting. About 75 protesters are being kept out. The people inside seem to be part of some unidentified political scene--perhaps the Multnomah County Democratic Party? Or Health Care Reformists? A couple of people I talk to define themselves as “political junkies”.
Many of the people gathered outside are with jobs with justice. I try to have a conversation with a couple of people, who are proselytizing about why there is no solution acceptable outside a single payer system. I am not buying their arguments. They keep regurgitating the same things they have written on their signs: "Corporate Profits out of Health Care.” I agree that there needs to be a complete overhaul and reform on the way corporations who are part of the health care delivery system are allowed to do business. HOWEVER, As someone working in health care, I also want to see access for every single person in America--NOW. The protesters come across as anti-corporate purists who will derail efforts that don’t give them EXACTLY what they want, which is a complete reinvention of American capitalism.
Inside, once the meeting starts, there are two speakers. The first is Judith -a person who is living with chronic disease. She requires more medical care than the average person, including a list of pharmaceuticals, all of which she has, in a pile for us to see on the podium. She has had many run-ins with insurance companies, fighting to get the care she requires with the ‘pre-existing condition’ that she has.
Somehow, she got lucky and won the lottery to be accepted into OHP. She works part time and earns just over the federal poverty level, so she will no longer be accepted to OHP. She is going to have to apply for disability benefits. Her self worth is a big question. Through all her appeal processes she has to maintain the idea that she is worth treatment. She thinks that she is worth keeping alive, but does the state? Do insurance companies? What give the insurance companies the right to determine if she is kept alive? We need a federal initiative to make this right.
The second speaker is Terry Mills, PCC nursing educator and President of the National Nursing Association. She argues that we have made some gains in modern medicine, but on balance, our health care system is SICK. It is not doing what it needs to, despite spending so much money. We are 29th in the world in infant mortality rates. We spend $1.3 trillion on preventable chronic disease.
Judith and Terry both state that they believe everyone in this room would like to see a single payer system in this country. In the same light, we must come together and make change happen. The urgency of NOW propels us forward on this. We have the power to make a change in health care now and we must do it despite the disappointment of not getting a single payer system.
Finally Earl Blumenauer is introduced, and he then introduces Dr. Howard Dean. As the two gentlemen exchange their admiration for each other’s work, the door at the back of the room opens for a second and the chanting voices of the protesters outside echo through the auditorium: “Single payer now!”
Highlights from Howard Dean’s speech:
There will be disagreements in this debate.
The recent election was all about people under the age of 35 and bipartisanship. However, health care should not be sacrificed on the altar of bipartisanship.
(Obama has said that if he gets 85% of what he wants with a bipartesian majority it would be preferred to getting 100% of what he wants with a 51% democrat-only passage).
The arguments for and against single payer are currently being re-framed.
We can’t have an economic system without health care.
Dr. Dean acknowledges the people outside shouting for single payer. There are people across the county who want that, but there are also many who want to keep what they have with their company or private insurance. There should be a choice: If you like what you have, you keep it; if you want single payer (medicare) you can choose that too. It is good that the protesters are out there making noise. We really have to drag this conversation as far to the left as possible, because the republicans and ‘blue-dog’ dems will drag it back to the right.
Insurance companies are going to be forced to change (part of the bill as introduced makes it illegal to deny coverage based on pre-existing conditions as well as life-time limits on payouts) We have learned that the free market does not work in health care.
Highlights from Earl Blumenauer’s speech:
We will fail if we create false choices. (ie. the choice between single-payer and nothing).
The veterans administration has managed to do what we would like to see the rest of the health care in this country do: Things like negotiation of prescription prices, cost cutting and providing good care. Portland (with the community coalition of clinics) provides better outcomes for people with less money.
Q & A from the audience:
Q: Are you incorporating food safety into the bill on the floor?
A: We need to change the illness-based system to a wellness-based system. This involves a change in the American ideals. We do need to educate people about what the heck is in our food. As a doctor, Dr. Dean is concerned when the animals who provide meat need to be covered in antibiotics. We also need to encourage people to get a living will to stop sucking money out in the last few months of life. We are working on a way to pay doctors to sit down with patients and talk to them about death instead of ordering thousands of tests.
Blumenauer: The real value of food is not reflected in its cost. Why does a Twinkie which has a dozen highly processed ingredients cost less than a local organically grown carrot?
-He doesn’t really answer the question…there is a food safety bill currently getting mulled over and torn up in the congress… but it is not being linked to the health care bill, per se.
Q: What is being done about workforce development in all of this reform?
A: We need to kick things down the chain. Let nurse practitioners do the job they are trained to do. Etc. (this should include NDs –trained to be PCPs).
We also need to eliminate the fee-for-service model.
How do we help the field of primary care, we should start by making sure that medical students don’t leave school with hundreds of thousands of dollars in debt. We need to incentivize vertical care models such as Kaiser. The way the system is currently set up hospitals will see the prevention of major surgery as a loss to their bottom line.
Doctors are not paid to listen to patients and plan for their wellness and death with dignity. They are trained and paid to perform procedures on them. This is the way capitalism interacts with health care.
We need to reverse that.
We have to change the financing system of health care first, then work on health care reform.
-When we have people in the ‘business’ of health care , investing in things that are not on board with creating a well society, the system is stacked against itself. Legislation can control and reverse this situation, and it should.
There were some suggestions for the people in the room to connect to a network, start sending articles, educating people, have house parties, raise the temperature.
2009 is the year for this reform to happen.
Quiet conversations can have a big effect.
Ron Wyden? Where are you on this? Will you pass the reform? Dr. Dean and Mr. Blumenauer encourage people to contact Mr. Wyden’s office to get his support. We need Ron to get right with the idea of getting the legislation passed to get everyone covered. He will respond to his constituents.
The focused message here is: There must be a public health opinion.
Many of the people gathered outside are with jobs with justice. I try to have a conversation with a couple of people, who are proselytizing about why there is no solution acceptable outside a single payer system. I am not buying their arguments. They keep regurgitating the same things they have written on their signs: "Corporate Profits out of Health Care.” I agree that there needs to be a complete overhaul and reform on the way corporations who are part of the health care delivery system are allowed to do business. HOWEVER, As someone working in health care, I also want to see access for every single person in America--NOW. The protesters come across as anti-corporate purists who will derail efforts that don’t give them EXACTLY what they want, which is a complete reinvention of American capitalism.
Inside, once the meeting starts, there are two speakers. The first is Judith -a person who is living with chronic disease. She requires more medical care than the average person, including a list of pharmaceuticals, all of which she has, in a pile for us to see on the podium. She has had many run-ins with insurance companies, fighting to get the care she requires with the ‘pre-existing condition’ that she has.
Somehow, she got lucky and won the lottery to be accepted into OHP. She works part time and earns just over the federal poverty level, so she will no longer be accepted to OHP. She is going to have to apply for disability benefits. Her self worth is a big question. Through all her appeal processes she has to maintain the idea that she is worth treatment. She thinks that she is worth keeping alive, but does the state? Do insurance companies? What give the insurance companies the right to determine if she is kept alive? We need a federal initiative to make this right.
The second speaker is Terry Mills, PCC nursing educator and President of the National Nursing Association. She argues that we have made some gains in modern medicine, but on balance, our health care system is SICK. It is not doing what it needs to, despite spending so much money. We are 29th in the world in infant mortality rates. We spend $1.3 trillion on preventable chronic disease.
Judith and Terry both state that they believe everyone in this room would like to see a single payer system in this country. In the same light, we must come together and make change happen. The urgency of NOW propels us forward on this. We have the power to make a change in health care now and we must do it despite the disappointment of not getting a single payer system.
Finally Earl Blumenauer is introduced, and he then introduces Dr. Howard Dean. As the two gentlemen exchange their admiration for each other’s work, the door at the back of the room opens for a second and the chanting voices of the protesters outside echo through the auditorium: “Single payer now!”
Highlights from Howard Dean’s speech:
There will be disagreements in this debate.
The recent election was all about people under the age of 35 and bipartisanship. However, health care should not be sacrificed on the altar of bipartisanship.
(Obama has said that if he gets 85% of what he wants with a bipartesian majority it would be preferred to getting 100% of what he wants with a 51% democrat-only passage).
The arguments for and against single payer are currently being re-framed.
We can’t have an economic system without health care.
Dr. Dean acknowledges the people outside shouting for single payer. There are people across the county who want that, but there are also many who want to keep what they have with their company or private insurance. There should be a choice: If you like what you have, you keep it; if you want single payer (medicare) you can choose that too. It is good that the protesters are out there making noise. We really have to drag this conversation as far to the left as possible, because the republicans and ‘blue-dog’ dems will drag it back to the right.
Insurance companies are going to be forced to change (part of the bill as introduced makes it illegal to deny coverage based on pre-existing conditions as well as life-time limits on payouts) We have learned that the free market does not work in health care.
Highlights from Earl Blumenauer’s speech:
We will fail if we create false choices. (ie. the choice between single-payer and nothing).
The veterans administration has managed to do what we would like to see the rest of the health care in this country do: Things like negotiation of prescription prices, cost cutting and providing good care. Portland (with the community coalition of clinics) provides better outcomes for people with less money.
Q & A from the audience:
Q: Are you incorporating food safety into the bill on the floor?
A: We need to change the illness-based system to a wellness-based system. This involves a change in the American ideals. We do need to educate people about what the heck is in our food. As a doctor, Dr. Dean is concerned when the animals who provide meat need to be covered in antibiotics. We also need to encourage people to get a living will to stop sucking money out in the last few months of life. We are working on a way to pay doctors to sit down with patients and talk to them about death instead of ordering thousands of tests.
Blumenauer: The real value of food is not reflected in its cost. Why does a Twinkie which has a dozen highly processed ingredients cost less than a local organically grown carrot?
-He doesn’t really answer the question…there is a food safety bill currently getting mulled over and torn up in the congress… but it is not being linked to the health care bill, per se.
Q: What is being done about workforce development in all of this reform?
A: We need to kick things down the chain. Let nurse practitioners do the job they are trained to do. Etc. (this should include NDs –trained to be PCPs).
We also need to eliminate the fee-for-service model.
How do we help the field of primary care, we should start by making sure that medical students don’t leave school with hundreds of thousands of dollars in debt. We need to incentivize vertical care models such as Kaiser. The way the system is currently set up hospitals will see the prevention of major surgery as a loss to their bottom line.
Doctors are not paid to listen to patients and plan for their wellness and death with dignity. They are trained and paid to perform procedures on them. This is the way capitalism interacts with health care.
We need to reverse that.
We have to change the financing system of health care first, then work on health care reform.
-When we have people in the ‘business’ of health care , investing in things that are not on board with creating a well society, the system is stacked against itself. Legislation can control and reverse this situation, and it should.
There were some suggestions for the people in the room to connect to a network, start sending articles, educating people, have house parties, raise the temperature.
2009 is the year for this reform to happen.
Quiet conversations can have a big effect.
Ron Wyden? Where are you on this? Will you pass the reform? Dr. Dean and Mr. Blumenauer encourage people to contact Mr. Wyden’s office to get his support. We need Ron to get right with the idea of getting the legislation passed to get everyone covered. He will respond to his constituents.
The focused message here is: There must be a public health opinion.
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