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The Names of the Dead

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While the political theater slogs towards it’s ‘battle fatigue’ finale in Washington, D.C., and elswhere in the United States of Amnesia, one American, who also happens to be a politician has decided to approach our health care conundrum in the spirit of the Cluetrain Manifesto and from the footprint of the human experience via a story telling process, i.e., the human narrative.

The name is Congressman Alan Grayson, and the site is Names of the Dead (dot) com. While some will immediately look to party affiliation, and standing with respect to the health reform bills before the Congress to position how they’ll ‘receive’ (or discount via an ideological filter) his message, I encourage you to watch some if not all of the videos.

They are personal stories of Americans who died directly as a result of delayed access to medical care. An empirical basis for the claim that lack of health insurance is associated with mortality is provided in the peer reviewed study Health Insurance and Mortality in US Adults.

The publishing of this report is a timely and top of mind topic, since as a male I am one of the 47 million Americans without health insurance, and a boomer in his 50s, who has occasion to think about the 1 in 6 prospects of prostate cancer in my future. Specifically I have pondered, and have avoided to date, submitting to a PSA test. And yesterday via virtual participation in the TEDMED hashtag stream (#tedmed) I came across a prostate CA piece from theVisualMD dot com, which only further affirmed my fear, and stoked a somewhat borderline despair.

Why ‘borderline’ despair? A few illogical and perhaps ‘magical thinking’ reasons come to mind:

  • I am avoiding the test since ‘ignorance is bliss, and I am uninsured?’ Ergo, if I or any lab for that matter doesn’t know, then it can’t be confirmed as a pre-existing condition, right?; and
  • If I am a positive, then what? I am not insured and can’t afford the treatment. So county here I come? No thanks, I don’t subscribe to the ‘John Goodman theory’ about the mythology of the uninsured in America.

So my choices are to sit with the 1 in 6 odds and continue as I am, pretending not to be concerned. After all, my history is disease free, and as a health care ‘insider’ I avoid interacting with the health care delivery system as a general rule, staying active and eating healthy for the most part.

Yet, I can’t help but think about those stories that Grayson is sharing with America and asking myself, will I be on the list soon?

So while we debate and more accurately obfuscate the nature of the problem we face vis a vis health reform solutions, people die daily. The ‘dead man walking’ queue witnesses some 122 new recruits each and every day.

The health reform imperative is real tweeps. Unfortunately the dividing line all to often seems to be between those who are employed, and have health insurance (aka, the I got mine crowd) and those who do not; many of whom are employed or self employed but none-the-less locked out of the system due to obscene health care costs or opportunistic underwriting and/or retrospective rescission schemes.

So what’s it going to be peeps? As a society, who will we value and install as the ‘anchor’ tenant in medicine? Will it be (generically speaking) a Mayo model, or the status quo, volume incented, quantity driven series of competitive fee-for-service sweat shops, dba ‘McAllen’s’ (generically speaking of course)?

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Written by 2healthguru

October 29, 2009 at 10:47 AM