The bottom line in health care

healthIn my previous post on Single-payer health care: Why not?, I talked about our family’s experiences with health care in France, UK, Ireland, Italy, China, Australia, and other places in comparison to that in the US. This included health care for children and the elderly, and both minor (blood donation, physicals, skin growth removal) and major (broken hip, eye infection) procedures.

Thinking a bit more about this I realized that there were four essential facts that emerged from this wide variety of experiences. In every industrialized country except the US,

  1. Equitable: Everyone has the right to health care.
  2. Effective: People live longer, healthier lives.
  3. Economical: They spend less on health care, as much as 50% less.
  4. Efficient: There is much less bureaucracy, fewer forms, less running around, less waiting.

dollarI might add a fifth point, too: The scare stories that we hear (“you have to wait forever!” “you can’t choose your doctor!”) are simply false, or they index issues that are the same or worse in the US. The information we get about health care promotes profit, not health.

There are many issues–changing demographics, new technologies, new medical knowledge, changing standards, globalization, and more–which affect health care. But the fundamental difference in the current US situation is that health care is driven by the bottom line. Insurance companies, pharmaceutical companies, media corporations, hospitals and clinics, doctors and other health care professionals, and all others involved in health care operate in a system in which rewards bear little relation to the overall quality of care or efficient use of resources.

One can debate each of the points above, but the evidence from OECD, UN, WHO, WTO, and other international organizations is overwhelming in support of them. Other systems offer health care that is more equitable, more effective, more economical, and more efficient.

So, why is single-payer, or national health care not even worth discussing? Why does the Obama plan dismiss it? Why does even public broadcasting ignore it?

How to behave at the final defense

While cleaning out 30 boxes of files accumulated over many years, I came across an article by Neil Postman, which though long-misplaced, was fondly remembered. Postman  provides a humorous, but all too true account of the doctoral oral examination.

As he says, he rarely pays attention to “the content of an Oral – for example, what the dissertation is about or what idea the candidate is defending. [His] attention is always directed toward what the Oral is really about, namely, the conduct of relationships, obedience to authority.”

Here are a few excerpts, but I recommend reading the whole piece:

  • When the Orals begin, the door to the room is closed…like the closing of the main hatch of a submarine. Those inside are sealed off…from the rest of the world.
  • Eating during an orals is a breach of the system in that it not only dilutes the solemnity of the occasion but it reminds people that there are needs in life other than the passing of orals… [One candidate] brought with him a styrofoam cupful of chocolate ice cream which he sensuously engulfed as if he were replaying a scene from Tom Jones…it was a symptom of a general insensitivity to the nature of the occasion, and he was flunked without regret.
  • an attitude which combines concentration with slight bewilderment is about perfect.
  • leaning one’s elbows on the table, with fingers resting on one’s temples is very good, especially when accompanied by an intense frown.
  • Those who ask convergent questions are usually interested in the dissertation. Those who ask divergent questions are usually interested in the candidate. With the exception of very few of my colleagues, no one is much interested in ideas. (Those who are, of course, have never really understood the functions of an oral examination.)
  • questions [from the candidate] such as, “Why do you want to know that?” or “Are you quite sure you have your facts right?” are monstrous, and will bring down upon the candidate the full weight of the combined insecurities of the professors.
  • professors not only ask questions; they also make little speeches as prefaces to their questions…From the candidate’s point of view, these speeches are of no consequence since they are designed for the attention of other professors…The candidate would do well to appear interested but can put the time to good use by relaxing and trying to order his thoughts.
  • the oral examination is a serious test of how well a young scholar understands the structure of this and, by extension, other academic situations.

References

Postman, Neil (1978). Final orals: In defense of a thesis. The Gadfly, pp. 2-5. (the Littoral Press, iSSN 0160-1237)

The story of stuff

home-diggerAnnie Leonard has created an excellent, 20-minute video+animation that calls for creating a more sustainable and just world: The Story of Stuff with Annie Leonard

The story is told in an engaging, even funny, way, very accessible to children, as it addresses serious environmental and social issues. It discusses the inadequacies of the linear model for the materials economy, which conceives stuff in terms of extraction, production, distribution consumption, and disposal. Annie shows how these mostly hidden processes affect communities in the US and abroad. It’s lively, informative, humorous, and makes us think of the stuff in our lives in a new way.

The story of stuff website has additional resources, and the book will be available March 9, 2010

Using photography for qualitative research

nikon-d40-digital-cameraWhile lost amidst sorting through 30 boxes of my files, I’ve occasionally come across some gems. One is

English, Fenwick W. (1988, May). The utility of the camera in qualitative inquiry. Educational Researcher, 17, pp. 8 – 16.

As we do research, prepare proposals for conferences, and work with community members to document their own experiences, it’s worth thinking about alternative methods for doing and presenting research.

English’s article (available online through Sage or the UI Library) uses interesting photographs to discuss the role of the camera in inquiry. He also explores the metaphor of the photo as a way of thinking about different approaches to a research subject, foe example, the wide angle view that surveys a situation versus the telescopic that focuses in on a particular issue.

Mapping cemeteries

Several of our Youth Community Informatics sites are mapping cemeteries. What sounds like small project, or even a gloomy one, soon opens up into far-reaching explorations of history, geography, health, families, technology, mathematics, literacy, and more.

At Iroquois West Middle School, youth started with a story about a primary school’s project to study cemeteries: Learning from graveyards. The “Map Masters” soon expanded this by incorporating technologies of GPS and GIS into their mapping project of the Onarga Cemetery. They have already made many discoveries and are continuing to do more. They’ll also connect with cemetery mapping projects in Cass County and East St. Louis.

One interesting tombstone that we found at the Onarga Cemetery was in the shape of a tree trunk. The name of the person buried there was Emory Gish. According to our reseach on symbolism the tree trunk showed a life cut short. The number of broken branches might symbolize the number of deceased family members buried nearby.

Guns against tyranny?

douglassA recent political cartoon showed an ayatollah in Iran pointing a gun at an unarmed citizen, who feebly tried to respond with a pointed index finger. It implied that if Iranians had gun rights they’d have a better chance of standing up to tyranny. The implication was that our Second Amendment had been written for a similar purpose: to protect ordinary people from governmental oppression.

But whatever merits or problems one might see in the Second Amendment today, it’s worth remembering that it was not conceived to enable people to stand up to government, but for precisely the opposite purpose. James Madison wrote the Second Amendment to reassure Southern states that Congress would not disarm their militias, which they deemed to be necessary for slave control. Thus, the amendment ensured that people in power could continue to oppress, not the other way around. For Iran today, this would be akin to guaranteeing that the ayatollah shown in that cartoon would always have a gun, while the citizen did not.

jamesmadisonCompromises to ensure ratification

The Constitution required ratification by at least nine states. Eight had ratified it, but anti-Federalists in other states held sway. Virginia was divided, with George Mason and Patrick Henry arguing against ratification. They raised the specter that Congress might refuse to call forth the militia to suppress a slave insurrection or could even disarm the Southern militias.

Although the Federalists prevailed, James Madison’s career was damaged. In order to resurrect it, he promised that he would support adding a bill of rights including this provision: “A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed.”

Carl Bogus (1998) shows that Madison wrote the amendment for the specific purpose of assuring his constituents that Congress could not use its new powers to deprive the states of an armed militia. Their primary concern was not that Congress would disarm the militia and thereby prevent hunting, self-defense, national defense, sport shooting, or resistance to governmental tyranny. Instead, it was that disarming the militia could bring an end to slavery. Despite later revised interpretations, the amendment did not grant individuals a right to keep and bear arms for random purposes, but instead for “well regulated” militias whose essential purpose was to prevent a slave rebellion, as happened in Saint-Domingue (now Haiti) just three years later.

As in any political arena, there were multiple interpretations and motivations at the time, as well as misunderstandings due to making sense of these more than two centuries later (Amar, 2005). A major concern in 1788 was of course the war against England and fears about future invasions. But it’s also clear that a driving force was the desire to preserve the institution of slavery, thus using guns to maintain tyranny, not just to resist it.

References

Amar, Akhil Reed (2005). America’s Constitution: A biography. New York: Random House.

Bellesiles, Michael A. (2002, July). Constitutional meanings. Common Place, 2(4).

Bogus, Carl T. (1998, Winter). The hidden history of the second amendment. UC Davis Law Review, 31(2).

Douglass, Frederick (1881). Life and times of Frederick Douglass, his early life as a slave, his escape from bondage, and his complete history to the present time. Hartford, CT: Park.

Mencimer, Stephanie (2008, March). Whitewashing the Second Amendment. Mother Jones.

Spitzer, Robert J. (2000). Lost and found: Researching the Second Amendment. Chicago-Kent Law Review Symposium on the Second Amendment, 76.

Journey sticks for learning geography

This video about journey sticks for learning geography presents a project for Key Stage 2 pupils (ages 7-11) in England. It’s a different age level, orientation, population, and technology from our Youth Community Informatics project. Even so, it has some interesting ideas and you’ll enjoy watching it. It shows how simple tools can help young people open up to the world around them.

The origins of mobile phone and email

atsignMartin Cooper and Raymond S. Tomlinson have just been granted the 2009 Prince of Asturias Award.

Cooper invented “the first handheld mobile telephone and supervised the ten years that were necessary to commercialize the product. He … formulated the Law on Spectrum Efficiency, also known as Cooper’s Law, which states that the maximum amount of information that is transmitted over a given amount of radio spectrum doubles every 30 months.”

tomlinsonTomlinson worked at Bolt Beranek and Newman (now BBN Technologies). He helped develop the TENEX operating system, which had several innovative features, including a full virtual memory system, a user-oriented command line interpreter, and a command escape recognition system. In 1971 he developed the ARPANet’s first application for email by combining the SNDMSG and CPYNET programs so messages could be sent to users on other computers. He selected the @ sign to identify the user’s computer. Before long, that sign became the icon of the digital era.

Ray and I were colleagues at BBN, and teammates on the Great Swamp Volleyball Team, but I was just an ordinary user of that ground-breaking operating system and that early form of email.

References

Kapitzke, Cushla, & Bruce, Bertram C. (2005). The arobase in the libr@ary: New political economies of children’s literature and literacy. Computers and Composition: Special Issue on the Influence of Gunther Kress’ Work, 22(1), 69-78. [doi:10.1016/j.compcom.2004.12.014]one of

Juneteenth World Wide Celebration

Yesterday was the Juneteenth World Wide Celebration, the commemoration of the ending of slavery in the United States. As you can see in President Obama’s statement below, it’s based on the actual, as opposed to the mandated, freeing of slaves in Galveston, Texas in 1865.

I remember the celebrations in Texas when I was young, and it’s good to see those events being recognized more widely. That’s not because Juneteenth marks the completion of America’s struggle against racism, but because understanding our past can help us begin to deal with the reality of racism today.

whitehouse_juneteenth