A little sincerity is a dangerous thing, and a great deal of it is absolutely fatal. -Oscar Wilde

Sunday, December 27, 2009

Holidays and health care reform perspectives

I hope that the handful of you that read my little journal had a lovely holiday, or if you don't celebrate, a lovely day. Christmas remains my favorite holiday, even though it doesn't really "feel" like Christmas when you're so busy in the time leading up that you're ready to drop from exhaustion. My all too brief winter break consisted of a lot of cooking and last minute baking/ confection making, DVD watching (while baking/ cooking), and napping. The cats, they do so like the toasty apartment and the bounty of treats, catnip, and toys from their admirers... not to mention the human-sized hot water bottle for their own napping.

It's sad that this was in all likelihood my last Christmas season here, and yet there was no visit to Oglebay or other light displays, no visits to the various holiday attractions, and little time with friends or family. Given that I'll be the low man on the totem pole wherever I am next season, I'll probably just be in and out for Christmas. Which means that there really isn't a "next year" anymore. It's weird to think about. I've tried to arrange time with others, but I think that there's a significant amount of denial and the insistence that I'm not going anywhere... making everything that much harder on me.

So... I made the first cut of the Presidential Management Fellowship. The next step is a really, really long test down in DC. So I'll be down January 13th, in downtown (the site's near the Farragut West metro stop), exact arrangements to be determined. I'm applying for a federal positions as they arise, but there's a state-level fellowship that looks intriguing. That one could place me in Virginia, NC, Maine (my top choices).

Anyway. Speaking of my future career and such, how about that health care reform? It's... something, but it's not real reform. It's an attempt to broaden access, but it's so bogged down with trying to keep various interests happy and it's lacking guiding principles like "nobody will go without health care" or "we will revamp our system to make it at least efficient enough to not spend one-fifth of our GDP on care that's not making our country particularly healthy". Or how about actually reducing the 5,000+ monthly deaths from preventable medical errors. It's also a testament to how far the country has shifted to the right in the past 40 years or so. The bills in the conference committee now are actually not so terribly different from health care reform legislation proposed by Richard Nixon, of all folks. Unfortunately, Watergate came along soon after, and that was pretty much the end of that. But it's a sad state of affairs when ideas that came from a fairly conservative president are now being blasted as "socialist." And it's an even sorrier state of affiars when this is, you know, only my field of study in which I'm a thesis away from a masters, and yet certain friends and family seem to think that I still know nothing about the subject. Huzzah for personal politics getting in the way of actual thought.

It pisses me off endlessly how people are in denial on both sides of the political spectrum. No, we DON'T have the best health care in the world. We're on par with countries like Costa Rica in terms of infant mortality, despite spending twice as much per capita as the next biggest spender. Yes, we have cutting-edge technology- but only a small fraction of the population can actually access it even with insurance thanks to arcane agreements between hospitals and insurers, cost-sharing and rules about "experimental" treatment. So what good is that technology if only the ultra-rich have access? On the other hand, stop comparing the US to Canada-- Canada has one-tenth of our population, is far less diverse, and has a completely different national character. And like it or not, we can't just destabilize such a huge chunk of the economy. Health care in the US has become a particularly large brain tumor at this point-- it's quietly grown into a major problem while we were all focused on more immediately pressing issues. But going in all helter-skelter is just as dangerous as completely ignoring the problem. But as we've sadly learned and seen, over and over again, nobody is willing to actually listen to the people who study this issue (ahem... like myself...). Almost everyone has their own political axe to grind, and very few are willing to let something like facts get in the way.

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