I'm generally a pretty pessimistic person. Or maybe I'm just a realist. For example, I spend a lot of time reading and thinking about climate change, and I have reached absolutely no conclusions about anything. I feel like no one can have an informed opinion on the subject because there are just too many variables and unknowns.
I feel sort of the same way about health care in this country. As a ER doctor friend said to me recently "there is no system" in the health care system.
But Atul Gawande, a physician who writes for the New Yorker, has the power to make me less pessimistic. He did it last summer when he wrote about end of life choices. He did it 2 years ago when he contrasted health care in a smallish place in Texas with care given in Rochester, MN.
Now he's done it again by writing about medical hot spots: specific places and specific types of people who account for huge gobs of health care $$. And how some very smart people are using common sense and grass roots techniques to keep those specific people healthier. If you're interested in this kind of (wonky?) thing, you gotta read it; I can't summarize it.
Photograph by Phillip Toledano.
2 comments:
Its nice that this caring soul was able to invest so much of his time and energy being a social worker to the most expensive patients who chronically over used the health care system...The real world, however, of working as a social worker therapist isnt that easy or neat and tidy...For one thing, we dont have huge chunks of time to talk and sit with people on why they are sick...Health insurance companies keep strict controls on how much time we spend with patients...Getting that kind of time for the most chronic patients is a luxury...Secondly, most chronic patients have multiple psychological and psychosocial problems and need complex , long term social services that this country, the voters and the big health insurance companies refuse to invest the time and money for...I was turned down countless times advocating for many clients by managed care for wanting to do exackly what was done in this study for a few people he interviewed...The study was heartening but not realistic in terms of applying this tot he real world and didnt already inform we the providers something we didnt already know working in the broken system...Complete overhaul of the healthcare and social service system and widespread public education of voters about mental and physical health and prevention of illness is what will improve health more anything...As a social worker therapist with 20 years doing what he did for one day, proposing this is the solution to the healthcare crisis is really a drop in the bucket of a larger, unseen web of problems....He's just touched a tiny tip of the iceberg of the problem.
Stephanie Simpson, MA, MSW
Thanks for the insight Stephanie. I started out my post by saying "I'm generally a pretty pessismistic person....But...."
The "but" was a big step for me. I was trying to see some hope for our broken health care system, and Atul Gawande was just persuasive enough to get me briefly over the hump of pessimism. But now you've bumped me back into reality and I'm all "oh hell, there's no hope." At least not in my lifetime.
Your concluding remark "He's just touched a tiny tip of the iceberg of the problem" is exactly how I feel about so many problems. But I'm trying to change my ways and start feeling, really feeling, that tackling a big problem can be successful if you just work on "tiny tips of the problem." Then you take on another tip, and another, and another. And eventually you've achieved a lot.
That's the optimistic way to look at things, right? Or is optimism a fool's way?
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