Have the Rules of Politics Changed?

At the end of Star Trek II, The Wrath of Khan, Mr. Spock dies, and when asked by an anguished Jim Kirk why he sacrificed himself, he states simply: “Don’t grieve, Admiral: The needs of the many outweigh the needs of the few…or the one”

Jonah Goldberg, an editor at large of the conservative National Review Online, bemoans the shifting of the rules of politics, from what has up to now been straight lines from point A of a societal shift, to Point B, our typical response to it; I quote:

“For more than 40 years it has been a rule that environmental disasters – and scares over alleged ones – help environmentalists push tighter regulations…  According to the rules populism is a force for getting the government to do more, not less…According to the rules, Americans don’t care bout the deficit during a recession….And yet (today) none of these rules seem to be applying; at least not too strongly…As a conservative…it’s becoming harder and harder to shake the feeling that something bigger than politics as usual is at work here.”

Indeed, something bigger than “politics” as the public generally defines the concept is at work, and I believe Mr. Spock’s dying words provide the explanation.

We have…voters and legislators alike…abandoned the willingness to do what is best to meet the needs of the many, wanting instead to ensure that our idiosyncratic needs, i.e. those of the few, are met.

Thus the schizophrenic reactions from every body politic, left/middle/right.  The extreme Right wants less government….unless it negatively impacts entitlements they hold dear like Social Security and Medicare; extreme liberals want more government…unless it interferes with individual causes like immigration and sensible regulation of the internet; Centrists may see both sides of the issue, but are paralyzed by indecision, or flip-flop, because they too get mired in what will best serve an individual vs. greater good.  We want what we want when we want it, without regard for either the long-term or overall impact of our choices.  We don’t seem to care about the big picture…the needs of the many.

In Star Trek III, Mr. Spock comes back to life in perfect sci-fi form…so his sacrifice wasn’t a final one after all.  The same is true for us.  By doing what’s best for the many over time, even when it will create some hardship for the few in the (relative) short-run, our sacrifices, too, may be difficult, but will not be permanent.  From energy sources to social security, only once the many agree to place the country’s wellbeing as a whole above their own individual wish lists, will we at last be on the path to a better nation.

Thinking for Ourselves….Part II

Here’s some quick, easy, and helpful tips for self-determination of thought so we can stop relying on TV & Radio pundits to do the thinking for us…

  • Assessing legislation: It’s easy to tell when legislation is designed to help a special interest rather than us (it’s clear in a bill’s language, carved out exceptions, etc.) – what makes this even easier is that pretty much all legislation is designed to help the politicians as much (or more) than their constituents; how would you create that bill (in general terms) so it benefits us, not them?  Now you know how to think/respond to not only the legislation at hand, but your legislators about it…
  • Assessing decisions made by leaders, whether elected or otherwise: Those who have been in a supervisory/decision-making position know first-hand how difficult the job is, and that you can’t please everyone…those who have experienced a variety of supervisors know the difference between a true leader (helps others to do the right job the right way) and a “manager” (tells others what to do/seeks no input); true leadership requires balance – balancing the needs of the many against those of the few, doing the utmost to create a win/win for all concerned and if that’s not possible, ensuring there’s balance between all interests so everyone at least comes away with something they need.   When those at the fringes of both sides of an issue are unhappy with the outcome, that’s a very good sign that the outcome is balanced, that true leadership rather than “management” has taken place, and that the decision is generally a good one
  • Avoiding The Dunning-Kruger Effect: Discovered by Cornell University David Dunning (along with Prof. Kruger) this states that our incompetence masks our ability to recognize our incompetence – wow, that’s a catch 22…and it underpins much of the erroneous thinking we unwittingly do (like letting others do the thinking for us…).  To keep this from happening to you, simply increase your level of competence.  This is easily accomplished by:
    a). some fast fact-checking of claims/opinions/statements made (the internet makes this effort that much easier), thus making sure you form your own thoughts based on fact, not emotion or a situation in process that may not even pan out; and

    b). understand that we all have levels of incompetence and be strong enough to find out what are yours…once you know what they are, you can ensure you don’t fall prey to them…

  • Don’t make decisions when you’re very angry or depressed: When you do, they will most often be bad ones… This is why we see Boomers holding opinions that are self-contradictory (wanting government out of their lives while preparing to collect SS/use Medicare), or choosing to behave badly, from shooting at Census workers to brawling at their children’s sporting events…  That incompetence thing above is fueled by such powerful negative emotion, which masks our ability to think more rationally/use deductive reasoning (or any reasoning at all for that matter…).  These are awfully hard times – making bad decisions that will come back to haunt us later will only make things worse.  Remedy: seek some input/help from someone you trust who isn’t angry/depressed, and listen to them.

As we Boomers, the ones in power and with the greatest influence, wield that power and influence, it is imperative that we live by Spidey’s uncle’s words: “With great power comes great responsibility” – what we do, how we vote, what we say now, will not just make a lasting impression on our young children/grandchildren, but will form the basis of our lives for years if not decades to come.

To do these things with little preparation, in-depth thought, and with too little rationality, is no different that letting a teenager drive with no training and practice (whoa…that’s scary – teens driving with lots of training/practice is scary enough…), seeking a job without a resume let alone a well-written one, or going on vacation without packing for it…

We can do this right.  Let’s start right now.

The Real Issues for Health Care Reform

Boomers face the highest levels of unemployment since our post college days, which, of course, includes loss of medical benefits – none of us yet qualify for Medicare.

So, reform is crucial for us, particularly at our age (we need insurance more to stay healthy).

Yet some of us remain vehemently opposed to this legislation, purportedly because it unacceptably adds to the federal deficit, and/or does too little to impact change that is significant enough to matter.

Both objections are founded in specious reasoning (or for some, no reasoning at all, unfortunate for the most educated generation our nation has ever had…).  According to the CBO, the bill will reduce the deficit, and the elements of the bill clearly provide long overdue protections, some immediate.

The issues, it seems, are not those on which Boomer objectors have based their lack of support.

They are:

  • How the insurance companies will respond to the legislation… Will they increase their prices as soon and often as possible?  And what protections exist for that scenario?
  • What else is needed to ensure consumer protection in a capitalist system where businesses, designed to make an impressive profit for their shareholders, are key players in our health care.  And, in the case of health insurance companies, they can do so without regard for their impact on the lives of those they “serve”

So I ask my fellow Boomers to concentrate on all the ways we can make this legislation better, and more cost efficient – including Medicare Advantage plans which pay for member perks by charging all Medicare recipients – meaning the majority who don’t use/get those perks (since in as little as one year, this will impact us)

We know this process is far from over, so let’s make sure that by 2014 we have something really excellent.

We Americans, all of us (particularly our children and grandchildren), deserve it.

Medicare for Younger Boomers…

…a great idea, or an expansion of a program that has gone beyond it’s effectiveness?
Well, by the response of those Boomers chanting “keep your hands off my Medicare” it would seem the answer is clear.
I wrote the White House & a number of Senators around 2 months ago, recommending that an expansion of Medicare be the alternative to a “public option” – i.e. why reinvent the wheel; just fix the wheel you have (Medicare does need some overhauling to keep it solvent and make it far more efficient) and use it, I opined.
Although my thinking was to use it for all age groups, to start by offering it to most of we AARP types makes more sense.  If that works, it can be further expanded from there.
Given that a whopping 12% of Boomers 55-64 (4.3M) are uninsured according to a Kaiser Family Foundation study, coupled with a huge number 55 & up being forced to retire early and as a result losing the healthcare coverage that goes with their job, we represent a large portion of the population in need of coverage, at a time in our lives when such coverage is essential.
Expanding Medicare is the most palatable way to do this, with far less resistance to it than any other “public” option.  And certainly those citizens who are oh so happy with their Medicare coverage but don’t want the uninsured to have the same security if that means everyone must give a little for more to get, this may calm their fears.
And the time-frame prior to any healthcare reform legislation kicking in will give the Feds the time to clean up Medicare prior to expanding it.
My fellow Boomers, many of our generational colleagues need relief, now.  It is up to all of us to ensure they get it.
Expanding Medicare is the most efficacious way to do just that.

How Boomers Can Change the Healthcare System

Wow…..that’s quite grandiose, eh?  That we as a generation could CHANGE the healthcare system as we know it?

It isn’t, and we can.  Here’s how.

I’ll start with the problem in the system that is within our control.  A big chunk of what’s wrong with healthcare is not being discussed: that too many doctors have long since abandoned quality care for quantity billable hours.  Here’s the result and how each one harms the system:

  • When we feel that our doctor cares less about us than his/her bottom line, we are more apt to sue when things go wrong – we believe they do not have our best interest/care at the core of their work, as a result it is much easier to believe malpractice, malicious or otherwise;
    Harms the healthcare system through higher levels of frivolous lawsuits
  • When doctors are not taking the time to truly listen, learn about us, automatically get our records from our other doctors and collaborate with them on our care, the result is the need to order tests and lots of them – when you work in a vacuum, you need to gather information to fill that void, information that often can be gleaned from other sources rather than more tests;
    Harms the system through needlessly perpetuating tests, not based on our tendency to sue, but their tendency to do too little discovery on their own, using their medical arts training
  • Speaking of working in a vacuum, doctors today take a full-blown silo approach, attending to only their tiny specialty piece of our personal health-needs puzzle, as though their part of the body is completely disconnected from the other parts (not to mention the emotional/psychological aspects of our physical health) – it isn’t – all of the body’s parts work in concert, and specialists need to consider other systems/parts that impact their specialty’s – but too few do;
    Harms the system by again creating the need to order batteries of tests; also lends to more misdiagnoses, the need to see more doctors until you find someone who might put the pieces together for you, and mistrust that fuels lawsuits
  • Overbooking is the medical mantra – thus doctors expect us to wait for sometimes an hour, before being seen for a pre-scheduled appointment; beyond the facts that if we ran our businesses like that we wouldn’t have one and the practice is clearly disrespectful to us (treat our time as far less valuable than theirs), the most important problem here is that the person making decisions about our healthcare issues is in such a rush, there is simply no way s/he can do a quality job;
    Harm to the system is increased misdiagnoses or no diagnoses (once the most obvious cause for your symptoms has been ruled out, the medical shoulders shrug and you’re left still not knowing what’s wrong with you…or you’re sent to yet another specialist) both of which increase our costs (more doctor visits/tests), and once again, increase the lawsuit tendency.

Now here’s what we can do to fix it because, as I mentioned above, this is within our control:

  • Insist on better care – do not accept poor quality medical practice, as the more we accept it, the more of it we’ll get; let any doctor you see know upfront what you expect from him/her, and be prepared to seek other practitioners if you don’t get it – do not settle for mediocrity as though you have no choice
  • Insist that your doctors talk to each other, that your records be shared, and that your doctor listen to all of your concerns and existing medical needs/issues, regardless of the body part you’re there to address – neither they nor you know what’s impacting what until you discuss it
  • Do not wait more than 15 minutes to be seen – unless the doctor has an emergency or they’re fitting you in on an emergency basis – let the scheduling person know this intention when you make your appointment, and make checking on the doctor’s timeliness a part of your doctor-choosing decision; then follow through if they do make you wait longer than the time you’ve agreed to wait – let them know you’re leaving, and give them one more chance to do it right by making another appointment (if you wish); usually your return visit will be handled much better…
  • Become a well informed consumer/partner in your care – go to your appointments prepared, understand as much about what’s happening to your body as you can rather than fully depending on the doctor whose only half-listening anyway, insist on explanations for their recommendations, benefits/down-sides, etc. rather than blindly accepting what they decide – I have provided my doctors with alternatives they’d not considered as a result of my due diligence
  • Do not agree to tests with which you don’t feel comfortable or, after some research you believe to be unnecessary – you’d be quite surprised by how many tests you’ll find are more about CYA for the doctor vs. your well-being, once you’re more fully informed

We Boomers have no problem asking for what we want, we are the best educated generation so our research skills are excellent, and we are unwilling to accept the “status quo” (these are just 3 of our generational characteristics that come in handy, here) – much more so than any other generation, including our childrens’.  We can use these abilities to change the expectations we have of the medical professionals in our lives, thus changing the way our own doctors work with us.  By using only those doctors who meet all the above criteria, we are putting our dollars to work supporting best medical practice, not worst.  

And with 78 million of us, that will have a huge impact.  Over time, those with the best practice approaches will thrive, the rest will not. 

The resulting reductions in lawsuits, unneeded tests, and additional doctor visits as one specialist no longer automatically sends you to another before doing all s/he can to diagnose your problem him/herself, will make a nice dent in our healthcare costs.

Make cents?