"If Only the Nation Were More Like San Francisco"

by: daprovocateur

Mon Jan 04, 2010 at 13:00:50 PM PST

(cross posted at NPA Blog)

The most recent edition of San Francisco Magazine (which I read only when I see it strewn across piles and piles of books, journals and mags at my in-laws' place in Sonoma) features a run-down found here on Healthy San Francisco, a health care access system for SF residents to receive care at nearly all health care providers in the city (My long-time SF friend reminds me that it's not a health insurance plan so what you do when you get alcohol poisoning in Napa or get shot in Oakland - or vice-versa - is beyond me). I am looking forward to actually reading the thing and learn about its inner-workings, but what I find most intriguing is this commentary by SF Mag's Editor-in-Chief Bruce Kelley.

Kelley states:

When it comes to national healthcare reform, I think we should throw participatory democ­racy out the window. This one policy debate would go better if the American public were silent and disengaged, refusing to blog, carp, watch Fox News, or exercise its voice. It would also be helpful to suspend the constitution, strip all interest groups of power, and install a temporary dictatorship. One smart person would make the final decision how to address the healthcare disaster. She’d be advised by other smart people. She would wave a wand. Then Congress would return from a short hiatus, and the sausage-making would resume.

Kelley goes on to tell that that's basically how Healthy SF came to be - without anyone actually noticing - and since it's such a hit, we should replicate the process and fix US health care a la SF...

the holidays are here and we're still at war

by: los anjalis

Sat Jan 02, 2010 at 10:00:00 AM PST

Pilgrims in the parking lot
Arteries clogged with blood clots
Pushing through the aisles of department stores
Neon crosses and Christmas lights
Credit card debts and brand new bikes
The holidays are here and we're still at war...

(more after the jump)

Unicorns

by: revolution.is.medicine

Mon Dec 28, 2009 at 23:22:30 PM PST

Yesterday, I noticed a sign on the wall at our hospital just outside our office. Taped above a table, it reminded doctors to bring lunch trays back to the lunchroom, not left on the table near the door. Far beyond the standard business casual passive aggressive mandates, this sign climaxed in a fury of times roman 26 bold: "Doctors, your lack of consideration for staff and patients is horrifying!!!"

Really? Not the lack of health care in the USA, that our patients wait by the hundreds to be seen. That's A-OK. But dishes not done, scourge of modern civilization. All this for a lunch tray hurriedly left between patients, rounds, and pages? Really? It bothered me. A lot. It reminded me of everything wrong with our hospital. Quick to ascribe the most negative human attribute to stupid actions, slow to address systemic solutions to real issues. Neglected lunch tray = Horrifying lack of consideration. Poverty, disease, despair = normal and unnoticed.

The sign has been up for years, visibly reminding the entire patient, staff, physician community about the paucity of compassion amongst our doctors. & Yesterday it really, really, really bothered me.

Today, it took the sign down. I ripped it up, recycled it.

Today, BTW, I also added anew sign on our otherwise dull door. Title:

"Welcome to Our Family and Community Medicine Department." Followed by big picture: prancing unicorn and falling stars. Caption: "Making the hospital fabulous since 1974!"

New slogan for our department at bottom of page: "Family Medicine: where puppies and unicorns meet the street."

I feel much more at home.

Moral of story: when feeling run down by bureaucrats and hegemonic systemic illness, make happier signs. Preferably with unicorns.

los angeles' homeboys travel to rural alabama

by: los anjalis

Tue Dec 29, 2009 at 09:00:00 AM PST

The video -- "Alabama's Homeboys" -- captures the critical intersection of rural poverty, joblessness, crime, race and youth, and leaves the viewer with more questions than answers, but is quite inspiring. The Times also provided extremely sobering socioeconomic statistics about Prichard, Alabama at the same link.  It's wonderful to see Homeboys Industries continuing their stellar work in the face of a financial crisis.  Folks who would like to support Homeboy Industries can donate money as part of Homeboys' "virtual carwash". And if you're in Los Angeles you can volunteer at Homeboy Industries, dine at Homegirl Cafe, or purchase Homegirl Cafe's salsa, now selling at Ralphs.  

(cross-posted at LAist)

calling for civil discussion among progressives

by: los anjalis

Mon Dec 28, 2009 at 08:00:00 AM PST

This week has seen intense discussion among progressives over whether to support and fix the health insurance reform bill or whether to kill it. Such debate began after the Senate version of the health insurance reform bill was stripped of its hugely popular "public option" and then further stripped of a possible "Medicare buy-in" by Senators who essentially held the US Senate hostage.

This debate has been important, and it is healthy for progressives to have differing opinions on a piece of legislation, but recently there has been some disappointing yelling across the aisles and name-calling. On both sides.

[Of note, there are some folks who from the start have called everything "less" than single-payer (100% government-funded and privately/publicly delivered healthcare) a compromise and vowed not to support anything but single-payer. Those folks have a right to their opinion but I'm not referring to them, they haven't been fighting together with other progressives for improving this bill all along. I'm talking about progressives who have tried to make this process workable from what was put on the table.]

(more after the jump...)

cooperation with evil

by: los anjalis

Fri Dec 25, 2009 at 21:36:29 PM PST

The New York Times has a piece out today -- Christmas Day -- that sheds some light on cooperation with evil in the context of the abortion debate and the health insurance reform bill that just passed the Senate yesterday.

The Senate bill, approved Thursday morning, allows any state to bar the use of federal subsidies for insurance plans that cover abortion and requires insurers in other states to divide subsidy money into separate accounts so that only dollars from private premiums would be used to pay for abortions.

Just days before the bill passed, the Catholic Health Association, which represents hundreds of Catholic hospitals across the country, said in a statement that it was "encouraged" and "increasingly confident" that such a compromise "can achieve the objective of no federal funding for abortion." An umbrella group for nuns followed its lead.

The same day, the United States Conference of Catholic Bishops called the proposed compromise "morally unacceptable."

(more after the jump...)

all wrapped up

by: los anjalis

Fri Dec 25, 2009 at 17:08:02 PM PST

He jokes that the upside is that, with each package he unwraps, he finds something inside that's just what he needs.

Here's to rediscovering that we've got all we need. (Thanks to tanya karakashian for sharing the article).

'twas the night before christmas and all through the senate...

by: los anjalis

Thu Dec 24, 2009 at 17:50:43 PM PST

• Today (Christmas Eve) marked the 25th straight day of debate. This is just short of the record for the longest number of consecutive days that the Senate was in session, in the winter of 1917 (thanks to @wonkroom on Twitter for this fact).  The extended debate in 1917 was due to anti-war legislators stalling debate about whether or not to arm US merchant ships during World War I ... (more below)

a bizarre process & a historic vote: healthcare reform

by: los anjalis

Mon Dec 21, 2009 at 08:00:00 AM PST

So what exactly happened?  Well, the US Senate voted 60-40 NOT in favor of PASSING the bill -- but in favor of ending debate and stopping further filibustering on a specific set of amendments put forth by Senate Majority Leader Harry Reid.  Yes, they voted for "cloture" -- to end debate on the bill.  Were the debate to continue, Republicans (or Sen Lieberman or Nelson) would have more and more chances at filibustering the bill (a process by which they are allowed to read every page of the phone book aloud or do other things a 2nd grader wouldn't even do, in order to stall the process of moving a bill forward)...  

showdown

by: poppyseed

Sat Dec 05, 2009 at 07:00:00 AM PST

caterpillars

by: poppyseed

Mon Nov 23, 2009 at 22:02:02 PM PST

one of the first things i learned was that you sign over your government checks to them, which they use to pay your room and board, and then they give you what's left over. and the second thing i learned is that they're unregulated.

so you can see where this could go.

specialists

by: poppyseed

Mon Nov 16, 2009 at 07:00:00 AM PST

oblivion

by: poppyseed

Tue Nov 03, 2009 at 22:14:15 PM PST

so this guy was mean to me and we hate him

by: poppyseed

Fri Oct 30, 2009 at 20:39:01 PM PDT

i really hadn't done anything wrong, except that i had. i walked past the door and he was sitting there like a teenager who's fifty years old-- legs crossed, arms crossed, staring all pissed off at the floor. and i passed the door and saw that there was no chart, like there often isn't and popped my head in the doorway to say i was off to find his emergency back up hospital chart.

in that millisecond, i realized that i knew him, i realized that he looked pissed off, and i realized that he had a couple of bottles on the counter, which is patient body language for i need refills.

public option ping pong. lieberman intercepts.

by: los anjalis

Wed Oct 28, 2009 at 08:00:00 AM PDT

As always, a pleasure to see both of these brilliant women talk this out.  And yes...

trying to leave the hospital

by: poppyseed

Sat Oct 17, 2009 at 13:07:02 PM PDT

high noon

by: poppyseed

Sat Oct 10, 2009 at 07:00:00 AM PDT

(names are changed, of course)

the emergency back-up

by: poppyseed

Mon Oct 05, 2009 at 07:00:00 AM PDT

don't talk to me about liver

by: poppyseed

Sat Sep 26, 2009 at 08:00:00 AM PDT

i know liver. i remember how my favorite professor told me of clutching at her for two full years, trying to buy a little more time. i know that once her kidneys veered off course there was not stopping it. the desk just had to point at her bed, at her family, now at least twenty-five strong, filing past her bed as if it were a state funeral, but not yet. they held her hands and cried softly as her body which wasn't quite a body yet but wasn't really their grandmother anymore either softened under the morphine i gave her because it can't really be comfortable, can it. it certainly wasn't from where i sat.

she hadn't done anything wrong, not that it matters but we both know that in some sense, yes, it kind of does, kind of makes things worse. her immune system attacked her liver. maybe some day someone will know why but for now no one does and for years there wasn't much to do no matter how smart or careful or well-read you were and it was all leading up to this and trapped behind my desk i had to see it all.

The 4 people against health reform

by: Minesh

Tue Sep 22, 2009 at 08:55:57 AM PDT

Three months ago I started working at Atlanta's Grady Memorial Hospital, one of the country's largest public hospitals.  It's been a privilege to care for people who otherwise have no option for quality health care.  I wish all 435 Congressmen and 100 Senators could spend a day with me at Grady.  Better yet, I wish they could spend a day with one of my patients.  Go into their homes, have dinner with them, watch them pay their bills and juggle often chaotic lives.  I'd like to hear them tell my patients that they don't think the current system needs changing, or that it costs too much to change, or that they are more concerned about undocumented immigrants getting care than they are about keeping their constituents out of bankruptcy...

In thinking more about the opposition against health reform, I think I've found 4 types of people who oppose health reform.  I think they have different reasons and motivations; thus, we need different approaches.  So at the risk of over-generalizing, here it goes:

Person 1: Chris The Confused Citizen

Chris knows the health care system is not working.  He may have felt it personally, or through someone he knows.  But Chris has difficulty supporting health reform because he's confused by the mixed messages.  It's not that he's not smart; it's that health care is indeed confusing.

Especially health care in America.