Tomorrow is Obama’s big healthcare speech. This is his last chance to significantly alter the downward spiral of American culture.

We are dying a slow death of poison-by-status-quo. The way America has been doing things — financially, militarily, medically, and environmentally — is not only not working, in each area our actions are so unsustainable that continuing on the same path can only lead to massive chaos and human suffering.

In each of these areas, Obama came with a sense that he definitely got it and was prepared to usher in monumental change. Financially and militarily he has been, at best, a continuation of Bush. Bankers are still getting richer while the rest of us get poorer, and we’re still dropping bombs on Iraqi and Afghani civilians in pursuit of policies that benefit no one but military contractors.

Environmentally, he has been better than Bush, barely. But mostly he’s still defending status quo industries like coal and automobiles when, again, what the planet needs is monumental change.

Healthcare “reform” has been the hardest to watch. When we discount the people’s voice right from the outset — strong majorities of patients and doctors favor a single payer system — it’s a clear sign that the status quo is ruling the day.

The unsustainable status quo in American healthcare is insurance and pharmaceutical industry profits, including shareholder dividends. That is the main reason American healthcare costs too much. It is unconscionable to have a great nation brought to ruin, and for its people to needlessly suffer, so that a small overfed elite can make money.

That’s what Obama needs to say. When they scream “Socialism” he has to say “Yes, when it comes to healthcare, that is the best way.” He has to unequivocally remove the profit motive from American medicine.

If he fails, then the status quo rules, and a once great nation continues its downward spiral.

Michael Sky | CommonHealth

Getting to be too late for Obama and healthcare, though he still has a chance for a radical start-over when he addresses the full Congress in two days.

He could do himself a big favor by listening to Moyers even better, put him charge of the process.

Michael Sky | CommonHealth

Lily was three-and-a-half years old when we adopted her from China. She had lived her first two-and-a-half years presumably with her birth family and then another year in the orphanage.

All we had for medical records was a final check-up: Lily was in good health, ideal weight, no signs of developmental delay. There were no records of early illnesses, nor of any vaccinations, but it seemed likely that she  breastfed as a baby and that her year in a poor, overcrowded orphanage had exposed her to some of the common childhood diseases.

Soon after getting home we took Lily to see the local pediatrician, a good friend of ours, Dr. O. As first time parents, we’d spent the months leading up to the adoption reading and thinking through the various issues that face all parents, including vaccinations, which we had decided against.

As he retired from office, Dwight Eisenhower imparted a scary warning about the “military-industrial complex”: an insidious merging of America’s security apparatus with private and corporate profiteers that gobbles up vast national resources while spewing waste and destruction in its wake. Though there’s long been much nodding in agreement with Ike’s assessment, nothing has slowed the growth or dimmed the power of the military-industrial complex.

In 1971, President Nixon declared a “war on cancer,” promising a cure within the decade. Nixon totally misunderstood the “enemy” and committed the nation to an endless war of attrition and frustration. Even worse, he committed vast amounts of wealth to the funding of the “medical-industrial complex” that, like its military counterpart, drains the public treasury while providing a too often unhealthy medical product.

These mammoth conglomerates share a number of traits:

All healthcare practices, techniques, treatments, devices, and medications can be placed on a spectrum ranging from softest to hardest.

At the softcare end of the spectrum we find such approaches as massage, herbalism, diet, yoga, and emotional counseling, as well as broader social factors, such as public sanitation, sufficient access to pre-industrial food, and income equality.

At the hardcare end of the spectrum we find surgeries, most prescription drugs, acute and traumatic injury care, chemotherapy, radiation therapy, organ transplants, vaccinations, and extreme psychiatric practices, such as electroshock.

The basic premise of commonhealth is that to the extent that an individual, community or nation has over-committed to hardcare approaches, its heathcare expenses rise precipitously, fewer community members have secure access to regular care, and overall outcomes — as measured in such areas as infant mortality, life expectancy, and iatrogenic illness — worsen.

Conversely, when we commit time, money, energy, and attention to softcare approaches, expenses fall, everybody has secure access to quality care, and medical outcomes improve.

An ideal medical system would affirm the importance of both approaches and would utilize mostly softcare, while resorting to hardcare practices only when necessary.

In this season of American healthcare reform, we frequently hear comments that begin: “In the richest nation in the world….” and finish with some variation of “….we should be able to provide decent affordable care to all our citizens,” or “….we should have better health outcomes than some 30+ nations that are not nearly as wealthy.” The assumption being that, while money can’t buy you love, it certainly can buy you the best doctors, hospitals, technologies, and drugs.

Unfortunately, America allows some 20% of its healthcare spending to go to sickness profiteers in the insurance and pharmaceutical industries. Since non-profit, single-payer solutions were not even allowed into the current debate — the “public option” proposal, in its current form, is more frustrating tease than radical transformation — it seems inevitable that post-reform healthcare in America will continue to function as a massive transfer of wealth from ordinary Americans to the rich.

This is indeed most unfortunate because it feeds into an even greater problem facing America: the vast and ever-widening gap between the wealthiest 5% and the rest of us. This income inequality is not just crassly immoral, as so puke-ishly personified by greedy financiers grabbing billions in booty for themselves, while millions of their “fellow Americans” lose jobs, homes, and health insurance. As British researchers Richard Wilkinson and Kate Pickett explain:

Until recently, most of the argument about the scale of income inequality in modern societies has been about fairness and unfairness. But it has recently become possible to compare the scale of income differences in different societies and see how the social fabric of society is affected by how much inequality there is. Research using this data carried out since the early 1990s shows that many of the most pressing health and social problems are worse in more unequal societies — often much worse. Societies with bigger income differences between rich and poor seem to suffer more of a very wide range of health and social problems.

“We will never solve our problems using the same kind of thinking
that caused them in the first place.” —Albert Einstein

The healthcare debate of the past few years must have Einstein nodding sagely from the grave. For all the volumes that have been written, for all the legislative starts and stops, for all the heated discussions of experts and pundits, little has been said about the medical thinking that underlies our current healthcare crisis. We have fixated on the secondary concerns of administrative bureaucracies and payment systems, when we should be exploring long-overdue changes in societal attitudes, lifestyles, and healing practices.

American medicine grew out of and remains mired in the Industrial Age. The “kind of thinking” that characterizes an industrializing society is reflected throughout our current healthcare system:

• the turning of “healthcare” into a mass-produced consumer item;
• the imbalanced relationship between so many doctors and their patients;
• the overuse and abuse of invasive drugs and surgeries;
• the shifting of power and prestige from general practitioners to high-paid specialists;
• the discounting of mental, emotional, and nutritional causes of illness;
• the over-medicalizing of the should-be sacred events of birth and death;
• the granting of ultimate authority to distant, profit-driven bureaucrats;
• the fundamental dis-ease of the modern hospital;
• and the continuing failure to see polluted air, water, and soil as vital public health issues

Everyone agrees that reforming American healthcare requires reducing costs. We spend far more per capita than any other modern country, with significantly poorer outcomes, including millions of citizens without insurance.

Of course, there’s less agreement about which costs most need cutting. Defenders of the status quo oppose anything that might impact their already adequate care. They offer little in the way of solutions and would prefer to table the issue for another twenty years.

Single-payer advocates point out that the major difference in America’s healthcare bill, compared to other nations, is that some 20% of every healthcare dollar goes to administration. Most other nations (and our own medicare system) spend less than 5%.

Sounds bad, but calling it “administrative costs” conjures a picture of large bureaucracies filled with secretaries, clerks, and mid-level managers who spend all day doing paper-pushing tasks in wasteful, inefficient ways.

Imagine that you are the mother of two children, the youngest a three-year old boy. Both pregnancies were healthy, the deliveries relatively smooth.

As with your first child, you’ve been totally involved in your three-year old’s life since birth. He’s with you always. You could stare into his eyes for hours. Though he looks very much like his sibling, you could list a hundred ways in which he’s different, unique, one-of-a-kind.

You frequently find yourself saying, “He’s the happiest person I’ve ever known.”

Three days after his third birthday he got round 4 of his DPT. Within minutes of receiving the shot, he began a high-pitched shrieking, like you’ve never heard before. It went on for nearly two hours. He was also running a fever. He was utterly inconsolable.

Eventually, he slept. But when he woke up the next day he was different. He wouldn’t make eye contact. He wasn’t talking. He definitely wasn’t happy.

Thus began his slow slide into what would eventually be diagnosed as autism.