Tuesday, September 23, 2008

Well said...

In these tough times right now, we must take perspective of our view of this crazy world. This editorial below by Norman Solomon succinctly and clearly makes a claim for "waking us up" and taking perspective.

Too Big to Fail and Too Small to Matter

by Norman Solomon

These times provide a crash course on the corporate state:

If a company like AIG is too big to fail, the government will rescue it. Mere people -- too small to matter -- are expendable.

The insurance industry is too big to fail. A person's health is too small to matter, so -- when it fails due to the absence or loopholes of insurance coverage -- that's tough luck.

The Defense Department is too big to fail. The people it's killing in Iraq and Afghanistan are too small to matter.

The U.S. nuclear arsenal is too big to fail. The Nuclear Non-Proliferation Treaty, undermined by Washington, is too small to matter.

Overall, the warfare state is too big to fail. The virtues of peace are too small to matter.

Agribusiness is too big to fail. Family farmers are too dirt-small to matter.

The leverage for the U.S. Treasury to subsidize Wall Street is too big to fail. The leverage to subsidize mothers and children kicked off welfare is too small to matter.

The political momentum for bailing out corporate America is too big to fail. The political momentum for funding adequate payment rates from Medicaid to reimburse healthcare providers is too small to matter.

The oil conglomerates are too big to fail. Global warming is too small to matter.

The prison industry is too big to fail. The need for preschool is too small to matter.

Corporate power is too big to fail. The ordeals of working people and want-to-be-working people are too small to matter.

Human worth as maximized by dollars: too big to fail. Human worth as affirmed by humanistic values: too small to matter.

The current odds of pumping at least several hundred billion taxpayer dollars into corporate America: too big to fail. The current odds of launching a massive federal jobs program: too small to matter.

Such priorities and mindsets are in overdrive at the intersection of Pennsylvania Avenue and Wall Street. But a basic shift in government priorities is possible. That's what happened three-quarters of a century ago, when a progressive upsurge prevented the re-election of President Herbert Hoover -- and then effectively mobilized to pressure the new occupant of the White House.

After campaigning in 1932 on a middle-of-the-road Democratic platform, Franklin Roosevelt went on to become a president who denounced the "economic royalists" and made common cause with working people and the unemployed. People across the country organized for social change. In the process, you might say, the power of progressive movements became too big to fail.

Something like that could happen again.

Monday, September 22, 2008

Little empathy

I came across a recent article on the Archives of Internal Medicine which struck a chord to me. Actually, I'm not really surprised since I have had concerns of this since I was in medical school and the emphasis on training for the "science" of medicine and the lesser emphasis of the "art" of medicine. I came in naively to believe that there is a balance to both. I still believe in that balance but the training for new medical professionals as well as the emphasis of over-specialization has definitely tilted to the point where we now see doctors no longer having that empathetic skill to connect to their patients. Even more striking is with the recent tide of "market-forces" and "letting the market decide" for medicine is how people are just treated like commodities and widgets - it's pretty sobering...whatever happened to real interaction with real people? It's definitely lost in translation with all the hype of the cure-all pharmaceuticals and state-of-art technology. *Sigh*.

Wednesday, September 10, 2008

A sorry state of affairs....

More bad news on the horizon - not much of a surprise as this trend was going on since I started medical school in 1996, however, I feel that the backbone has broken and the demoralization of primary care has, in essence, become the end result of the reliance and emphasis of overspecialization, supported by the the Medicare payment schedule equations and de-valuing of primary care visits in general.