Universal Healthcare vs. All Encompassing Healthcare

Interesting discussion I had tonight.  It got very heated until we started understanding we were not debating the same issue – I was arguing for universal healthcare and the other person was stating that the US healthcare system makes it too expensive for providers to give the same care to everyone.  We eventually concluded that we agree!  I’m a strong advocate of universal healthcare, but having been born and raised in Europe my definition of it doesn’t always resonate at first with folks who only know the US healthcare system.  Universal healthcare is based on equity in access, it does NOT mean everybody gets all care they dream of, or want.

For one, obvious elective healthcare, such as liposuction to get a slimmer line, is not covered.  Every country that I know of and that has successfully implemented universal healthcare (which includes EVERY first world country except the United States) has gone through a prioritizing exercise where medical procedures are ranked in efficiency and general benefit to the population at large – i.e. vaccination is both very effective (preventative medicine is vastly more cost effective than corrective action – if you don’t believe it, ask your dentist); while heart replacement surgery benefits very few individuals at astronomical cost. My own state of Oregon led the way in the US years ago.

We all (maybe) would love to be able to ensure ultimate medical treatment to everyone – heart replacement surgery, liver transplant, etc.  But we also know that our resources as a nation and in the world are limited.  Do we only offer these exotic treatments to those we can pay? – That’s already the case; if they can pay, I’m sure there’s a doctor somewhere who can provide the care.  Do we offer them only to our fellow countrymen? And live with the moral choice that our countrymen are worth more than foreigners. Even within our country, we’re unlikely to be able to provide such treatment to everyone, so do we limit it to folks of a specific skin color, a specific gender, a specific income level?  None of this sounds acceptable in this 21st century, so how do we do it?

We need to simply accept that universal healthcare does NOT mean all procedures available to everyone, but instead follows the model used by all other advanced countries: everyone gets basic healthcare and people can buy supplemental healthcare to address less common issues.  Every child in this country, and I would argue in the world, deserves free vaccination for well understood diseases (notwithstanding the concerns of the few folks at the fringe of society who don’t believe in it)[1].  Every woman deserves prenatal care (see “Consequences from lack of prenatal care” in Wikipedia’s Prenatal care in the United States.

Children shouldn’t be penalized for the poor life style choices of their parents – and if you don’t believe this, I would like you to take a hard look at you moral compass.  While I’m not myself a Christian, I was raise as one and am quite familiar with the faith and its precepts, and I have a very hard time understanding how the vast majority of Americans can claim to be Christians and at the same time deny compassion to all children regardless of their parents’ choices.

[1] Sidebar – I know and understand that there are a very small percentage of cases where vaccination can have serious negative effects, and I do respect these people’s concerns and feelings.  Yet, ultimately we must decide whether healthcare is a communal or personal issue.  I take the stance that basic healthcare is a communal responsibility. Which also means that I accept the fact that, if I get a rare disease that would cost enormous amount to cure, if I get liver disease from over drinking, or lung disease from smoking, I will not get free care.

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The Problem With Collective Grief

From the New York Times article.

“But is it really logical for the Dutch person to feel more for his 193 dead countrymen than, say, for the four Belgians and four Germans who were also on that flight? For a Dutchman, do 200 dead strangers call for greater dismay than 200 dead Iraqi or Afghan strangers killed in a bombing? ”

And the answer: “To reply in the affirmative would be to fly in the face of humanism.”

exemplifies well humanity’s evolution away from irrational religions, be they faith-based as the traditional religions or social-based as patriotism, communism and the rest of the 19th and 20th century movements, toward humanism – the trust in individual freedom only limited by the freedom of others.

If humanists outnumbered believers in religions and national supremacy, there would not have been such a tragic event requesting our collective mourning.

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SCOTUS OKs Business Sharia

In light of yesterday’s decision by the US Supreme Court (Burwell v Hobby Lobby), an unnamed investor from Saudi Arabia is buying up all shares of Starbucks with the plan to transform the company in a closely-held business and impose Sharia law on its employees, including mandatory wearing of burqa for all female barista.

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Technology Adoption Doppler Effect

Re-reading Geoffrey Moore’s Crossing the Chasm got me to thinking about the discrepancy I perceive between the model and my own experience of where people view themselves in relation to technology – which leans more toward innovators/early adopters.

I believe Geoffrey Moore is right in terms of the actual behaviors of technology buyers, but he may have downplayed one factor that influences marketing profoundly, the innate desire for a sizable segment of the population to be viewed favorably (who doesn’t want to be “Like”’d)!

Viewed through this lens we perceive a shift, not in behavior, but in response to stimuli (i.e. marketing) from the laggards and conservatives toward the pragmatists and early adopters. Moreover, my hunch, based on my personal experience, is that this shift increases the further up the technology adoption curve one gets. While the laggards’ response to marketing is very much aligned with their actual purchasing behavior, conservatives sometimes like to see themselves as more to the center, closer to pragmatists. The later in turn abhor the thought of being considered conservative in their technological choice and strive to be viewed as “with it” in terms of technology. Even more so with the early adopters who have the vision to see the next application for the new technology but want to be seen as enthusiasts on the bleeding edge.

I therefore postulate that while the adoption curve from a purchasing perspective is quite aligned with Geoffrey Moore’s curve

  • 1% enthusiast
  • 19% visionaries
  • 30% pragmatist
  • 30% conservatives
  • 20% laggards

marketers’ target (marketers strive for stimulus, it’s the sales person’s job to make the sale) is shifted to the left:

  • 5% see themselves as enthusiasts
  • 25% see themselves as visionaries
  • 30% see themselves as pragmatists
  • 25% see themselves as conservatives
  • 15% see themselves as laggards

Hence an additional difficulty for marketers: bridging the unconscious desires of technology adopters with their rational behaviors.

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Snowden – traitor or hero

He’s been called both

Does he qualify on either count?

Traitor: someone who betrays.  What does that mean?

Betray: 1) to lead astray; 2) to deliver to an enemy by treachery; 3) to fail or desert especially in time of need; 4) to reveal unintentionally; 5) to disclose in violation of confidence

  1. This wasn’t a betrayal in this first meaning. On the contrary, one could say Ed Snowden was leading the country back on the right path.
  2. He did however deliver information to the enemy.  But was it by treachery?
    • Treachery: here we start getting into circular definition (BTW, I’m using the online version of Merriam Webster) 1) violation of allegiance or of faith and confidence :  treason; 2) an act of perfidy or treason. Both definitions send you to
      • Treason: 1) the betrayal of a trust :  treachery; 2) the offense of attempting by overt acts to overthrow the government of the state to which the offender owes allegiance.
    • Dead-end. And it’s also clear Ed Snowden didn’t deliver information in order to overturn our government.
  3. “Desert in time of need” – reasonable people could argue both sides.  Are we truly in a time of need?  You make up your own mind on this one…
  4. Unintentionally 🙂 not a chance
  5. Violation of confidence – there’s truth in here!  Ed Snowden must surely have signed some confidentiality agreement, and he most certainly violated it.  But is he a traitor for that reason?  If so, haven’t we all violated confidentiality at some time or other?  Are we then all traitors?

Granted, I’m biased… like everyone else.  My gut understanding about the meaning of traitor is that it involves doing harm, and I don’t sense a desire to do harm in what he did.

What about Hero? 1) mythological or legendary figure; 2) principal male character in a literary work; 3) object of extreme admiration.

  1. Not old enough for that 🙂
  2. I’m sure he will become one, but not yet.
  3. I’m sure that’s true for a sliver of the population, but certainly not for the majority.  Has he received support? certainly.  Admiration? no doubt.  Extreme admiration?  I don’t think so – there is enough ambivalence even among his supporters that “extreme” is not an appropriate qualifier.

So, he is neither.  Not a traitor, nor a hero.  Just an American citizen doing what he believes is his duty for the country. 

But didn’t his actions harm the national security?  Possibly (though with the level of secrecy surrounding it, the truth won’t be know for years, if ever). 

Was the harm greater or less than that of the illegal and immoral rendition program our country unofficially orchestrated after 9/11 or of the water-boarding practiced by the CIA in violation of the Geneva Convention?  Only time will tell – we’re too close to it to be objective.  Any assessment today is irrelevant and it will likely take a hundred years or more for tempers to settle and objectivity to prevail.

As for me, in Ed Snowden’s TED talk I saw a very articulate young man whose actions sparked the current and much-needed national debate on the role of the CIA, secrecy, parallel legal channels, privacy, rule of law. etc. 

Whistleblower seems to be the most appropriate qualifier for Ed Snowden, and as such he will be reviled by the conservative guard and extolled by progressives.

Mr Snowden, I admire your courage.

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Schools kill creativity


OK – overload – two posts in one day

Sorry folks.  This has been sitting in my inbox for weeks – both work and play interfered and I just now go to it. If you really can’t wait, skip the stuff below and click on the link above.

There’s a lot to digest here, but as usual with TED talks it “resonates”!

Quick thoughts: Can I go back to the right school now?  I can… right?  hmm…

I’m making choices today with the brain/personality I have today, not the one I had 40 years ago, or that I might have had if education in France hadn’t been so regimented (as in “army-style regimented”).

I was a fidgety kid like the dancer in Ken Robinson clip, but would I had become a dancer?  Who knows. Today I think I have two left feet.

1978-05 ~ X 003 - au large de OuistrehamI was a dreamer – and remain one to this day. My passion lies in those extraordinary moments seeing a sunrise over the immensity of the ocean.

I could never draw or paint, or write neatly for that matter!

I’m looking forward to retiring – but what would I go back to school for? Sunset watching 🙂

Yet – there is hope in Ken’s message – both for me and our son and his eventual children.

I don’t know where this will lead me, but our son shows a healthy mix of science and creativity (creating Celtic designs using his own rig combining a high-powered laser with a 3D printer for example.)  He’s on a good path, and I trust his progeny will too.

We need more focus on whole-person education – not just jocks and brains.

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EMV Payments On a Fast Track to Becoming a New Standard in the United States

Just spotted the above in a security blog.

The funny thing is that when I came to the US, 34 years ago, I had a credit card with a chip, and merchants where looking at me funny because they didn’t know why it was different.

Unfortunately it took that long to overcome the “not-invented-here” syndrome or, just maybe, US banks were patiently waiting for the patent on this technology to expire.  So much for your security…

After the spate of recent credit card breaches, everyone’s scrambling for solutions and finally facing what’s been staring them in the face for decades (even if these solutions may be irrelevant to the actual breach).

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