Enlightened Conflict

a different case for better healthcare for all

August 3rd, 2017

life expectancy health statistic

 

 

I have made the case a number of times why healthcare for everyone benefits America from a productivity standpoint. Today I will try to make a case for healthcare for all by pointing out an underlying real issue which creates some disillusionment <which obviously drove some of the Trump support during the election> in middle America.

 

We often discuss inequality in terms of economics & opportunity … but how about something which cuts to the core being of everyone – life expectancy inequality.

 

I came across a map created in May of this year showing life expectancy by county.

 

life expectancy health map colored

 

Well.

 

Yikes.

 

Okay.

 

Double yikes.

 

The average life expectancy … yes … average … in individual counties can vary by up to 20 … yes … 20 … years.

 

Yes.

 

If you live in certain counties the average life expectancy is around 87 years <remember … this is average for an entire county> and in other counties the average life expectancy is around 67 years.

 

Holy shit.

 

Average.

 

20 years difference.

 

And I am not smart enough to do the cross tab <or invest the energy> but if you look at the life expectancy map and you were to overlay the Trump voter support I would bet <and I am not a betting man> that the counties which have the 20 years less life expectancy … shit … the counties with lower standard deviation life expectancies in general … went overwhelmingly for the Trumpster.

 

So for all the intellectuals, faux & real, who suggest many of the Trump voters are ignorant, misguided and stupid … you may want to shut up and think about this for a second.

 

These people have a legitimate gripe.

 

Yeah.

 

Life expectancy is pretty legitimate.

 

I mean if my local community is dying off around me and I look around at other communities who seem not only getting better breaks but are actually living longer … well … I am gonna start thinking I am being overlooked and underappreciated.

 

............ Life expectancy standard deviation ................

………… Life expectancy standard deviation …………….

 

 

Combine that with the fact the gap between longer life expectancy counties and lower life expectancy counties is actually growing and, well, I am gonna start truly believing that the elites & establishment do not really care.

 

 

“There’s no sign of the gap closing. In fact, it appears to be widening. Between 1980 and 2014, the gap between the highest and lowest life spans increased by about two years.

 

“With every passing year, inequality — however you measure it — has been widening over the last 34 years. And so next year, we can reliably expect it’ll be even more than 20.”

 

“That is probably the most alarming part of the analysis.”

 

———–

Christopher Murray:  Institute for Health Metrics and Evaluation

 

So.

 

Having attended this rodeo before, I know I can count on getting a number of intellectual sounding emails pointing out the inevitable flaws in my thinking and conclusions. My suggestion to those people is please hit ‘unsend’ and get off your intellectual high horse and think about this.

 

Flawed logic or not … if I am in a county dying off at early ages I am more likely to be thinking I live in India and not in America. And if I even perceive that, if I even have a sense of that, I am gonna start wishing for what I thought America was again.

 

Parse out the flawed aspects behind my ‘America was again’ thought if you want but on the surface this is a no brainer thought. Dying can make you wish for a shitload of things that intellectually can seem less than logical but are actually well intended thoughts – because, uhm, this pertains to life & death.

 

All of this permits me to circle back to healthcare.

 

Maybe print out the map of life expectancy and put it beside your computer while you read this part.

 

health is wealth illness expensiveWe talk about putting healthcare in the hands of people.

 

We talk about subsidies for health insurance companies.

 

We talk about inordinate bureaucracy for … well … physicians, hospitals and patients.

 

We talk about high premiums, high deductibles and high falutin’ reasons why healthcare works and doesn’t work.

 

It’s all talk.

 

And it’s all bullshit.

 

Important bullshit in terms of actually getting something done but unimportant bullshit in terms of we are not getting something done.

 

Just because someone lives somewhere doesn’t mean they should have a lower life expectancy than someone who lives somewhere else … at least if they live in America <other countries deal with their own problems>.

 

Is health insurance the only reason for this?

Of course not <so keep your snarky emails to yourself>.

 

But health is certainly a reason for this.angry but open our minds tupac

 

At the core of life expectancy is … well … health. And I don’t really care how much you earn, what kind of education you have had, what kind of job you have, or do not have, but it seems like if you live in county X you should be offered equal health opportunities to those received in county Y.

 

There is more than enough inequality haunting the United States these days without having health services & insurance inequality.

 

There is more than enough inequality haunting the United State these days without having life expectancy inequality.

 

a glimpse of what a Trump win really looks like

May 5th, 2017

 

average check

 

I almost called this “confusing a win with simply checking a box on a to-do list.”

 

This is about yesterday’s American House of Representatives vote to repeal & replace Obamacare <albeit it doesn’t really repeal nor replace but rather try and fix in an absurdly negatively way>.

 

Anyway.

 

How you play the game is most likely in my top 3 important things in Life.

Anyone who reads enlightened conflict has most likely discerned this.

 

Yesterday we were able to gain a glimpse behind the curtain of what winning looks like in Donald J Trump’s eyes.

 

Do whatever it takes.

 

The only winner that counts is me.

 

As long as I can stand on the pedestal and say ‘I won’ <adding a bemused “I am president”> it is a win.

 

The American Healthcare system did not win yesterday.

The American citizen seeking good health and a good healthcare support system did not win yesterday.

The people who voted for a seriously flawed option did not win yesterday.

The Republicans did not win yesterday <although they may have breathed a sigh of relief in the moment for ‘having met a promise’>.

The Democrats did not win yesterday <although they may feel in some self serving way that they did>.

 

The only one who won was Donald J Trump <okay … health insurance trump complicated scarycompanies won today … they are back on the path to returning to doing business the way they had been doing business which, as I may remind everyone, we didn’t particularly enjoy back then and they made a shitload of money>.

 

Back to Trump.

He gave the appearance of ‘fulfilling a promise’ by making a transaction … okay … it wasn’t a transaction because nothing was exchanged between two parties.

 

Let’s say he won by “checking a box.”

 

Yeah.

We all need to remember this moving forward with regard to Trump wins.

 

Winning to Trump is like checking a box on a to do list.

 

Came in to oval office today and had picture taken. Check. <win>

 

Mentioned on news today. Check. <win>

 

Cut some regulation <which I really have no clue of the impact> so it appears like I am “freeing up business”. check. <win>

 

A yes vote on something I have no clue what the impact is on people who I am responsible for. Check. <win>

 

I can guarantee you that he has no idea of the possible consequences of this vote <a> to Republicans in the House or <b> to people. The only consequence that matters to him is the illusion of a win.

 

He is the NASCAR driver who has caused 3 crashes in a race he ends up winning and claims he is the best driver … because he won.

 

I am constantly amazed that there were so many people on a variety of level get your shit together kid to adultwho were resentful, angry, and unhappy enough to vote for someone who almost everyone recognized on some level is not really competent to be president as well as … well … just seems fundamentally “not quite right.”

 

I am constantly amazed by how easily so many people are accepting of “a hollow win” and a “hollow winner” with a seeming disregard for the fact that ‘blowing shit up’ <the country, institutions, other countries, healthcare, government> doesn’t have some consequences – some intended and some unintended.

I am constantly amazed that so many people have forgotten that how you win is significantly more important than the win in and of itself.

I am constantly amazed that there are so many people who have forgotten how rotten our healthcare system was before The Affordable Healthcare Act and how many people are blindly guiding us backwards toward what we know and hated.

 

I do not believe the country and the citizens are hollow but we have a president who is doing his absolute best to use his own hollowness to hollow us out.

 

Sigh.

 

As for healthcare.

 

I will pound away on this day in and day out until some politicians understands the economic & business view of a good healthcare system.

 

Maybe it would help them if they would think about what a “win” looks like.

 

It isn’t “accessible & affordable” <healthcare’s version of efficacy> it is a National non-Absenteeism day.

 

<whew … imagine if we actually had one day where everyone in America showed up for work, for class, in daycare, for whatever> and saw how productive Life, and America, could be>

 

A successful healthcare system from an economic point of view would be to have one day which every single worker in America showed up at work, on time, healthy and did a full day of work.

 

No one out sick.

 

No one out because someone in their family was sick and they needed to take care of them.

 

if only dreams wishesNo parent out because they had to take care of a sick child … or maybe even take care of their child because the daycare center supervisors were sick.

 

No child, our future generation of workers, misses school  and class.

 

No one out because senior dependents, or independently living seniors related to you, are healthy and receiving services they deserve.

 

No one out because the additional services , which far too often are described as ‘luxuries’ or entitlements, provide a support system which not only keeps someone working but healthy and less tired <rested: which translates into higher productivity when working>.

 

The consistency with regard to the way we miss the importance of health to a productive, happy economic powerhouse as a country is mind numbing to me. I do not disregard the moral imperative aspects but for all we talk about, over & over, the importance of freeing up businesses and economic growth and free market … the most powerful machine, invention and tool the American economy has is the people.

 

Shame on everyone for not discussing this.

 

While I love bashing Trump for his lack of understanding of what it takes to run a business let alone a country … this is a politician issue. I have never heard one, just one, politician ever make this point. This is basic ‘running a business 101.’

Stop talking about insuring healthcare to citizens of a country as a moral imperative <although it is> and start talking about the real tangible benefits of an effective healthcare system.

 

I can partially excuse Donald J Trump because he has never really run a business. His only business hands on experience was construction. In his mind, and experience, when 5 construction  workers didn’t show up one day he didn’t unhappy unsatisfied people life businesspay them and went to Home Depot and found 5 more workers. He had no additional expense and lost no productivity.

 

For the rest of us in the business world when we run a 300 person company and 5 people do not show up we still pay them and we have to decide whether we invest in bringing someone in and absorb the lost productivity of ‘lost labor’, less efficient labor and the machinations of dealing with an empty resource space. We lose productivity. We lose profit. We lose every time an employee is absent in a cascading way of consequences.

 

Sigh.

 

And, to be clear about a ‘free market’ concept, in general consumers do not win within the health insurance system. To point that out I will not take the lazy route of pointing out their hefty profits and ‘making money’ but rather point out HOW they make their money. Health insurance companies make their money by selling policies combined with filling as few claims as possible <and limiting the highest of those they are required to fulfill>. This translate into selling people things they don’t need or will never use, trying to avoid offering things they don’t particularly want to fulfill claim wise and charging a premium to someone who they believe will actually file a claim <this can either be a healthy person with a profile which indicates they are a ‘claim filer’ or a less-than-healthy person who will actually have needs>.

 

I point that out because health insurance companies are only in the “encourage attendance in Life” business as much as it encourages the non-filing of claims … not for any real economic productivity objective.

 

And … I point that out so small government people can get their head out of their asses on how government involvement can actually benefit people.

 

It is lazy to suggest the government shouldn’t be involved in health insurance for its citizens just as it is lazy to simply say the issue with health insurance companies is their profit motivation <it is more how they make their profits>.

 

 

republican healthcare repeal hurts

 

Regardless.

 

If this is winning the Trump way, I am already tired of winning.

 

 

Enlightened Conflict