Want Healthcare LLC

New Year’s Resolutions

January 3, 2013 at 2:47 PM 1 comment

Usually I begin the year with a resolution about weight loss, exercise, meditation, or some other health habit: you know, the usual kind.  I will probably make some of these resolutions again this year, as in years past.  But this year, I’m also resolving to blog once a week.  I think I set up this blog about a year ago, and have been much less than diligent since about writing in it.

Part of this lack of blogging is related to the fact that I don’t entirely get its use and benefits, at least not yet.  Fortunately, I have experience with not getting it, and persevering despite that.  When I headed a company, I did networking the conventional way, meeting people in person, going to lunch, etc., for a full three years before I understood why.  So I have some faith that some time down the line, this will get clearer for me.

Right now, here’s why I think we do this, in person or on the Internet.  I don’t think one blogs purely to supply others with information.  Most of what I could tell anyone about anything they care about has already been posted by Reuters or CNN an hour before I found out about it.  We live in the information age, and about the last thing anyone needs is more information.  People take long vacations on desert islands to escape that sort of thing.

Instead, if we are lucky, blogging give others insight into the way we think, and how that might be helpful in their own situation.  I think I have shied away from posting partly because it seems odd to assume that the random firings of my neurons might be interesting/entertaining/thought-provoking for others.   And, in the vast majority of cases, I think that will be right; people will read and think, “Not helpful”.  But the beauty of the blogosphere is that those people can move on to someone else’s blog that they do find helpful.  To all that remain, welcome.  Both of you.

We live in an extraordinary time in so many ways, but germane to this blog, we live in the age of American health care reform.  Some of you may have heard me speak about this, but there are a few core reasons why this is:

• We as a nation are out of money.
• We as private enterprises are out of money.
• We as individuals and families are out of money.
• I have slides to prove all of the above are related to the cost of health care.
• Other than that, it’s going very well.

Okay, there are other things at play here, which we will go into over time, but suffice it to say for now, being out of money has an amazing clarifying effect on one’s thinking.  All the other things we will talk about here have been true for many years, even decades.  But the one thing that compels us to have this conversation now, this topic that ranks just below having root canal for most of us, is that we are out of money to buy off the pain of real reform.  I don’t know if anyone’s noticed, but the debate over entitlement reform is largely about one really big entitlement, the one we call Medicare.  Yes, there is Social Security, but simply by changing the cost of living adjustment and raising the eligibility age some, we can take care of most of that problem.

But Medicare, there’s a problem that goes beyond actuarial analysis of the stability of an insurance pool.  While it is technically an insurance program, it is so much more to so many people.  In the simplest terms, it is hope.  It is an amorphous institution in most of our minds, that attempts to buy miracles with pooled resources created by a collective agreement to pay into the pot, without know which miracles we will need for ourselves, of even if we will need them at all.  Unfortunately, the price of this hope is going up at roughly two to three times the rate of general inflation, and it is crowding out other things that also create hope.  But these latter things are for those closer to the beginning of their lives rather than those closer to the end.  These are things like bridges, roads, schools, and other things that create future prosperity, for individuals and the American community as a whole.  There is a commercial on TV right now that decries the tyranny of the “or”, the necessity of choice.  Why can’t we have it all, it asks while the spokesperson does a funny dance?

We can’t have it all, because we never could, and we are having trouble believing that our perception of limitless resources was an illusion.  We make popular movies in which against impossible odds, the hero/heroine saves the day, no matter what any stinking authority figure tells them.  In the movies, the one in a million shot always comes through.

In a way that makes me a little sad, we are having to give up the illusions of childhood, and become adults.  We are being asked by our posterity to recognize limits, that we will not be forever young, that we must choose the nuanced discussion over the sound bite, choose the understanding of others as being as complex as we feel ourselves to be, and just as sympathetically flawed.  We have met the authority figures, and indeed they are us, only with wrinkles and lines that we do not recognize as our own in the mirror.  These things all fall to us: the necessity for mercy, for difficult choices, and for prayers for wisdom in an imperfect world.  None of these can be delegated or outsourced anymore.

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