Opioid Bottle

Make Love not War, Right to Work, Right to Life, Pro-Choice, Pro-Life, My Child is an Honor Student, My Child Beat Up Your Honor Student, I Rather Be Driving A Nail Through Your Head, blah blah blah blah. When did our country stop being able to think critically about complex subjects? When did 10 word bumper sticker answers become accepted as intelligent conversation? More importantly, how does a person have so much blind faith in a 10 word bumper sticker answer from a politician or political action committee? Is it as simple as “birds of a feather flock together?” Something has to change…

Early last week I sent out the following tweet, “@realDonaldTrump a perfect example of why we need to #KeepParis (in reference to the Paris Accord Environmental Agreement)” With the tweet I attached 3 pictures that I’ve taken over the years of the mountains. Let’s be honest, I’m almost being a hypocrite because my tweet was a stupid 10 word bumper sticker. For Twitter though, this was a pretty basic, non-threatening tweet by anyone’s standards, or so I thought. Almost immediately I got a response back accusing me of being on the “wrong side of history” and that President Elect Trump was going “to show me the right path”. My initial thought was wait, WHAT!

DSC_0294

(This was one of the pictures I uploaded with my #KeepParis tweet)

Ok President Trump supporters it’s time to pay attention here and ask yourselves “who really is on the wrong side of history”. Yes, your candidate won the Electoral College which according to our Constitution is how you become President of the United States. That said many if not most of us (the country) do not understand the Electoral College logic. We understand vote tallies of which your President Elect Trump lost by over 3 million votes, which in our current political climate constitutes an “ass kicking”. I know our country is brought up thinking that we are a perfect shinny democracy when in fact we are not. The U.S.A. is a republic with a first past the post voter system. To put it another way, a majority of the country, state, county, school district can vote against a candidate but that candidate can still win their respective election as long as they receive one more vote than the next candidate. You still with me President Trump supporters??? Much like life, voting is more complicated than just yes or no, black or white, or up/down.

You know what left; the previous paragraph is for you too. I think President Elect Orangeman is a narcissistic, misogynistic, criminal just like you. He is barely qualified to run a lemonade stand, let alone the country. Much like Hilary Clinton, Mr. Trump has NOT been charged with a crime so technically he is only an orange, narcissistic, and misogynistic man for whom our Constitution says is qualified to be President. That said he won the election fair and square as near as I can tell. Don’t get me wrong, we should never stop protesting or demanding more from the President Elect, however, it is time we moved back to policy debates and concede the election is over. We will have a President with no policy creation experience what so ever, there has to be an opportunity in that fact I’m thinking.

Before I switch to talking about healthcare policy and the Affordable Care Act (ACA), I want to take a moment and talk about policy creation. Right now Republican’s in Congress, along with President Elect Trump, want to repeal the ACA or Obamacare as quickly as humanly possible. They have already started the necessary budget parliamentary procedures in order to defund the ACA, they don’t have the actual votes to repeal so they are using the budget process to destroy it. Part of their reasoning is that Obamacare is hurting millions of people and therefore we must change it. They have all kinds of individual patient stories of premiums rising, patients losing their favorite doctors, patients being denied drugs, and many other sad stories. There seems to be no end in sight to the number of Jeff’s, Candace’s, Mary’s, and Philip’s this law has hurt. The trouble I have with this logic is that the ACA was not specifically written just for Jeff, Candace, Mary, or Philip. It was written for the entire country with the hopes of improving the quality of life for those 20 plus million that had been previously uninsured up to that point.

It is also important to realize that absolutely no public policy will ever be 100% beneficial for everyone, much like 100% efficiency for machinery is only theoretically possible. There will always be people affected poorly by public policy, no matter what the intention of the creators is. Does that mean we shouldn’t try to create the best policy possible, no of course not? We should always strive to create the best public policy possible with the absolute understanding as knowledge and experience improve changes to said policy should happen accordingly.

The ACA is a perfect example of public policy that is not perfect. However, I think it is right to point out at this point that is has survived 60 repeal attempts by Republicans in Congress in the last 5 years. Not one of these attempts has been successful despite Republicans spending close to $100 million of taxpayer money on them. During these 60 repeal attempts, not once has a Republican floated a different or alternative plan for Obamacare. If this is not a perfect example of pure politics I don’t know what would be.

I would like to take this opportunity to point out that my health runs on pure science, Facebook posts run on pure politics. Understand the difference.

The bipartisan Committee for a Responsible Federal Budget recently came out with a report stating that a repeal of Obamacare would cost $350 Billion, yes BILLION (www.paintalks.com/350billionjusttorepealobamacare). So, before Republican’s have come up with a replacement plan for the Affordable Care Act, taxpayers have to lose another $350 Billion on top of the $100 million lost to purely partisan votes. For reference, the ACA was 20,000 pages long, which means we could spend $17.5 million per page of the ACA to improve it for patients instead of blowing the $350 BILLION on yet another purely political stunt. At the risk of sounding arrogant, I’m guessing I could improve the ACA at $10 million per page if President Elect Trump wants to hire me.

Originally I was a lukewarm supporter of Obamacare. I was a strong proponent of Universal HealthCare; I believe healthcare is a human right. In a country with so much wealth and prosperity, I find it personally offensive that my illnesses can be commoditize into a product to be sold on a free market for profit. My human decency and spirituality finds this offensive on so many levels, however I seem to be in the minority opinion. Ok I’m off my soapbox now. My lukewarm support came because the ACA did protect children from being kicked off their parents insurance (punishing parents/kids because they were born with Juvenile Rheumatoid Arthritis is just wrong), college students could stay on their parents plan until 26, and the ACA prevented discrimination against me for having preexisting conditions. These common sense provisions were long overdue in the insurance industry, which is why I gave the ACA my lukewarm support.

Over the last 5 years I’ve become a strong supporter of the ACA for one simple reason, it has fundamentally changed the healthcare conversation in our country for the good. No longer is healthcare discussed with the word “should”, it has changed to “include”. The lack of access to quality care is being discussed more and more. Patient engagement is no longer a buzzword; it is starting to happen on a regular basis. Design thinking is searching for human centered solutions to all kinds of healthcare issues, not profit centered solutions. Healthcare equality, treating men and woman the same, has seen much progress compared to yesterday’s paternalistic medicine model. Probably the most important change is the shift from fee-for-service model to a value-based payment system. Why is this important you ask? Value-based payment models finally takes into account a patient’s quality of life. It puts the Care back into Healthcare. Unfortunately though, the pain from illnesses is a constant while public policy in our country is designed to move at a snails pace on purpose. This is a horrible combination considering the millions of people this conversation affects.

As a chronic patient with a degree in political science, my heart hopes that we can build better insurance models that take into account the actual life of a chronic patient. However, as a chronic patient I also know that our current healthcare system loves the word chronic but in the end has no real idea how to treat us. I would love to sit in a room with fellow patients, providers, healthcare professionals, designers, and business leaders, with a $350 billion budget, and answer the question “how might we improve the ACA for now and the future?”

In the end, the ACA is barely 5 years old. The first 2 years of the ACA was based on forecasted numbers because these new markets had not matured yet. Guess what, most of these forecasts were wrong. Shit happens, after all, even the best Steven Hawking/Bill Gates forecast is nothing more than trying to predict the future. As in healthcare, mistakes are an opportunity to learn and move forward. Attempting to defund or repeal the ACA takes us back to the old, paternalistic models of medicine that started the ACA conversation in the first place. Imagine the system we could create if we spent the $17.5 million per page on improving the ACA instead of trying to reinvent the wheel, which most experts agree will include many if not most of the current provisions of Obamacare?

What little specific details the President Elect and his cabinet (paintalks.com/trumpcareriskanalysis) have released are scary, all indications are they want to defund Medicare, Medicaid, return to fee-for-service, and turn us all into profit centers for a already bloated healthcare system. The American Dream suggests we can and must do better than this. This is so much more than a tax issue, access issue, or healthcare issue; this is a human life issue. Lets quit with these 10-word bumper sticker solution conversations and elevate our discourse to a level worthy of our existence and spirituality.

IMG_1728

“Our lives begin to end the day we become silent about things that matter.” Martin Luther Kind Jr.