The Great Recession that started in December 2007 ended in June 2009 and recovery began to be a reality for certain sectors of the U.S. economy. However, involuntary unemployment remain high among more and more families who had depleted their savings, lost their homes, and for many people, lost their hope. Unemployment is down, but for many people, they have not recovered from long periods of involuntary unemployment. U.S. citizens living in one of the most advanced nations in the world, rich in resources, talent, and knowledge--all the ingredients for prosperity and a decent standard of living for all-- remain in a state of intense pain.
Too many people on so-called Main Street (which include side streets, back streets, the back roads, the other side of the tracks) are finding today that they cannot succeed no matter how hard they work, and no matter how scrupulously they follow the rules. At the same time, other Americans, including the worst of Wall Street, apparently cannot fail--no matter how inept, corrupt, or lazy they are, and no matter how many times they break the rules. President Obama, in his State of the Union address, tried to reassure ordinary citizens that there is still hope, but we have to help him make America do the right thing for all of its citizens.
There are 400 families controlling more wealth than 180 million Americans. But corporate America's millions of casualties are beginning to find their voices, stand together, and fight back against joblessness, homelessness, and despair. Inclusion and fairness must continue to be the mantra as the movement of millions of people--committed to fixing our democracy--find solutions to income inequality while progressive business groups find new pathways to prosperity for their communities.
There is always some unemployment in a complex, dynamic economy like that of twenty-first century America. However, "not since the 1930s have so many Americans find themselves seemingly trapped in a permanent state of joblessness." Long-term employment is deeply demoralizing for workers anywhere. Losing your job often means losing your health insurance, household family savings are depleted, bill can't be paid, and homes are lost. Lose a job in this economy and you will find it hard to find another. And if you stay unemployed long enough, you will be considered unemployable. The blow to this dilemma is also a blow to dignity and self-respect.
In America today, we have both the knowledge and the tools to end this suffering of involuntary unemployment. Being a citizen in America means different things to people. But the center of gravity is always the same: in our country, an ordinary person with citizenship--who was not born with great wealth or a famous last name, but who is willing to apply herself of himself--should be able to find employment, live in a safe community, make progress financially, retire with dignity, and give her or his children a better life. We are talking about living a life of consumption; it is about being able to live a life with meaning and purpose, productivity and contribution. Thus, using smart choices, honesty, and hard work should be sufficient keys to a fulfilling life.
Monday, February 18, 2013
Sunday, February 10, 2013
Part I: The Noise of Silence (Defined)
What is the voice of silence? The voice of silence can be heard very loud among individuals in our society who find themselves being marginalized, disenfranchised and ignored. It is the sound of voiceless people living in poverty, children who are hungry, those who are unemployed, the sick, elderly without proper housing and adequate health care. It's the low-income citizens or no income citizens; it's the migrant worker without access to health care; it's the mentally ill with a dreaded undiagnosed disease; it's the substance abuser who cannot get appropriate treatment; it's the raped victim who may not be able to get a legitimate abortion; it's the sound of depression, stress, chronic diseases, illiteracy, loneliness, fear, and anxiety. Are we the people listening? Are we the people paying attention?
Part III: The Noise of Silence/Health Care
Managed health care, the model for health care before Obamacare, emerged in the 1990s as an attempt to answer the problem of excessive costs in the U.S. healthcare system. The hope was that by treating the caring profession as a business rather than a service, bottom-line discipline would bring run-away costs under control. The changes in health care delivery are exemplified by the health insurance industry, which created a new method of delivering health care.
A wide range of groups emerged to "mange" care, that is, managed care organizations (MCOs), health maintenance organizations (HMOs), preferred provider organizations (PPOs), point of service groups (POSs), independent practice associations (IPAs), insurance reviewers, hospital administrators, institutional managers, and the purchasers of groups needing care who run the health care corporations. The difference between HMOs and PSOs (provider-sponsored organizations) is ownership. HMOs are usually owned by insurance companies, whiles PSOs are owned directly by doctors and hospitals. Essentially, the "1 percent" of the health care industry in our society who prefer the business medical model as oppose to the new potential accountable care organizations (ACOs) resulting from the Affordable Care Act (the "99 percent" Obamacare).
Whatever the type, managed care functions as individual, profit-driven corporations whose product is medical care. The vocabulary used by these organizations reflects their corporate image: the "consumer" (formerly the patient), the "provider" (the physician and other health care professionals), the "insurer" (the reimburser for any care), the "buyer" of health services (most often the large employer organizations). A certain dollar amount is negotiated for health care for a certain number of patients whether the care is given or not; the provider shares with the insurer any financial risk for the actual costs of care. And despite the observation by some health industry analysts that managed care heralded an alternative to the medical model, it fits squarely with that model.
In this new Health Reform environment, language can be a barrier in describing the underserved population in the U.S. healthcare system. A person-centered approach will help to reduce health disparities among people who are classified as low-income, minorities and lack access to adequate quality health care. Merck pharmaceutical with its MerckEngage .com commercial best describes the person-centered model: The people in the commercial provided the following:
..."I am not a statistic; I am not a target-market; I am not a demographic, or data, or a patient. I am a person; a butcher; a mom; a daughter; a teacher.....I am a human being who happens to have type II diabetes. The Affordable Care Act allows us to be fully human, if "We the People" decide to make health care available to all the citizens in the United States.
A wide range of groups emerged to "mange" care, that is, managed care organizations (MCOs), health maintenance organizations (HMOs), preferred provider organizations (PPOs), point of service groups (POSs), independent practice associations (IPAs), insurance reviewers, hospital administrators, institutional managers, and the purchasers of groups needing care who run the health care corporations. The difference between HMOs and PSOs (provider-sponsored organizations) is ownership. HMOs are usually owned by insurance companies, whiles PSOs are owned directly by doctors and hospitals. Essentially, the "1 percent" of the health care industry in our society who prefer the business medical model as oppose to the new potential accountable care organizations (ACOs) resulting from the Affordable Care Act (the "99 percent" Obamacare).
Whatever the type, managed care functions as individual, profit-driven corporations whose product is medical care. The vocabulary used by these organizations reflects their corporate image: the "consumer" (formerly the patient), the "provider" (the physician and other health care professionals), the "insurer" (the reimburser for any care), the "buyer" of health services (most often the large employer organizations). A certain dollar amount is negotiated for health care for a certain number of patients whether the care is given or not; the provider shares with the insurer any financial risk for the actual costs of care. And despite the observation by some health industry analysts that managed care heralded an alternative to the medical model, it fits squarely with that model.
In this new Health Reform environment, language can be a barrier in describing the underserved population in the U.S. healthcare system. A person-centered approach will help to reduce health disparities among people who are classified as low-income, minorities and lack access to adequate quality health care. Merck pharmaceutical with its MerckEngage .com commercial best describes the person-centered model: The people in the commercial provided the following:
..."I am not a statistic; I am not a target-market; I am not a demographic, or data, or a patient. I am a person; a butcher; a mom; a daughter; a teacher.....I am a human being who happens to have type II diabetes. The Affordable Care Act allows us to be fully human, if "We the People" decide to make health care available to all the citizens in the United States.
Part II: The Noise of Silence/Depression
The extent to which the noise of silence pierce the fabric of our society is but a reminder for "We the People" to take action to stop this noise. Depression is just one of the problems inherent in a society where the voiceless can not be heard because we fail to find adequate solutions. The health care crisis creates unprecedented opportunities for the people of faith to be major providers of preventive education and a site for an expanded role for primary health care.
The new prevention and wellness programs provided for in the Affordable Care Act (ACA) in opposition to the advocates of the free market system often celebrated as a mechanism, unabashedly driven by self interest, that lets us exchange goods and services without the need for redemption. Healing is more than treating diseases; health care more than a commodity; and huge corporations not the vehicle of choice for the delivery of appropriate health care. What we need is a comprehensive and accessible health care system that is available for all U.S. citizens.
The Center for Medicare and Medicaid (CMS) now covers annual screening for depression for Medicare beneficiaries in primary care settings that have staff-assisted depression care supports in place to assure accurate diagnosis, effective treatment, and follow-up. The decision to use a specific tool is at the discretion of the clinician in the primary care setting. However, coverage is limited to screening services and does not include treatment options for depression or any diseases, complications, or chronic conditions resulting from depression.
Choices in treatment will be influenced by one's value system, and recovery may be linked to one's personal faith. The "faith factor" is significant in a patient's recovery from a wide variety of illnesses. It appears that the faith itself rather than the object of the faith is of primary importance. The first element of faith is expectancy of improvement which may actually produce improvement. Suggestion is another powerful force. If one expects to improve, one will. Cultivating a sense of hope about oneself and the course of one's illness is central to recovery. Hopelessness creates a sense of futility.
The new prevention and wellness programs provided for in the Affordable Care Act (ACA) in opposition to the advocates of the free market system often celebrated as a mechanism, unabashedly driven by self interest, that lets us exchange goods and services without the need for redemption. Healing is more than treating diseases; health care more than a commodity; and huge corporations not the vehicle of choice for the delivery of appropriate health care. What we need is a comprehensive and accessible health care system that is available for all U.S. citizens.
The Center for Medicare and Medicaid (CMS) now covers annual screening for depression for Medicare beneficiaries in primary care settings that have staff-assisted depression care supports in place to assure accurate diagnosis, effective treatment, and follow-up. The decision to use a specific tool is at the discretion of the clinician in the primary care setting. However, coverage is limited to screening services and does not include treatment options for depression or any diseases, complications, or chronic conditions resulting from depression.
Choices in treatment will be influenced by one's value system, and recovery may be linked to one's personal faith. The "faith factor" is significant in a patient's recovery from a wide variety of illnesses. It appears that the faith itself rather than the object of the faith is of primary importance. The first element of faith is expectancy of improvement which may actually produce improvement. Suggestion is another powerful force. If one expects to improve, one will. Cultivating a sense of hope about oneself and the course of one's illness is central to recovery. Hopelessness creates a sense of futility.
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