There is no other sporting event other than March Madness in which there is so much opportunity for the Davids to take on Goliath with a realistic chance of winning at least a round or two.
We've already seen some underdogs draw blood-- the US vs. England being one of the most noteworthy.
The world is also having to come to terms with Africa. South Africa, Ghana, and Ivory Coast earned points in the first match.
In Group A, mighty France and Mexico are on equal ground, thus far, with tiny Uraguay and the next to the bottom seed, South Africa.
Group F is a similar situation with New Zealand and Slovokia sitting level with Italy and Paraguay.
Tiny Slovenia sits atop Group C with traditional power, England and up and comer, USA tied for second.
Ghana beat Serbia. Ivory Coast held Portugal to a draw.
Group H is yet to play but we should expect at least one unexpected result if the trend continues.
At least one of these underdogs should have a bit of a run, out of their group or perhaps into the quarterfinals. There is a realistic chance that someone other than the consensus favorites (Spain, Brazil, Argentina, England, Germany) will win the whole tournament.
We certainly hope someone does. Blow your uzavulas for David (any David).
Tuesday, June 15, 2010
Saturday, March 27, 2010
If I Were Pope, as Yet Another Scandal Breaks
This week I will celebrate my tenth anniversary as a converted Catholic. I consider myself devout. I go to daily Mass. I relish and savor the mystery, the ritual, the drama of the Mass. I believe in transubstantiation. But there's more to this picture than a cursory glance reveals.
When I identify myself as a devout Catholic, that's only the last chapter of the story. There's a whole novel you have to read before getting to the Catholic part. You could call the Catholic conversion the surprise twist no one saw coming as they read through the book up to that point.
After spending ten years in the protestant clergy (United Church of Christ), I had very good reasons for leaving the Church, not just the ministry, and considering myself a "post-Christian secular spiritualist." For the purposes of this column we'll leave it at that. Why I left the ministry and the Church and wrote an article entitled, "Jesus was wrong," is another whole column. All you need to know for purposes of this one is that I considered myself a victim of religious abuse in the fundamentalist evangelical tradition in which I was raised, and after attempting to do battle with my religious roots by obtaining the education and power of the clergy to change the rules and the message, I eventually gave up and decided the Church wasn't worth saving.
Even at the peak of my ministry I did not believe in physical miracles. I believed that God gave the universe free will as well as the creatures in it. So a hurricane, earthquake, murder, or nuclear war were all consequences of free will exercised by people or by nature, and that God who created the world in that way, who chose to abdicate the ability to suspend or interfere in the laws of nature and allow all creation and all creatures to find their own way, run their own course, etc. would not or could not turn around and move the game pieces. That is what I believed at the height of what I would call my clergy phase. If at the time in my life that I would have been most predisposed to accept belief in Divine activity in the world, I certainly wasn't inclined to believe in any sort of miracles in my post-Christian phase.
But then something happened, and the entire house of cards came crashing down.
I married a Cuban woman is a very devout Catholic. She was 37 when we married. It was her first marriage. Her only dream in life was to be a mother. She was obviously perfect for the role, and was playing surrogate mother to the children of several friends and family members. But after only a year of marriage she had double bypass surgery, and if that wasn't enough to put the kibosh on dreams of motherhood, we discovered that we were both infertile. The fertility specialist told us our chances of conceiving without the use of technology were, functionally, zero.
But, on a visit to Our Lady of Victory Basilica in Buffalo in October of 1996, exactly one year after the open heart surgery, Maria, prayed at the grotto of Our Lady of Lourdes for a baby. She would later learn that she became pregnant during that same reproductive cycle.
Despite my attempts to rationalize, I knew in my heart and had to eventually admit consciously that there was no other explanation for the conception and birth of our daughter. It was a miracle.
Now in order for me to come to that conclusion, I had to reverse my position on the existence of a God as described in Judeo Christian tradition, and also had to reverse my position on the nature of that God, especially as regards the occurrence of physical miracles. And on top of everything else, I had to acknowledge that this God was found in a Catholic holy place, answering the prayer of a Catholic woman.
Now, in the interest of full disclosure I always did find myself drawn to ritual, mystery, mysticism, spiritual drama. Those aspects of the Catholic Church are especially meaningful to me. Not the doctrine or dognma though. In fact when I decided to convert I had a heart to heart with our priest and made sure he understood that I felt drawn to the church on a mystical level but I still can't endorse most of the verbal expressions of Catholic beliefs. I said if I can join the Church with my eyes open but my ears closed, I would join. I knew, and made sure he understood, that if I allowed myself to get caught up in a consideration of Catholic teaching, it would scare me away. He gladly accepted me on those terms.
So now, I'm a ten year Catholic, completely immersed in the ritual, the tradition, the drama and mystery of the Mass, and completely repelled and appalled by the Church's refusal to ordain women-- at the top of the list of about a hundred other things. But I'm there, and I'm one of them, for the same reason Moses eventually accepted God's call to rescue the Israelites. He came upon a bush that was burning but not consumed.
You could say the miracle conception was my burning bush. Once you've run head-on into something you don't believe in but can't explain it away, you have to concede. I didn't understand it, didn't want to understand it really. I was willing to accept it blindly, as way outside of my worldview but somehow also true. The true essence of "mystery." Like Moses, I ran into an enigma and had to simply conclude that although I am too dense to understand it or explain it, God did what I believed God couldn't or wouldn't do and because of that I have a miracle daughter.
But it is not an easy time to be a Catholic. Last weekend I was having the typical Facebook conversation with a friend who is what I would call an uncritical Catholic. She was citing the US Conference of Catholic Bishops in their insistence that the new health care bill had language in it that would allow Federal funds to pay for abortion.
I replied that unless such language was written into the bill with invisible ink, I can't imagine what the bishops think they know that the rest of us don't know about the legislation, and while I'm no fan of the bill that was eventually written because it appears to be written to get passed and create the illusion of health care reform more than actual reform, I have no doubt that between the Hyde Ammendment and the Executive Order prohibiting Federal funds from paying for abortion, anyone who is concerned about such things does not seem to be justified.
I then went on to make the comment that with all the issues going on in Europe right now that should warrant church leaders attention, the US bishops seem to have chosen to focus on creating a straw dog around saving the unborn rather than doing anything the least bit substantive about the already born and the sex abuse they suffered-- most recently revealed in Germany, on the Pope's watch, when he was Archbishop of Germany.
It concerns me that the Church leadership, from the Pope on down, is tone deaf (to put it politely) on this issue. They claim to speak with moral authority when they threaten to excommunicate any elected official who votes for anything related to abortion rights, yet they do nothing to excommunicate Catholic clergy who have done more than simply "vote" on wounding the soul and psyche of a child forever.
Frequently I run into people who are either former Catholics converted to agnosticism, or are former clergy colleagues considering themselves in a sort of justice-war against the Catholic Church because of it's treatement of women and it's Byzantine bureaucracy and the accompanying abuse of power. As the German scandal is frothing, I feel pressed to answer to these people, whether or not they demand it. So here's my answer.
First, I am a Catholic because of things completely beyond my control or comprehension. As many reasons as I could list for not being a Catholic, the one reason that counts is operative in my life. I am living a miracle. There is a miracle living and growing in my heart and in my house. And as far as I can discern, the Catholic Faith had everyting to do with this miracle.
Second, I am a Catholic because the mystery of events in my life has drawn me into the perpetual and systematic cycles of ritual. I don't know how or why, but I know that I am drawn to immerse myself in ritual and be consumed by it, with eyes wide open but ears closed, brain turned off. I know that if I follow the ritual daily it cleanses and refreshes me. It empowers me. Quietly yet profoundly.
Third, I am a Catholic despite abuses and hypocrisy at the top. As I have said, the essence of the Church is much more my local congregation and our priest, not the Pope and the Conference of Bishops. We have had our share of hypocrisy, corruption and abuse of power by our leaders in America, yet we can remain patriotic, we can love our country and everything that's good about it, despite the abuses of Nixon or Bush II, or anyone else in our government who has done or is doing horrible things to someone or covering up horrible things by someone else. I don't justify or support such corruption in either context, yet I also don't use it as an excuse to quit.
Despite everything, the essence of the Cathoic Church is not the Pope, the College of Cardinals, or the US Conference of Catholic Bishops. The essence of the church, along with its rituals, the one who leads those rituals. It is our humble, loving, longsuffering parish priest who lets people like me join the Church without signing off on the creeds or the Catechism, and does his best to model love and justice in his daily life.
I feel sorry, in a way, for people who were once Catholic but have abandoned the non-verbal, subconscious power of the ritual to renew and refresh the soul, the psyche, and the intellect. Humans seem to be tremendously dependent upon rituals for their mental health and for healing of emotional wounds. Those who bail out of the church eventually create new rituals in their church-free lives to replace the rituals they have abandoned.
So when the Pope appears to have been asleep at the switch at best, and intentionally under-reactive to sexual abuse in the German Church when he was it's leader, I can think about Father Sherry in my parish and I can think about the universal healing and empowering essence of the rituals of the Church, and I can live with myself as a Catholic, for another day.
But, that does not mean the Church is off the hook with me.
If the leadership of the Catholic Church is serious about addressing the issue of sexual abuse in the Church, regardless of how statistically rare such abuse may be in the larger picture, it must take a vow of silence for an extended period of time. The bishops of the Church, including it's Prime Bishop, Pope Benedict, must shut up. No more pontification about any other moral or spiritual ills in our world until this matter is sufficiently resolved. They need to realize they cannot speak with moral authority about any issue unless or until they have sufficiently and publically come to terms with this issue, with their lack of moral authority when it comes to the sexual abuse of children (and some adults) in the Roman Church.
In the Old Testament, when a king or a prophet or a priest was deeply grieved by the failures of their people (or their own failures) they would tear their clothes and walk the streets in "sackcloth and ashes" for an extended period. Eventually they would sense that they had done so long enough and they would regain their authority. But when that authority lapsed, it could not be regained without shutting the mouth and ripping the clothes.
If the Pope and his bishops are serious about protecting the Church's moral authority and their claim on it, we need to see some torn vestments, we need to see more than a smudge of ashes on the forehead once a year, and we need to see a return to sackcloth.
If I were the Pope I would issue an edict that on Good Friday every member of the Catholic clergy would rip their vestments from end to end as part of the Good Friday Mass. Next, any priest who has ever been known to have abused a child or adult parishioner must be immediately stripped of orders, of benefits, and of protection. They should be defrocked, censured, and delivered to the nearest police station. If that were to happen, maybe the world would begin to take the Church seriously again, and maybe the hierarchy of the Church would continue to take itself less seriously forever, or at least a good long time. All such developments would be a good thing for Catholics and for the world.
When I identify myself as a devout Catholic, that's only the last chapter of the story. There's a whole novel you have to read before getting to the Catholic part. You could call the Catholic conversion the surprise twist no one saw coming as they read through the book up to that point.
After spending ten years in the protestant clergy (United Church of Christ), I had very good reasons for leaving the Church, not just the ministry, and considering myself a "post-Christian secular spiritualist." For the purposes of this column we'll leave it at that. Why I left the ministry and the Church and wrote an article entitled, "Jesus was wrong," is another whole column. All you need to know for purposes of this one is that I considered myself a victim of religious abuse in the fundamentalist evangelical tradition in which I was raised, and after attempting to do battle with my religious roots by obtaining the education and power of the clergy to change the rules and the message, I eventually gave up and decided the Church wasn't worth saving.
Even at the peak of my ministry I did not believe in physical miracles. I believed that God gave the universe free will as well as the creatures in it. So a hurricane, earthquake, murder, or nuclear war were all consequences of free will exercised by people or by nature, and that God who created the world in that way, who chose to abdicate the ability to suspend or interfere in the laws of nature and allow all creation and all creatures to find their own way, run their own course, etc. would not or could not turn around and move the game pieces. That is what I believed at the height of what I would call my clergy phase. If at the time in my life that I would have been most predisposed to accept belief in Divine activity in the world, I certainly wasn't inclined to believe in any sort of miracles in my post-Christian phase.
But then something happened, and the entire house of cards came crashing down.
I married a Cuban woman is a very devout Catholic. She was 37 when we married. It was her first marriage. Her only dream in life was to be a mother. She was obviously perfect for the role, and was playing surrogate mother to the children of several friends and family members. But after only a year of marriage she had double bypass surgery, and if that wasn't enough to put the kibosh on dreams of motherhood, we discovered that we were both infertile. The fertility specialist told us our chances of conceiving without the use of technology were, functionally, zero.
But, on a visit to Our Lady of Victory Basilica in Buffalo in October of 1996, exactly one year after the open heart surgery, Maria, prayed at the grotto of Our Lady of Lourdes for a baby. She would later learn that she became pregnant during that same reproductive cycle.
Despite my attempts to rationalize, I knew in my heart and had to eventually admit consciously that there was no other explanation for the conception and birth of our daughter. It was a miracle.
Now in order for me to come to that conclusion, I had to reverse my position on the existence of a God as described in Judeo Christian tradition, and also had to reverse my position on the nature of that God, especially as regards the occurrence of physical miracles. And on top of everything else, I had to acknowledge that this God was found in a Catholic holy place, answering the prayer of a Catholic woman.
Now, in the interest of full disclosure I always did find myself drawn to ritual, mystery, mysticism, spiritual drama. Those aspects of the Catholic Church are especially meaningful to me. Not the doctrine or dognma though. In fact when I decided to convert I had a heart to heart with our priest and made sure he understood that I felt drawn to the church on a mystical level but I still can't endorse most of the verbal expressions of Catholic beliefs. I said if I can join the Church with my eyes open but my ears closed, I would join. I knew, and made sure he understood, that if I allowed myself to get caught up in a consideration of Catholic teaching, it would scare me away. He gladly accepted me on those terms.
So now, I'm a ten year Catholic, completely immersed in the ritual, the tradition, the drama and mystery of the Mass, and completely repelled and appalled by the Church's refusal to ordain women-- at the top of the list of about a hundred other things. But I'm there, and I'm one of them, for the same reason Moses eventually accepted God's call to rescue the Israelites. He came upon a bush that was burning but not consumed.
You could say the miracle conception was my burning bush. Once you've run head-on into something you don't believe in but can't explain it away, you have to concede. I didn't understand it, didn't want to understand it really. I was willing to accept it blindly, as way outside of my worldview but somehow also true. The true essence of "mystery." Like Moses, I ran into an enigma and had to simply conclude that although I am too dense to understand it or explain it, God did what I believed God couldn't or wouldn't do and because of that I have a miracle daughter.
But it is not an easy time to be a Catholic. Last weekend I was having the typical Facebook conversation with a friend who is what I would call an uncritical Catholic. She was citing the US Conference of Catholic Bishops in their insistence that the new health care bill had language in it that would allow Federal funds to pay for abortion.
I replied that unless such language was written into the bill with invisible ink, I can't imagine what the bishops think they know that the rest of us don't know about the legislation, and while I'm no fan of the bill that was eventually written because it appears to be written to get passed and create the illusion of health care reform more than actual reform, I have no doubt that between the Hyde Ammendment and the Executive Order prohibiting Federal funds from paying for abortion, anyone who is concerned about such things does not seem to be justified.
I then went on to make the comment that with all the issues going on in Europe right now that should warrant church leaders attention, the US bishops seem to have chosen to focus on creating a straw dog around saving the unborn rather than doing anything the least bit substantive about the already born and the sex abuse they suffered-- most recently revealed in Germany, on the Pope's watch, when he was Archbishop of Germany.
It concerns me that the Church leadership, from the Pope on down, is tone deaf (to put it politely) on this issue. They claim to speak with moral authority when they threaten to excommunicate any elected official who votes for anything related to abortion rights, yet they do nothing to excommunicate Catholic clergy who have done more than simply "vote" on wounding the soul and psyche of a child forever.
Frequently I run into people who are either former Catholics converted to agnosticism, or are former clergy colleagues considering themselves in a sort of justice-war against the Catholic Church because of it's treatement of women and it's Byzantine bureaucracy and the accompanying abuse of power. As the German scandal is frothing, I feel pressed to answer to these people, whether or not they demand it. So here's my answer.
First, I am a Catholic because of things completely beyond my control or comprehension. As many reasons as I could list for not being a Catholic, the one reason that counts is operative in my life. I am living a miracle. There is a miracle living and growing in my heart and in my house. And as far as I can discern, the Catholic Faith had everyting to do with this miracle.
Second, I am a Catholic because the mystery of events in my life has drawn me into the perpetual and systematic cycles of ritual. I don't know how or why, but I know that I am drawn to immerse myself in ritual and be consumed by it, with eyes wide open but ears closed, brain turned off. I know that if I follow the ritual daily it cleanses and refreshes me. It empowers me. Quietly yet profoundly.
Third, I am a Catholic despite abuses and hypocrisy at the top. As I have said, the essence of the Church is much more my local congregation and our priest, not the Pope and the Conference of Bishops. We have had our share of hypocrisy, corruption and abuse of power by our leaders in America, yet we can remain patriotic, we can love our country and everything that's good about it, despite the abuses of Nixon or Bush II, or anyone else in our government who has done or is doing horrible things to someone or covering up horrible things by someone else. I don't justify or support such corruption in either context, yet I also don't use it as an excuse to quit.
Despite everything, the essence of the Cathoic Church is not the Pope, the College of Cardinals, or the US Conference of Catholic Bishops. The essence of the church, along with its rituals, the one who leads those rituals. It is our humble, loving, longsuffering parish priest who lets people like me join the Church without signing off on the creeds or the Catechism, and does his best to model love and justice in his daily life.
I feel sorry, in a way, for people who were once Catholic but have abandoned the non-verbal, subconscious power of the ritual to renew and refresh the soul, the psyche, and the intellect. Humans seem to be tremendously dependent upon rituals for their mental health and for healing of emotional wounds. Those who bail out of the church eventually create new rituals in their church-free lives to replace the rituals they have abandoned.
So when the Pope appears to have been asleep at the switch at best, and intentionally under-reactive to sexual abuse in the German Church when he was it's leader, I can think about Father Sherry in my parish and I can think about the universal healing and empowering essence of the rituals of the Church, and I can live with myself as a Catholic, for another day.
But, that does not mean the Church is off the hook with me.
If the leadership of the Catholic Church is serious about addressing the issue of sexual abuse in the Church, regardless of how statistically rare such abuse may be in the larger picture, it must take a vow of silence for an extended period of time. The bishops of the Church, including it's Prime Bishop, Pope Benedict, must shut up. No more pontification about any other moral or spiritual ills in our world until this matter is sufficiently resolved. They need to realize they cannot speak with moral authority about any issue unless or until they have sufficiently and publically come to terms with this issue, with their lack of moral authority when it comes to the sexual abuse of children (and some adults) in the Roman Church.
In the Old Testament, when a king or a prophet or a priest was deeply grieved by the failures of their people (or their own failures) they would tear their clothes and walk the streets in "sackcloth and ashes" for an extended period. Eventually they would sense that they had done so long enough and they would regain their authority. But when that authority lapsed, it could not be regained without shutting the mouth and ripping the clothes.
If the Pope and his bishops are serious about protecting the Church's moral authority and their claim on it, we need to see some torn vestments, we need to see more than a smudge of ashes on the forehead once a year, and we need to see a return to sackcloth.
If I were the Pope I would issue an edict that on Good Friday every member of the Catholic clergy would rip their vestments from end to end as part of the Good Friday Mass. Next, any priest who has ever been known to have abused a child or adult parishioner must be immediately stripped of orders, of benefits, and of protection. They should be defrocked, censured, and delivered to the nearest police station. If that were to happen, maybe the world would begin to take the Church seriously again, and maybe the hierarchy of the Church would continue to take itself less seriously forever, or at least a good long time. All such developments would be a good thing for Catholics and for the world.
Wednesday, March 10, 2010
No, Mr. President, There's One Thing No One's Discussed
Last week, in his latest pitch for "Health care reform" President Obama said, "Everything that can be said about health care has been said... by just about everyone."
With all due respect, Mr. President, the most important aspect of this discussion has not been addressed in any public forum, and we have no reason to believe it has been discussed in private top level meetings either.
In our previous post, we pointed out that the cost of requiring emergency rooms to treat everyone regardless of medical necessity results in a 3000% percent mark-up for minor care services obtained in emergency departments. Given the fact that 40-50%of patients seen in ER's only require minor care, we have to wonder how many uninsured we could cover at no additional cost if we simply stopped emergency room abuse. We have to wonder if pre-existing conditions could be covered with just some of the savings created by an end to mis-utilization of the emergency room.
I've attempted to contact the White House and my elected representatives with this point and have been (surprise, surprise) completely ignored. Please see my previous post (Health care, so easy a caveman can do it...) and forward it to everyone you know, especially elected officials and media.
With all due respect, Mr. President, the most important aspect of this discussion has not been addressed in any public forum, and we have no reason to believe it has been discussed in private top level meetings either.
In our previous post, we pointed out that the cost of requiring emergency rooms to treat everyone regardless of medical necessity results in a 3000% percent mark-up for minor care services obtained in emergency departments. Given the fact that 40-50%of patients seen in ER's only require minor care, we have to wonder how many uninsured we could cover at no additional cost if we simply stopped emergency room abuse. We have to wonder if pre-existing conditions could be covered with just some of the savings created by an end to mis-utilization of the emergency room.
I've attempted to contact the White House and my elected representatives with this point and have been (surprise, surprise) completely ignored. Please see my previous post (Health care, so easy a caveman can do it...) and forward it to everyone you know, especially elected officials and media.
Friday, February 26, 2010
Healthcare: So Easy a Caveman Can Do It! (So why can't Congress?)
Are you as frustrated as I am? All this back and forth about health care reform, health insurance reform, "socialized" medicine, insurance company greed, cost containment, etc. and no one-- literally no one in government or the media has begun to address a few of the key issues that contribute to the current crisis. All the Democrats do is take the current system, include more people in it, and increase the cost for it. The Republicans have offered a sham alternative that also fails to address core issues that could be resolved in the private sector at great savings, if they had even the slightest amount of imagination.
There will be NO real health care reform or health insurance reform unless or until the key issues at the root of our crisis are resolved. Today we'll tackle the first and biggest issue: the over-utilization of the emergency room.
This is the single most broken and most costly aspect of the U.S. health care system and no one is addressing it. Experts say that somewhere between 30% and 50% of patients seen in the emergency room do not require emergency services. Instead they could and should be seen by a primary care physician or a routine (minor) care clinic (staffed by nurse practitioners or physician assistants).
People go to the emergency room for minor care for several reasons.
1. They haven't taken time to establish a primary care relationship, and suddenly are sick, and have nowhere else to go.
2. Related to #1 above, they have good insurance, their insurance pays for most or all of ER care, and it seems easier just to go to the ER.
3. They have no insurance and the ER cannot turn them away (by law).
4.They aren't sure how serious their symptoms are and don't want to wait to be seen.
There is no excuse for 1-3. Those who aren't sure can certainly go to the ER for triage, or they can go to a minor care clinic for triage. Either way, if they aren't appropriate for care at the level of the program doing triage, they would have to move to a more appropriate level of care.
But wait, under current statutes, the emergency room can't turn anyone away. They can ask them to wait hours while more critical patients are served first, but they are not allowed to turn anyone away. Hmmm! Might this be the crux of the problem?
It just might be. And because of the fact that hospitals are not permitted by law to screen patients out of the emergency room, 30-50% of the patients treated there, don't need to be there.
Experts say that the absolute minimum bill for ER treatment in this country is $700, all inclusive. On the other hand, minor care can be provided by paraprofessionals under MD supervision for $25 per encounter. If every inappropriate patient seen in the ER was charged only the minimum, that means that 30-50% of the total number of emergency room patients are costing the system approximately 3000% more than the appropriate level of care should cost.
Somebody do the math. I don't have the numbers yet, but it is obvious that if 30-50% of patients in the most utilized department of the typical hospital is costing three thousand percent too much, that has to be a major factor in the cost of health care and health insurance. Why isn't anyone talking about this?
The solution: First of all, simple legislation requiring emergency rooms to screen patients for medical necessity and turn away patients that do not meet criteria would solve the problem. The legislation should include immunity from malpractice liability for any actions taken in good faith. Gross negligence could and should still be actionable, but unless someone can prove that a hospital missed obvious indications of a critical condition, they could not be sued for turning someone away. There should be ample latitude for giving the benefit of the doubt if someone more examination is need to rule out a serious condition. But most of the inappropriate cases are easily identified. The patient complains of cold or flu symptoms, other minor distress, or comes in with a minor injury. All of which could and should be treated by a paraprofessional such as a paramedic, physician assistant or nurse practitioner. Instead of costing a minimum of $700, such care would cost $25.
But what if minor care clinics are not available? Trust the market. If emergency rooms were required to turn away non emergent patients today, there would be minor care clinics on every corner by tomorrow.
But it's not good enough to read this article and agree with it and leave it at that. If you agree with it, you need to contact every elected official on the ballot in your precinct and demand that they do as much as possible given their sphere of influence and responsibility, to get this issue into the national health care dialogue and on the legislative agenda.
The other thing you can do is share this article with others, and spread the word by any means you can. ***
A comprehensive plan proposal: www.libertarianplace.com/heresourhealthplan.aspx
There will be NO real health care reform or health insurance reform unless or until the key issues at the root of our crisis are resolved. Today we'll tackle the first and biggest issue: the over-utilization of the emergency room.
This is the single most broken and most costly aspect of the U.S. health care system and no one is addressing it. Experts say that somewhere between 30% and 50% of patients seen in the emergency room do not require emergency services. Instead they could and should be seen by a primary care physician or a routine (minor) care clinic (staffed by nurse practitioners or physician assistants).
People go to the emergency room for minor care for several reasons.
1. They haven't taken time to establish a primary care relationship, and suddenly are sick, and have nowhere else to go.
2. Related to #1 above, they have good insurance, their insurance pays for most or all of ER care, and it seems easier just to go to the ER.
3. They have no insurance and the ER cannot turn them away (by law).
4.They aren't sure how serious their symptoms are and don't want to wait to be seen.
There is no excuse for 1-3. Those who aren't sure can certainly go to the ER for triage, or they can go to a minor care clinic for triage. Either way, if they aren't appropriate for care at the level of the program doing triage, they would have to move to a more appropriate level of care.
But wait, under current statutes, the emergency room can't turn anyone away. They can ask them to wait hours while more critical patients are served first, but they are not allowed to turn anyone away. Hmmm! Might this be the crux of the problem?
It just might be. And because of the fact that hospitals are not permitted by law to screen patients out of the emergency room, 30-50% of the patients treated there, don't need to be there.
Experts say that the absolute minimum bill for ER treatment in this country is $700, all inclusive. On the other hand, minor care can be provided by paraprofessionals under MD supervision for $25 per encounter. If every inappropriate patient seen in the ER was charged only the minimum, that means that 30-50% of the total number of emergency room patients are costing the system approximately 3000% more than the appropriate level of care should cost.
Somebody do the math. I don't have the numbers yet, but it is obvious that if 30-50% of patients in the most utilized department of the typical hospital is costing three thousand percent too much, that has to be a major factor in the cost of health care and health insurance. Why isn't anyone talking about this?
The solution: First of all, simple legislation requiring emergency rooms to screen patients for medical necessity and turn away patients that do not meet criteria would solve the problem. The legislation should include immunity from malpractice liability for any actions taken in good faith. Gross negligence could and should still be actionable, but unless someone can prove that a hospital missed obvious indications of a critical condition, they could not be sued for turning someone away. There should be ample latitude for giving the benefit of the doubt if someone more examination is need to rule out a serious condition. But most of the inappropriate cases are easily identified. The patient complains of cold or flu symptoms, other minor distress, or comes in with a minor injury. All of which could and should be treated by a paraprofessional such as a paramedic, physician assistant or nurse practitioner. Instead of costing a minimum of $700, such care would cost $25.
But what if minor care clinics are not available? Trust the market. If emergency rooms were required to turn away non emergent patients today, there would be minor care clinics on every corner by tomorrow.
But it's not good enough to read this article and agree with it and leave it at that. If you agree with it, you need to contact every elected official on the ballot in your precinct and demand that they do as much as possible given their sphere of influence and responsibility, to get this issue into the national health care dialogue and on the legislative agenda.
The other thing you can do is share this article with others, and spread the word by any means you can. ***
A comprehensive plan proposal: www.libertarianplace.com/heresourhealthplan.aspx
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