Loyalty To Others Vs. True To Yourself

Loyalty.jpeg

So after the aborted Healthcare bill to replace failing Obamacare, President Trump tweeted about the alt-right’s lack of support for the bill: 

“We learned a lot about loyalty [today].”


The Freedom Caucus refused to vote with the rest of the Republicans on the 7-year long awaited repeal and replace of Obamacare. 


Instead, they felt it didn’t go farther enough to rescind everything from Obamacare they hated, and they chose to leave Obamacare as the solution for the foreseeable future, rather than get a replacement bill they felt was also subpar.


Whether this was smart or dumb, time will tell. 


– Smart – If down the road, they get a better replacement to Obamacare then what was being offered now. 


– Dumb – If rather than a better replacement, we end up either stuck with Obamacare indefinitely or get an even worse alternative later. 


It’s a little like gambling Vegas–they decided to roll the dice again, rather than leave the table with their winnings. 


Sure, they could end up a bigger winner or they can lose it all, so we’ll see. 


But there is another important question here:


What obligation did they have to be loyal and vote with their party vs. being loyal to their own conscience?


The Democrats have held the line better in terms of voting as block–and hence they have proved superior in many cases in wielding their share of power. 


In contrast, the Republicans have been more divided and hence, they can’t get the votes they need to pass the legislation desired by the right–because somebodies are always holding out for a better deal. 


But Trump represents “The Art of the Deal,”–and a deal usually means negotiation, compromise, and that nobody gets everything they want.


So while everyone should vote and act their conscience, there is also something to be said for loyalty to the team effort. 


If everyone just holds out for what they want, then really that stoneheadedness will result in virtually nothing getting done. 


We’ve all got to give a little to get a little, as long as it doesn’t violate our moral compass, core values, and faith. 


Loyalty also has to do with showing and acting with respect. 


And being disloyal to the team and leadership has ramifications.


Those who seemed as if they were being true to themselves and their constituents–may end up having really let themselves and the others down, and not just Trump and Ryan. 


Finally, loyalty is a two-way street, and I have a feeling Caesar is not yet done with the great treachery that was perhaps so callously inflicted on him and the greater national cause. 😉


(Source Photo: Andy Blumenthal)

A Nation Conquered By Politics

La La La.jpeg

So Obamacare is failing with rates spiraling up out of control and choices narrowing for people that need good affordable healthcare. 


And the Ryancare replacement plan failed to garner enough votes and has been questioned by the alt-right as not going further enough to change things for the better. 


Blame the parliamentarian, blame each other, blame the Russians. 


Between the two sides of the aisle, there aren’t enough centrists, and the parties won’t work together on a solution to this or anything else apparently–hence the utter catastrophic deadlock and lack of progress in Washington going on for years now!


The democrats passed Obamacare along party lines without a single Republican.


And now Ryancare similarly had not a single Democrat. 


Resistance.  Resistance.  Resistance!


This is how polarized and ineffective our system of governing has become, when the two sides love their position and power more than they love the people of this great nation!


The Russians, Chinese, North Koreans, and Iranians didn’t have to fire a single shot…they just continued to shame our ineffectiveness with bogus deals and aggressive posturing, fed us boatloads  of misinformation (“fake news”) to agitate our already divided country, and then they left us to split asunder under of our democracy’s own weight. 


As the Republicans point fingers and the Democrats gloat–there is a great refrain of La La La Koosh Koosh going on–and the Superpower U.S. is looking not only asleep, but also fat, stupid and sprawled out pathetic with no where to go but up from here. 😉


(Source Photo: Rebecca Blumenthal)

Upside Down in D.C.

So coming downtown this week in D.C., I see this quite unhelpful posted sign. 



If you can read upside down, while rushing down a busy street with a million and one things on your mind for the day, it says, “Sidewalk Closed. Use Other Side.”



Of course, the people flowing speedily down the streets in the morning, were still walking on this sidewalk, despite the construction and potential dangers. 



But in a way this reminds me of a bigger question here–is this really a sign of the times?



Today, I read in the Wall Street Journal about continued problems with Healthcare.gov–no, not related to the crashing websites, exemptions and delays, parts being overturned (such as with the contraception mandate), low enrollment (particularly after accounting for over 5 million people that lost their coverage with the new law and in effect had to sign up), but now in terms of thousands of people who signed up not getting their benefits due to continued problems with the enrollment system.



This is not just an issue for this party or that, but rather matters of government that we as a unified nation must tackle togther to grow our capabilities and competitiveness econically, militarily, and socially. 



Are the signs pointing us in the right direction and what streets should we be going down as a nation in order to succeed? 



(Source Photo: Andy Blumenthal)

Electronic Health Records, Slow But Steady

Skeleton

The best article I have seen on the subject of Electronic Health Records (EHR) was in Bloomberg BusinessWeek (21 June 2012) called “This machine saves lives so why don’t more hospitals use it.”

What I liked about this article was how straightforward it explained the marketplace, the benefits, the resistance, and the trends.

Some basic statistics on the subject of EHR:

The healthcare industry is $2.7 trillion annually or ~18% of GDP.

Yet we continue to be quite inefficient with only about half of hospitals and doctors projected to be using EHR by end of 2012.

Annual spending on EHR is expected to reach $3.8 billion by 2015.

Basically, EHR is the digitization of our medical records and automation of medical services so that we can:

– Schedule medical appointments online
– Check medical records including lab and test results
– Communicate with our doctors by secure messaging/email
– Send prescriptions into the pharmacy electronically
– Automatically keep track of dosage and refills
– Get alerts as to side effects or interactions of medication
– Analyze symptoms and suggest diagnosis
– Receive prompts as to the latest medical treatments
– Recognize trends like flu outbreaks or epidemics
– File and speed claim processing

So why do many doctor’s seem to resist moving to EHR?

– Cost of conversion in terms of both money and time
– Concern that it can be used against them in medical malpractice suits
– Potential lose of patient privacy
– Lack of interoperability between existing systems (currently, “there are 551 certified medical information software companies in the U.S. selling 1,137 software programs”–the largest of which are from GE and Epic.)

The government is incentivizing the health care industry to make the conversion:

– Hitech Act (2009) “provides $27 billion in financial incentives” including $44K from Medicare and $63K from Medicaid over 5 years for outpatient physicians that can demonstrate “that they are using the technology to improve care.”
– Patient Protection and Affordable Care Act (2010)–a.k.a. Obamacare–calls for “accountable care organizations” to receive extra money from Medicare and Medicaid for keeping patients healthy, rather than by procedure–“they are expected to do so using computers.”

The big loophole in EHR right now seems to be:

– The lack of standards for EHR systems from different vendors to be compatible, so they can “talk” to each other.
– Without interoperability, we risk having silos of physicians, hospitals, labs, and so on that cannot share patient and disease information.

So, we need to get standards or regulations in place in order to ensure that EHR is effective on a national, and then even a global level.

A number of months ago, I went to a specialist for something and saw him a few times; what he didn’t tell me when I started seeing him what that he was retiring within only a few months.

Aside from being annoyed at having to find another doctor and change over, I felt that the doctor was not too ethical in not disclosing his near-term intentions to close up shop and giving me the choice of whether I wanted to still see him.

But what made matters worse is that I got a letter in mail with the notification–not even in person–along with a form to fill out to request a copy of my medical records at a cost per page, so that I could transfer them–hardcopy–elsewhere.

Of course, this was also the doctor who hand wrote prescriptions still and wasn’t able to get test results online.

To me, seeing someone with a great amount of experience was really important, but the flip side was that in terms of organization, he was still in the “dark ages” when it came to technology.

I look forward to the day when we can have both–senior medical professionals who also have the latest technology tools at their disposal for serving the patients.

In the meantime, the medical profession still seems to have some serious catching up to do with the times technologically.

Let’s hope we get there soon so that we not only have the conveniences of modern technology, but also the diagnostic benefits and safeguards.

(Source Photo: Andy Blumenthal)