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2 Comments

  1. Alan McGowan
    April 2, 2020 @ 8:44 pm

    Thank you for a cogent and realistic review of the health dangers facing us. I wish our policy makers and politicians had the courage to face up to the health issues you so clearly describe. Though I am well in my 80s I am in very good health and still teach part time, both undergraduates and graduate students. I worry about the world we are sending them into, which is a far cry from the world I entered when I graduated. They are worried and scared, and like you I am concerned with their mental health issues as well. Keep up the good work.

  2. Paul J Nelson
    April 2, 2020 @ 7:31 pm

    Two attributes of our nation’s population health and its healthcare may help challenge an insightful uncertainty about meaningful future needs. Two observations indicate the depth of our nation’s paradigm paralysis for its population health and its healthcare industry. First, our nation’s maternal mortality incidence began to worsen shortly before 1970 and has continued ever since then. It would need to be reduced by 70% to rank among the 10 best OECD nations. The number of women in association who die annually, solely because they lived in the wrong nation at the time of conception numbers 600-700. Rightly so, there are major efforts to reduce “maternal mortality.” So far, there has been no appreciable decrease in the long term trend. Remember that a pregnancy represents a biological condition of immune tolerance. Increasingly, there is pervasive evidence that chronic stress will cause immune disorders. It is likely that childhood maltreatment, childhood obesity, adolescent homicide/suicide, substance abuse/mortality, homelessness, mass shootings, adult depression/disability, and stagnant longevity at birth (now for 8 years) as well as maternal mortality are ALL related to our nation’s eroding social cohesion that began around 1960.

    Secondly, it is of interest that in 1960 our nation’s health spending represented 5% of the national economy, its GDP. As of 2019, it was 18%. An increase that parallels Parkinson’s Law almost exactly, viz. work expands to use the resources available. Furthermore, our dedication to the Kaizen Principle has paralyzed the healthcare industry’s capability for self-reflection. In comparison, the other OECD nations all spend less than 13% of their economies on health spending.

    It is likely that a substantial portion of health spending is related to the down-stream generational effects of our nation’s eroding social cohesion. It is unlikely that health spending cannot be managed without a means to systematically, community by community, solve the social cohesion problems associated with impaired social mobility and pervasive social isolation. It is likely that a decentralized, locally initiated and maintained strategy, community by community, that is nationally promoted will be required. Given the OECD nation’s health spending levels, $1.005 Trillion of our nation’s health spending of $3.57 Trillion in 2018 was wasteful.

    Two quotations apply: Maya Angelou said: “I have learned that people will forget what you did, people will forget what you said, but people will never forget how you made them feel.” And, Eleanor Roosevelt said: “It’s better for everybody when it gets better for everybody.”

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