Cosmos or chaos: Which way to health reform?

Note: The point of the post is to open up a view to the extraordinary power of the present moment; how we are inventing a new health paradigm. Ideas mustn't be limited to accepted standards such as "efficiency," etc. Although those standards are important, beauty is too.

Healing messages can be simple
We rely and organize the experience of illness - as well as the experience of health - around cultural archetypes. This process of cultural meaning typically transmits without our conscious awareness. Here is a nano-example:

If we suffer a cut to the skin that is deep and threatening, most of us will call 911 and/or drive immediately to the ER. We do not contemplate the symbols or assumptions embedded in the ER experience as we take action to stop the bleeding. In this case, the moment of healing is black and white: "Get to the ER, stop the bleeding ... or perish."

Healing messages can also be complex
Yet, in many other (perhaps most) cases, and especially in the area of health promotion and prevention, the complexity of healing messages really heats up. Grey matter abounds. Being healthy looks more like fluid movement toward certain forces rather than arresting the flow of other forces. Herein lies the sweet spot of health reform, the place where we have lots of potential to influence up (by generation) if we can figure out where to put the investment.

The sweet spot of health reform
Working our way into the sweet spot *is* rocket science as a colleague on Twitter wrote recently. (Please help me id this tweet.)

As it stands now, not only is an appointment for a well visit supposed to include tailored:

• temporal reinforcements (i.e., "I'll be in touch with the results;");
• an awareness of gender and religious preferences;
• succinct and passionate delivery of avoidance marketing messages ("Limit/avoid tobacco use"; "Avoid eating too much fat.");

we'd also like a moment of respite, a bit of energy transcending the doctor-patient relationship to makes us feel good. Not so easy for a health care worker or physician to convey all of this rich stuff in a 15 minute visit.

It's no wonder every one's first best guess is to believe technology can help. But perhaps we could get to the changes more organically by growing the country's social awareness of health as a finite resource. It is ours to lose.

A conceptual dialog
As the national conversation around trade-offs in health reform progresses, I wonder why a rare opportunity to reflect on "what makes us feel good/bad about our health" (long wait lines @ doctors' offices, no advance calls to drug stores, no guarantees for good health, difficulty with communicating on all levels, feeling alone, or powerless to deal with bad habits and expenses, and an overall sense that one needs to pay to play the health game) is being passed by. ...

Could it be that this omission is due to the difficulty of working with conceptual ideas on a national scale?

Or, alternatively, could it be that skirting conversations about negative work flow is a strategy to deal with information fallout - a feeling that we simply have too much data (and too many of those "black and white" needs) to synthesize, so, "Enough already!"

Then again, could it be plain old-fashioned profit and politics? Is it possible that politicians (and many Americans) disdain conceptual thinking because it exacerbates feelings of uncertainty while at the same time exposing alliances and preferences that most of us would rather leave alone.

Cosmos or chaos: Which way to true health reform?
Health reform is much more than performance art and politics. It is much more than retrofitting a highway design from the 50s and equipping it with EZ-Pass technology. Health reform is about the development of America's identity, as well as America's marketplaces. And that's why we need to have a strategy, a "cosmos" to help us move most efficiently.

That's right, we must create and engineer a "cosmos" for health care, not a chaos.

A cosmos for health care is a higher concept with a clear, energized vibration. It conveys the extraordinary responsibility we share in the creation of revised archetypes of care. It acknowledges what is wrong, where we need to learn. AND it illuminates the beauty of the ideas proposed, not just hammers away at the bean count level.

We are *gets tingles* literally inventing, and reinventing, powerful partnerships with the human genome, smart technology, data streams, and ever evolving human beings. If we do it well - we'll disrupt current health infrastructure for the foreseeable future. Of course we should expect chaos.

But we cannot stop at chaos. To stop at chaos is to miss this opportunity entirely. Like an artist who shows his angst without the beauty that grows out of it, we must be led to the cosmos of the next generation of care and opt in. That is the way to leverage the chaos of disruption.

A bias for beauty
We don't often think that health reform can be beautiful. In fact, we are heavily committed to a belief in anxiety and constrictive energy around choices, winning and losing. However, our process seems false. It seems to be one that hurries along, that forces quick steps to mimic progress on a path unnamed. The motions are jerky, motivated by a fear that the country's needs may (will soon) catch up and overwhelm the medical pacts we made long ago.

As the system asks us to follow a more orderly, simpler path along the journey what will be our response? Cosmos or chaos? An unrelenting, steep uphill with no respite, no shady overlooks, and, certainly, little inspiration?

Change is awkward
If we identify the changes so many of us yearn for, and create a way to talk about those changes on a conceptual level first, wouldn't we be better equipped to create cosmos (and requisite policies) that are truly transformational, affordable and life-affirming?
...
Related posts:
Mother of all health reform
Are we betting on the "me" in medicine?
A limitation of Health 2.0
Shopping for health insurance
If e-health was simple...
People, not patients

Health reform: For amateurs too?

We played "Kid's Topics" in the car on our way home from a long trip a few days ago. One of the cards queried, "What makes you feel better when you are sick?"

My son, age 8, blurted, "Sipping Coke sometimes helps!" My daughter said, "Getting hugs from my mom." They both agreed that "Resting on the couch with the TV on," also felt good when they felt bad.

So simple. These remedies are the things we have taught them to feel good about doing when they are home from school with an infection of some kind. "Take a sip of this warm Coke." "Rest here on the couch and I'll put on Animal Planet." Etc., etc.

Right or wrong from an evidence-based perspective, as parents we build and transmit our nations health culture. Period.

In the conscious minds of most of laypeople, what most of us identify as healing is not what experts purport, but what we are taught to believe in, right or wrong. Sometimes there is overlap, but not always. The disparities are cultural issues - not just educational/economic gaps - and, unfortunately, seem to have little to do with health care and health care rationing as it is being discussed today in the Federal arena.

Amateurs need a say in the health care debate in order to make this work.

In a wonderful piece, "The Avenging Amateur," a Time Magazine editorial by Kurt Andersen, historian Daniel Boorstin is quoted as saying, "The greatest obstacle to discovery is not ignorance, but the illusion of knowledge."

How true the existence of the "Illusion of Knowledge" has turned out to be in recent health care reform debates, even those on supposed "Social" channels, such as Twitter.

Unfortunately, without reforms that acknowledge and revise cultural expectations and underpinnings, we will have a hard time realizing health reform in this county. We may reform an aspect of the system -- the work flow, the billing -- but we will miss a tremendous opportunity for real reform if we do not develop a way to work on the cultural level.

When I contemplate what Obama's health care reform program (i.e., the money he's put on the table) might mean, I get the chills. To an amateur, it is simply a mind-blowing opportunity to engineer not just new work flows, but new meanings too.