October 11-14, Urbana, Illinois
Joel Thomas:
In anticipation of the health care design intensive in Urbana this October, I attempted to imagine what a collection of over 150 health activists from around the world "would look like." How would my ideas about health care reform be received? Would I radically alter my perspective over the course of the week? Would we be divided by ideological issues or arrive at some form of systems-change consensus?
As is often the case, the actual experience of the design intensive exploded my preconceptions. I did not anticipate the great diversity of participants: nurses, doctors, clowns, artists, medical students, and community activists, all intensely committed to systemic health care reform. "Design" was tricky, given the fact that we had four days to both reflect on the analysis of others and attempt to synthesize our perspectives. Due to the profound intellect, clear articulation, and immense compassion of the participants however, I was amazed at the level of humanism and joy that was brought to this critical issue facing our nation. I realized that "designing" was occurring not as the narrow development of a specific course of action that I had envisioned, but rather as a constant discourse of "perturbation." As I read this concept, the intensive provided the necessary space for the cultivation of a philosophy of engagement with the health care system that intends a fundamental revolution in the paradigm of care delivery.
As a social scientist and a medical student, I was able to extend my perspective regarding systemic reform by more critically appreciating the multiplicity of issues that need to be addressed (not only financial relationships, but also human relationships, the general philosophy of medical intervention, and the participatory aspects of care necessary for true community health). In this sense, the intensive proved essential in the evolution of my thinking surrounding health care reform that will be presented fully in my future book entitled "US Health Care for Activists." In its final analysis, the book will attempt to elaborate the specific steps that can be taken to create the type of systemic change that has revealed itself as imperative.
Joel Thomas, University of Wisconsin at Madison
med student, social scientist
author of "US Health Care System for Activists"
Larry Richards:
I invited four of my Nursing faculty to attend the Intensive with me, and we had an extremely informative and fun time. As someone with minimal background in health care, I found myself immersed in a strange and fascinating new world. My colleagues helped me with some of the concepts, and I felt that we all left with creative ideas and perspectives to discuss with our students and other faculty. It was eye-opening to say the least!
Larry Richards
Executive Vice Chancellor
Indiana University East
Michael Porco:
I am a Marriage and Family Therapist Intern living in Southern California and I traveled to the intensive in Urbana, IL because I felt deeply affected by the medical system both as a consumer and provider. I could not believe that a medical system, which is intended to help people, could cause so much harm.
I chose to be a therapist because I enjoy listening to people’s life stories and seek to partner with them in healing. One reason I didn’t choose to be a doctor is because I suspected that the medical system would not allow me enough time with each patient. I thought of being a psychiatrist but found that so many of them predominantly prescribe medication and are under the same time constraints that all doctors face.
I wanted to make a difference in the lives of those suffering the most so I chose community mental health. Unfortunately, I had no idea that the community mental health system contains many of the same constraints I hoped to avoid. While it is true that therapists are able to spend more time with patients than doctors are, we still deal with insurance companies refusing treatment and "managing" care. The system often encourages therapists to label children and adults with a "serious" medical condition or risk insurance limiting care or not paying for treatment at all.
To be human is to sometimes experience grief and loss but there is no medical coding for preventative mental health care so people often don’t seek help and end up experiencing a major depressive episode or similar condition.
When I arrived at the intensive, I was a person who was suffering. I was looking to share my story and interact with a loving group of people who aspired to reinvent health care. And I found what I was looking for! Young and old danced, laughed, and brainstormed, bringing joy to one another and motivating each other to bring back ideas and plans to their communities. I left inspired, full of hope and ideas.
I am both an idealist and realist. I know that people are not perfect and thus systems are not perfect. All I want is for us to have the courage to stand up and say that all people deserve high quality treatment when the body, mind, or spirit is hurting. The "Inside My Heart But Outside the Box: Thinking, to Change the Health Care Box" gave me courage and camraderie to do so.
Michael Porco, MS
Marriage and Family Therapist Intern
Burbank, CA
Sharing Inspiration--Brieanna Cross:
Patch Adams M.D. danced down the corridor with his clown costume on, twirling an elderly man in a wheelchair while Susan Parenti played the accordion and a crowd of clowns clapped along. In the Champaign County Nursing Home there were thirty clowns made from doctors, medical students, nurses, midwives, nurses aids, energy workers, music therapists, chiropractors, Americans, Canadians, Israelis, Brazilians, and many more! We descended upon the unsuspecting elderly with flowers, smiles, bubbles, laughter and delight. It was a beautiful sight.
We came from all walks of life to the Independent Media Center of Urbana, Illinois to a four day intensive titled, "Inside my heart but outside the box: Thinking, to change the medical box". Thinking to change the medical box can take you many places. Learning the facts underlying the problems with the U.S. medical system can be frustrating. However, with the School for Designing a Society and Gesundheit! Institute we were inspired not only to think out side the box, but to laugh, play, love and be joyful as we work to make what is outside the box a reality inside the box of our every day lives.
On my way back to California I wore a home-made t-shirt inspired by the workshop. On the front it reads, "The Imperfect Me: *I get zits *I have diarrhea *Sometimes I fail" (yes, you can laugh, its supposed to be funny). This was in honor of Bowen White M.D. and his book, "Why Normal Isn't Healthy". Dr. White, an expert in preventative and stress medicine, a clown and an affiliate of Gesundheit! Institute, was one of our many motivational speakers. He taught me that as a human (and even as a medical student) I have permission to be me and to make mistakes. I am studying the imperfect science of medicine, and healing, like life, is often learned through trial and error.
On the back of my t-shirt I wrote, "It's An Imperfect System: *The U.S. spends 1.7 TRILLION dollars on health care per year. *44 MILLION Americans have NO health insurance. *The WHO global ranking of health care placed the U.S.A. at #37 out of all countries."
Since when did America allow itself to come in 37th place for anything? Especially #37 in taking care of our own people?!
The W.H.O. reasoned that, "a fairly financed health care system ensures financial protection for everyone. Health systems can be unfair by either exposing people to large, unexpected costs they must pay on their own or by requiring those least able to pay for care to contribute more, proportionately, than wealthier citizens. The U.S. and South Africa are seen as the only prominent examples of industrialized countries that do not have comprehensive social health insurance." (Barlett & Steele Critical Condition; 2004: p14)
In a country like the U.S. that spends 15.3% of the gross domestic product on health care, where does all of the money go? Its true that we offer world-class, high-tech surgery to 2-3% of our population and some of the richest citizens of other countries that come here for specialized treatment. But the average American spent $4,887 in health care spending in 2001. Yet, Canadians, who spend 75% less ($2792) can expect to live 2.5 years longer than Americans. What's more is this stunning quote from Critical Condition, "studies show that an uninsured person is billed 3, 4, 5, sometimes as much as TEN TIMES more than an insurance company whose patient has the exact same treatment". (Barlett & Steele Critical Condition; 2004: p15) Would you pay ten times more than your neighbor for your transmission to get fixed on the same type of car? Something is wrong with this system.
Flying home with my t-shirt and a white feather halo on my head I had many great conversations with Americans about their views of health care. Our system needs to change and we all know it. So what can we do and, more importantly, how do we make it fun?
The first thing that we can do is to educate ourselves about the problems. That is why I am writing this and hopefully why you are reading it. Reading books about it is even better. The second thing we can do is look into other options. Try the Physicians for a National Health Program to hear about one idea http://www.pnhp.org/. Think of your own. Begin by thinking about your desires, things that are currently false that you wish here true. Here's one: Equal access to health care for all people.
We can all think of way of healing health care in America. What do we do if we need to gather resources before we can put our plans into action? As Susan Parenti from the School for Designing a Society suggests, "how we proceed in our day to day life carries and sends many messages. The minimal indispensable version of your desires can fuel your performance in every day life. You can be that version of your idea every day." If the minimal version is equality, let that drive your actions. Speak to everyone, janitors, surgeons and the homeless with inclusion and the same loving-kindness. Is this what Ghandi meant when he said, "Be the change you wish to see in the world"? That change can begin today.
"We cannot separate the health of the individual from the health of the family, the community and the world." --Patch Adams MD
Through your desires you create your reality. What is your vision?
In Peace and Revolution,
Brieanna Cross
Touro University, College of Osteopathic Medicine