A Single-Payer Healthcare System for All Americans

KISS - Keep It Simple, Stupid

K.I.S.S. – Keep It Simple, Stupid. (I got this cartoon on Facebook and decided to share.)

For most of us, getting healthcare in this country is way too hard, as the video at the end shows. So to those in Congress who would make it even harder, I say, “Keep It Simple, Stupid,” with a single-payer healthcare system for All Americans.

WHERE’S THE VISION?

I responded to an article in The Guardian that critiques Democrats’ healthcare arguments, and another article in The New York Times that criticizes Republicans. The NY Times article describes a structural flaw in modern capitalism, where tremendous income gains have gone to those at the very top while prospects have diminished for those in the middle or bottom.

Both polarized political parties seem to lack a clear vision for America, and without a strong vision, Republicans have been separating themselves from traditional conservative policy. Even the term “compassionate conservatism” has vanished. I voted for Bush, but without compassion and goals I can believe in, I can no longer call myself a Republican.

Because I’m a consumer advocate, I must oppose policies that seem to be, “for us to win, you must lose.” That selfish meanness is why I now call myself a Progressive. It’s why I founded Modern Health Talk five years ago, why I voted for Obama, why I supported the Affordable Care Act (ACA), and why I still advocate long-term for a single-payer universal healthcare system like Medicare-for-All. It’s also why I endorse a public option as a path toward that objective.

Unlike modern Republicans (and many Democrats), I have a vision for America where government and individual citizens cooperate in a functioning society and share responsibility and benefits. We must collectively invest in public education, public safety, public infrastructure, public utilities, and a skilled, healthy and productive workforce to drive innovation, profit, and GDP. You see, I value capitalism like Republicans, but I also know the benefit of public-sector organizations and initiatives. And I know that no individual or company “makes it” on their own. With that in mind, one of my first articles here described a hybrid public/private healthcare system that blends the best of socialism and capitalism.

MY ADVICE FOR DEMOCRATS

I like most of the populist message of Bernie Sanders and Elizabeth Warren, but I worry that they both are too far to the left and may scare away moderates. I’m not sure they share my vision for America, because their rhetoric seems to blame wealthy corporations and individuals, and capitalism, and their plans seem intent on punishing with high taxes and strong regulation.

Sure, Progressive policies and tax reforms are needed, but the Democrat’s message needs to be simpler, gentler and more inclusive. Make the case that we as a nation must share both the responsibility and benefits, and invest strategically – i.e. work together.

As for healthcare, quit complaining about Republican efforts to repeal & replace Obamacare, because that’s what they campaigned on, and your arguments are landing on deaf ears. And quit trying to save Obamacare as it stands, because it does have flaws, and Republicans know how to break it. Take the high road and the initiative by reaching across the aisle with a better plan – a plan that has broader objectives that both sides can support, like saving over $1.5 trillion each and every year in overall healthcare costs, while also improving outcomes and developing that skilled, healthy, and productive workforce.

MY ADVICE FOR REPUBLICANS

Republicans had 7 years to step back, ask the right questions, and then work with Democrats and all stakeholders to craft a workable Obamacare replacement. It doesn’t take a rocket scientist to know that Medicare-for-All would satisfy campaign promises to replace Obamacare with a system that provides everyone with care that’s better and cheaper. I find it ironic that Republicans still claim to be the party of fiscal responsibility but failed so poorly to see the potential savings of universal healthcare. There’s still time to change course, knowing that 80% of the nation doesn’t want their hastily and secretly devised plan.

MEDICARE-FOR-ALL

As the latest Republican attempt to repeal Obamacare stalls in the Senate, Democrats like Robert Reich argue that basic healthcare should be a right and guaranteed for all Americans.

OUR HEALTHCARE SAVINGS POTENTIAL IS IMMENSE

The U.S. now spends over $3.3 trillion/year on healthcare – in total, including insurance premiums, deductibles, out-of-pocket expenses, and government subsidies. That’s more than 17% of GDP, and it’s going up with 11,000 people turning age 65 every day and needing more care in old age.

The big savings potential is because our total spending is twice as much as what the other advanced nations pay, yet we still live sicker and die younger. Those other nations also struggle to constrain rising costs, but they have simpler and more-efficient single-payer systems that make coping with aging populations easier. Their incentives better align with goals.

To reach the savings potential, politicians must go beyond universal healthcare, because Medicare-for-All is not enough. It’s just another way of paying for health care. Although it’s far more efficient than any private health insurance, it doesn’t reduce the need for care in the first place. For that we need to focus on health, wellness and prevention, because as Benjamin Franklin said 250 years ago, “An ounce of prevention is worth a pound of cure.”

TECH INNOVATION WILL IMPROVE CARE DELIVERY

Moore’s Law and the FUTURE of Health Care” is an article I wrote from the perspective of a retired IBM technologist and futurist. It looks at the convergence of information science (processors & networks), biology (chemistry, genes & proteins), cognitive & neuroscience (neuron signaling), and nano technology.

SPECIAL INTEREST LOBBYING WILL SLOW PROGRESS

While I’m guardedly optimistic that tech innovation will greatly improve care delivery, I worry about misaligned incentives that promote profit from disease management rather than health & wellness, and about special interest lobbying. In his TIME Magazine report, “Bitter Pill: Why High Medical Bills Are Killing Us,” Stephen Brill describes the Medical Industrial Complex, which spends 3-times as much on lobbying as the military industrial complex. They obviously don’t want to lose $1.5 trillion/year in revenue and will oppose any of the reforms I suggest. Unfortunately, Brill’s article is now behind a subscriber pay-wall, but I posted a summary and a video interview with the author.

IF AIR TRAVEL WORKED LIKE HEALTH CARE

This satirical video makes fun of our overly complex healthcare industry, looking at what the airline industry might be like if it worked the same way.

The Future of Universal Design

Universal Design

This bathroom looks elegant but it also has all the elements for Aging in Place — a zero barrier shower threshold for walkers and wheelchairs, shower seat, hand-held shower, a foot bath with whirlpool jets and an attractive grab bar. (MTI Whirlpools)

By Guest Blogger Edward Steinfeld, ArchD, Professor of Architecture and Director of the IDeA Center for Inclusive Design and Environmental Access, State University of New York at Buffalo. The Future of Universal Design was originally written for Disability.gov, which is included in our list of government websites.

From Accessibility to Inclusion

Universal design (UD) is an idea that developed in the mid-1990s as advocates of making buildings and products accessible to people with disabilities realized that these features often had benefits for a broader population. Examples include curb ramps, automated doors, closed captioning in television sets and accessibility features for computer operating systems. Read More …

Austin Requires New Homes to be Accessible

Austin city council passes accessibility,
ramp ordinances for new homes

Wheelchair Lady doing Laundry
AUSTIN, TX (1/30/2014) — After two years of working on an ordinance amendment, the Austin City Council passed changes Thursday that will require all new homes be more accessible and visitable to people with mobility disabilities.

The idea to require changes to make housing more accessible first came up inside City Hall back in 1998. That’s when Austin adopted the changes for homes built with city funds. The intention was that it would lead to an across the board policy, but that never came to be.

City staff and council members have spent the last two years working with stakeholders to draft an ordinance amendment.

After much debate, and several postponements, the council passed the ordinance amendment 6-1 with Mayor Lee Leffingwell voting against the measure. Read More …

The Waiting Room, a feature length documentary

 

The Waiting Room - Title Text

Certified Nurse Assistant Cynthia Y. Johnson at Highland Hospital in The Waiting Room

Certified Nurse Assistant Cynthia Y. Johnson at Highland Hospital in The Waiting Room

The Waiting Room is like a punch to the gut for people cast off and left out of our U.S. medical care system, what some call the best in the world. When Democrats and Republicans vie for your votes and debate healthcare reform, remember that these are not the people they are talking about. Most don’t even notice the plight of those at the bottom — this ugly underside. But our politicians, and the billionaires who set their agenda, should be made to watch this documentary, because these are the 47 percent they talk about — the people left out of the American Dream. They’re real people.

This character-driven documentary film uses unprecedented access to go behind the doors of Oakland’s Highland Hospital, a safety-net hospital fighting for survival while weathering the storm of a persistent economic downturn. Stretched to the breaking point, Highland is the primary care facility for 250,000 patients of nearly every nationality, race, and religion, with 250 patients – most of them uninsured – crowding its emergency room every day. Using a blend of cinema verité and characters’ voiceover, the film offers a raw, intimate, and often uplifting look at how patients, staff and caregivers cope with disease, bureaucracy, frustration, hope and hard choices during one typically hectic day.

The ER waiting room serves as the grounding point for the film, capturing in vivid detail what it means for millions of Americans to live without health insurance. Young victims of gun violence take their turn alongside artists and uninsured small business owners. Steel workers, cab drivers and international asylum seekers crowd the halls. (movie trailer follows)

Read More …

Independent for Life

Book cover: Independent for Life: Homes and Neighborhoods for an Aging America

order online at University of Texas Press

 

From INDEPENDENT FOR LIFE: HOMES AND NEIGHBORHOODS FOR AN AGING AMERICA
edited by Henry Cisneros, Margaret Dyer-Chamberlain, and Jane Hickie, forward by John W. Rowe,
Copyright © 2012. Courtesy of the University of Texas Press.

 

Do you want to age independently in your own home and neighborhood? Staying home, aging in place, is most people’s preference, but most American housing and communities are not adapted to the needs of older people. And with the fastest population growth among people over 65, finding solutions for successful aging is important not only for individual families, but for our whole society. In Independent for Life, former HUD Secretary Henry Cisneros and a team of experts on aging, architecture, construction, health, finance, and politics assess the current state of housing and present new possibilities that realistically address the interrelated issues of housing, communities, services, and financial concerns.

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Singing in the Shower – More than Accessibility

A great hand-held shower unit hits the right note in any bathroom.

EDITOR: Last September I posted an article about the Universal Design Living Laboratory. Well now the home is finished and its occupants have moved in, so there’s more to write about, including universal bath & kitchen designs and landscaping. You’ll understand later why I so look forward to the article on landscaping.

Singing in the Shower

The shower is something most of us use every day, and it can be a bit challenging when living in a wheelchair. The right handshower can make getting clean an easier and more enjoyable experience.

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Universal Design: Homes That Work for Everyone

These photos showing Universal Design principles were posted on houzz.com by Kerrie Kelly, a ASID, MBA, and CAPS certified interior designer, certified aging-in-place specialist, author, and thought leader. She collaborates with publishers, manufacturers, homeowners and builders to inspire beauty and simplicity because…Everyone Deserves Great Design. TM Kelly authored “Home Décor, a Sunset Design Guide” published by Oxmoor House. The book was released in September 2009 and is still a defining guide to all styles of home décor. Visit Kerrie at http://www.kerriekelly.com and http://www.kerrielkelly.blogspot.com.

Houzz.com — When looking for home modification ideas, search through the photos & portfolios of leading Interior Design professionals for key words such as Kitchen, Bath, Stair Ramp, Stair Lift, Home Elevator, Universal Design, and Aging-in-Place.

Houzz Tour: Universal Design in San Francisco Home

For general contractor Jeff Kann, universal design goes beyond outfitting the space for wheelchairs. It’s about letting people participate in family and community life for much, much longer. Sound universal design avoids premature moves and creates sustainable and safer spaces, she says: “It’s about making the living spaces easier and safer for all ages.”

This remodel was conceived to create a comfortable and expanded living space on the first level of a two-story home in San Francisco’s Sunset district, creating an option to avoid the use of stairs entirely as the clients grow older. In the meantime, the homeowners can use the renovated first level now as a guest suite for visiting family and friends.

Houzz.com — When looking for home modification ideas, search through the photos & portfolios of leading Interior Design professionals for key words such as Kitchen, Bath, Stair Ramp, Stair Lift, Home Elevator, Universal Design, and Aging-in-Place.

Home Elevators: A Rising Trend

One of the nicest things my grandfather did for my grandmother was to have a home elevator installed. They lived in a two-story home with the main living area and bedrooms on the upper floor. My grandmother had become frail enough that getting upstairs from their main entrance on the ground level was a daunting task. My grandparents were not wealthy people, and their home was not large — maybe 1,800 square feet. But my grandfather knew how much she wanted to stay in her home, so he put one in. Now that’s love!

Pangaea Interior Design shows examples of the various types of home elevators and discusses their benefits.

 

Houzz.com — When looking for home modification ideas, search through the photos & portfolios of leading Interior Design professionals for key words such as Kitchen, Bath, Stair Ramp, Stair Lift, Home Elevator, Universal Design, and Aging-in-Place.

Doorless Showers Open a World of Possibilities

I’ll never forget my first experience with an open shower. On a French-class trip to Paris at the innocent age of 14, I arrived at my hotel tired, jet-lagged and longing for a good, hot soak. I pushed open the bathroom door and looked around, flummoxed. Where on earth was the bathtub? Then I glanced up and gaped: I was standing in the shower, which was just a handheld faucet and a grate in the floor — no tub, no door, no curtain, no threshold. The entire time I was there, I never mastered the art of soaping up and rinsing off without drenching the whole room.

It turns out, the French were onto something. Doorless showers have become a design darling in recent years. Not only do they create an open, expansive feel in a bathroom, but they also lend themselves well to universal design and aging in place. And while they’re a little more sophisticated now than my Parisian puzzler, they still require careful planning. Lisa Frederick shows us eight things to consider if you’re thinking about the doorless approach. (from houzz.com)

Houzz.com — When looking for home modification ideas, search through the photos & portfolios of leading Interior Design professionals for key words such as Kitchen, Bath, Stair Ramp, Stair Lift, Home Elevator, Universal Design, and Aging-in-Place.

 

Bathroom Safety Features That Support Your Style

Even if you are fit as a fiddle, it’s a good idea to provide as many safety features as you can in your bathroom. But does a bathroom that incorporates safety into the design have to look like it belongs in a hospital?

Absolutely not! Fixture manufacturers are now offering attractive designs that blend into your décor. Whether you love sleek, minimal design or are hooked on traditional, you can provide safety without sacrificing style. Pangaea Interior Design shows us several examples below, from houzz.com.

Houzz.com — When looking for home modification ideas, search through the photos & portfolios of leading Interior Design professionals for key words such as Kitchen, Bath, Stair Ramp, Stair Lift, Home Elevator, Universal Design, and Aging-in-Place.

 

Universal Design: for All Members of the Family

These photos showing Universal Design principles were posted on houzz.com by Kerrie Kelly, a ASID, MBA, and CAPS certified interior designer, certified aging-in-place specialist, author, and thought leader. She collaborates with publishers, manufacturers, homeowners and builders to inspire beauty and simplicity because…Everyone Deserves Great Design. TM Kelly authored “Home Décor, a Sunset Design Guide” published by Oxmoor House. The book was released in September 2009 and is still a defining guide to all styles of home décor. Visit Kerrie at http://www.kerriekelly.com and http://www.kerrielkelly.blogspot.com.

 

Houzz.com — When looking for home modification ideas, search through the photos & portfolios of leading Interior Design professionals for key words such as Kitchen, Bath, Stair Ramp, Stair Lift, Home Elevator, Universal Design, and Aging-in-Place.

 

 

Intel-GE Care Innovations, a critique

Care Innovations™ is a unique joint venture that brings together GE’s expertise in healthcare and Intel’s technology expertise 
— to help change the way health care is delivered.

I’ve worked with Intel before in the wireless standards area and have great respect for the company. And I also like their approach to market development, which often starts with ethnographic market research to understand the people who use technology products rather than starting with what’s technically possible. But in this case I question their design choices, because I think they ignored widely accepted standards and mainstream opportunities. Let me explain. Read More …

How Universal Design is influencing Architecture

Could Universal Design Be the Next Mainstream Movement in Architecture, Planning?

Click on book image, Universal Design: Creating Inclusive Environments, to learn more at Amazon.comNew textbook provides the first comprehensive introduction to a growing field

Release Date: April 20, 2012

BUFFALO, N.Y. — Universal design, which employs design to encourage health and wellness and other quality-of-life improvements, may be poised to become the next mainstream endeavor in architecture and planning, according to two leading experts in the field.  (I hope they’re right. – Wayne)

Edward Steinfeld, director of the University at Buffalo’s Center for Inclusive Design and Environmental Access (IDeA Center), and Jordana L. Maisel, the center’s director of outreach and policy studies, are authors of a new textbook, “Universal Design: Creating Inclusive Environments.”

“We believe we are close to a watershed moment,” the authors write in the preface to the book, which was released on April 10 and includes chapters on housing, interior design, transportation and more. “Whether they know the term or not, the work of leading architects and design firms reflects the adoption of universal design concepts.” Read More …

Occupational Therapists Help Modify Homes for Life

This article was originally published at 1 Call Bath Solutions and is re-posted with permission.

Click image to visit 1 Call Bath Solutions website at http://www.1callbathsolutions.com/I love working with occupational therapists. Why? Because we have the same goal of helping people live longer, fuller and more comfortable lives at home.

Occupational therapists are big picture experts.  Let’s take Mary.  She’s 85, lives at home and is challenged with Parkinson’s.  Sue, her occupational therapist, assesses her physical strengths and weaknesses, how the natural aging process is affecting her (things like eyesight and hearing that affect everyone over time), her medical condition and any psychological issues.  And the psychological part doesn’t mean there’s anything wrong with Mary—it could be just the typical fears of losing control over her own life and the lack of privacy that comes from depending on others.

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Aging-in-Place advice for Contractors

Don't just say, "Trust Me." Earn Trust.In this recessionary economy, home construction is slow, but one bright spot is home modifications for aging in place. I was happy to meet a reputable local contractor who is adopting Universal Design principals and embracing the Aging-in-Place market. They’re going to Houston next week for a Certified Aging in Place (CAPS) class, which covers low-tech construction projects but not high-tech solutions like environmental and medical sensors and telehealth services. Our discussion got me thinking about advice for builders and remodeling contractors that I created  several years as Communications Director for HOT. Homeowners of Texas is a non-profit consumer advocacy that helped get an abusive State agency abolished. But until we can produce our own video tutorials for contractors, I’m including several shorts (~5 min) from 5min Media, a leading syndication platform for broadband instructional, knowledge and lifestyle videos.

Housing Options: Retirement and Independent Living Communities

Housing Options: Aging-in-Place

How to Choose a Certified Aging-in-Place Specialist

Peter Pan housing – for people who won’t get old

Peter PanNPR host Michele Norris explores housing options for America’s aging population in her interview with Jon Pynoos, a professor of gerontology policy and planning at USC. (Listen to the broadcast or read the transcript HERE.)

Pynoos describes the high costs of nursing homes and assisted living facilities and the insurance options that pay for them, including Medicare & Medicaid. He then promotes aging-in-place at home as a much lower-cost option, but most homes were designed for people who aren’t old. He calls them Peter Pan homes. They have stairs, inaccessible bathrooms, and inadequate lighting, and they lack many of the safety features that would help people avoid falls.

“I won’t grow up.    I don’t want to go to school.
Just to learn to be a parrot,    And recite a silly rule.”

To help you assess your home and make modifications, contact a certified aging in place specialist (CAPS).

Related Articles:

National Demonstration Home for Universal Design, Part 1

Rosemarie Rossetti

Rosemarie Rossetti, Ph.D. (used with permission)

Thirteen years after a freak accident left her paralyzed, Rosemarie found a new mission in life: sharing what she has learned about Universal Design. She founded Universal Design Living Laboratory and is building a national demonstration home that will be opened to the public this fall. I’ll be writing a series of articles about her project and start with this, her story.

About The Demonstration Home Project

My Story

By Rosemarie Rossetti, Ph.D.

On June 13, 1998 my husband, Mark Leder, and I decided to celebrate our anniversary by going on a bicycle ride. It was a beautiful day with a clear blue sky, perfect biking weather. I was riding down the path ahead of Mark, when he heard a loud crack and yelled, “Look over there something is falling!” I glanced back at him and suddenly a 3 1/2 ton tree came crushing down on me, leaving me injured on the bike path. My life was changed in that instant! I was paralyzed from the waist down with a spinal cord injury.

Read More …

Bridging The Digital Divide

Transforming Rural Economies: Bridging The Digital Divide (excerpt)
by Maine State Representative Diane Russell

Growing up in Bryant Pond, about as rural as it gets in Maine, taught me a little something about being at the tail end of innovation. The last crank phone operator station in the country was located right down the street from our home. While the celebrity status is great, the educational piece was the vigorous debate over whether or not our town should upgrade to that fancy new technology — the dial tone.

Read the rest of her article

Wayne Caswell (Modern Health Talk) posted the following comment:

We all know that technology and the Internet are keys to telemedici­ne, telework (jobs), distance learning, e-commerce­, and e-governme­nt, but the latest FCC report to Congress says a full one-third of U.S. households lack broadband access. That’s either because they have no access to it or because it’s too expensive or they lack the skills or perceived need.

So, are we willing to write-off entire sectors of our population and give them inferior healthcare and access to jobs, commerce and government because they’re poor, black, Hispanic, elderly, live in rural communitie­s, and don’t have broadband Internet access? Or are we going to fund computer literacy and universal access to broadband? Which is cheaper or better? We can’t always rely on Market Forces. Sometimes public funding is warranted – like NOW (or actually 20 years ago).

5 Design Mistakes to Avoid Making in Your Home

eLocal Home Improvement BadgeWe’ve written often about Universal Design principals when remodeling for home healthcare, but here are some thoughts about design elements to avoid. Although the design found in a home is a matter of personal taste, there are a some design elements that professionals think are overused in our homes.  eLocal.com polled its panel of experts to find out what elements in home improvement need to be put to rest. Their responses and the reasons for them might not be what you expected. Curious to see what they thought? We present the top 5 design mistakes homeowners make…

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