Health Care For All

While it is an amazing thing that the Obama administration is taking on our health care system at this time, that a politician is willing to tackle such a daunting task, I have to ask why. Why would it be unpopular with people (voters) to make access to health care providers available to everyone? What are the real benefits and costs to the average person and to the community at large in providing everyone with health care access in the form of insurance?

First, while most people who have insurance assume they always will, this is not true. If you work for a small company, that company may find it too expensive to maintain access -- poof, your insurance is gone. An accident or illness can either take you out of the workforce unexpectedly, or can be reason for an insurer to discontinue services -- poof. You can lose your job (yes, even you), and -- poof. You can find yourself under-employed -- poof. You could easily find ourself among the uninsured. Many Americans spend some portion of their adult wage-earning years uninsured. If they are lucky, they won't need health care during that time. However, luck is not dependable.

Second, people who do not have health insurance are part of our community and still need health care. When people do not have a regular provider, someone to call when a health problem first arrises, they frequently go without care. After time, the problem usually gets worse for neglect, and eventually, the problem becomes an emergency. Emergency room care is more expensive, for both the individual and the community, financially and physically. Frequently problems that were easily treatable earlier become expensive, painful, traumatic experiences by the time they are seen in the ER. Other times they are fatal. Privacy is limited; continuity of care is even more limited; other infections are usually available to pick up while you visit. And all at an astronomical cost.

The one advantage in an emergency room is that you can't be turned away. Whether you can pay or not, whether you have coverage or not, you will get the care you need.

As a community, we all pay for this higher-cost care. We also all pay for the disability and decreased productivity that happens when diseases and injuries are allowed to get worse (for lack of other options).  Preventative care, early detection, regular check-ups, all cost far less than emergency care for late-stage diagnosis and treatment. If we vote only from self-interest, it is in our interest to make sure that everyone in our community (which is the nation if we are honest with ourselves) has access to health care.

Let's pay less by taking better care of each other from the start. 

H1N1 vaccine debate

I sympathize with the confusion the mixed messages from medical sources will cause. As a health communicator, I have worked and/or spoken with several people with a specialty in risk communication (such as the risk of a pandemic flu) and have weighed the debate thoroughly.

On the one hand you have people who are hesitant with new drugs generally. There is good reason for this. Every drug has side effects. New drugs, including vaccines, are not well tested in my estimation before going to market. This is especially true when there is a big push to get the drug available. (This was not true in the 80s with new AIDS drugs, and the political/public backlash about that has changed the process. However, increasing pressure from pharmaceutical companies and weakening of the FDA have also changed the bench-to-trench process for new drugs.) There is also discussion among some about what we are doing as a population to our immune systems by not exercising them. No one really knows the final answer on that one yet.

On the other hand, the next great pandemic is what the risk communication people consider to be the really scary threat to worry about. Far above terrorism or food-borne illness or natural disasters, they worry about the potential of a new virus in this global community we live in. They are happy that children are being taught to wash hands religiously, as that is one of the best defenses. If we could just get people to avoid going to work/school when they are sick, they say, we’d all be in a better place to handle such a crisis.

I don’t get us vaccinated against the flu normally (shocking to many of my colleagues) and won’t get us vaccinated against this particular flu either. Generally, flu vaccines are only going to be useful against +/- 30% of this season’s flu strains. (They are necessarily based on last seasons’ strains.) Most healthy people who are well nourished are well equipped to fight off the virus. The vaccine is intended to avoid unnecessary death, and for most of us that is not the threat. Mostly the virus represents a week or so of really unpleasant days and discomfort. For most of us. Not desirable, but not deadly.

All that said, you should make the best decision for your family and feel good that it is a good decision. With so little known about the long-term effects of getting vaccinated or not, both decisions are good and defensible.

why the kitchen table?

In so many cultures here in the U.S. and around the world, the kitchen table is where it all happens. When friends and family gather, this is the place where the real conversations happen. This is where people share their hopes, dreams, fears and failures. The kitchen table is where resolutions are made, and the terms social support and community have meaning.

What we eat; how, when, and with whom we eat; these are all there at the kitchen table. Our goals for our fitness and health, for our children and ourselves; our fears of failure and change; and the comfort and support to get us to the next level are all there, too. I've even heard a breastfeeding mother's chest eloquently described as the baby's kitchen, "warm, comfortable, and smells like food."

I am passionate about many of the things that happen here around the table: healthy, sustainable and non-toxic foods, for example; healthy body image and how we share that with our children; the conversations that lead to our choices around birthing and breastfeeding; that intimate support for all of life's changes and choices. Over a steaming mug or a slowly warming glass, a plate of food or the preparations of another meal, we share this part of our lives with the people we trust most. Maybe that is why our bodies are healthier when we share our meals.

The kitchen table is where health communication happens in people's lives, and that is where we need to be to support people in their choices. Pull up a chair; we've been waiting for you.