WHICH WAY ARE WE GOING

Sometimes the world does a 180 on you, tipping you upside down, spinning you around. North becomes south. The sun rises in the west and sets in the east. That’s what happened to me last week when I spent a couple days with friends at their waterfront home on South Puget Sound.

I’ve boated on and driven around Puget Sound for decades. But the South Sound, with its labyrinth of channels and bays that meander in all directions, disorients me. It’s one of those places where you have to drive north to get south.

Long ago, when I lived in Tacoma, I confessed to a pilot friend that I was no good at discerning compass directions.

“How can you miss when you live here?” he said. “You’ve got mountain ranges on both sides, each running north and south.” That’s no help in the South Sound area, where hills and trees block the mountains. Not until my second day of lounging on my friends’ porch, did it occur to me that the sun was rising in the west.

“What direction are we facing?” I asked my hostess. She pointed at a slight angle and said, “That’s south.”

“It can’t be,” I argued. I’d driven south from Seattle and was certain I was looking back in the direction I’d come from. She got out a map, and I retraced my circuitous route which took me to the north side of Hammersley Inlet.

Strangely, even after I looked at the maps and saw where I was, I couldn’t make myself feel that south was in front, instead of behind me. I tried to visualize the Tacoma Narrows, which I knew from looking at the map were to my right, but my mind “saw” them to my left. It’s the kind of disorientation that can prove fatal to people lost in the woods. Knowing that the compass is pointing in a certain direction does not necessarily equate with believing it, especially if you’re panicked.

The experience got me thinking about the impact of the health care reform debate. The New York Times observed, “Each side hopes to win ground by boiling down one of the most complex policy discussions in history into digestible nuggets.” Problem being, whose nugget are you going to believe? Especially when so many of those nuggets are designed to feed fear.

“The rumors out there are flat-out lies,” announced AARP at one point. Everyone from the Obama administration down is accusing everyone else of lying. On that point, at least, they’re probably all telling the truth. And the public is left disoriented and afraid. Afraid especially that providing care for ALL will result in less care for ME.

If we’re willing to look at other industrialized nations with universal health care – even government-run health care, we’ll find lower costs, healthier populations, and longer life expectancies. Why aren’t we willing to look in that direction? Could it be because our sun is setting in the east and our compass points south?

I appreciated that this essay sparked a number of varied responses. Here are some or parts of some. I do not necessarily agree with all the comments, nor will I vouch for various statistics cited, but I appreciate the civility of the discussion:

Well my compass is usually lost in the closet. Interesting points...who do you believe? P.C.

Regarding healthcare, it is a mess. I must say though that my husband and I have personally talked to friends from Canada, who outright hate their healthcare, and we personally know some with cancer that have died before they could receive care. Their cancer was diagnosed and then they waited a year or more to see a specialist. If you have a serious problem in Canada there is no guarantee anyone will see you in time. Personally as a health care provider, I find that appalling. M.C.

Super analogy, Mary. It is all very confusing and turning into hate-mongering. They can't even debate the issue let alone look at countries that have universal health care. I'm just going to be an ostrich and instruct someone to pluck one tail feather for "went down," two for "passed," three for "deadlock," four for "they declared an indefinite moratorium on illness or disease of any kind," five for "they were all declared insane and we have to start all over with elections," six for ... L.M.

I agree, on all counts. Another good one, Mary. C.A.

Good one. That explains a lot. K.S.

Could it be that records showing healthier are determined by how many use the "system"? We talk to many Canadians as we travel. They all say their health care system is like having no health care. The waits are so long for any needed care, they're either dead, or well before they get in to see a doctor or be treated, so they don't bother. Is that the meaning of health? The lower numbers of those who use health care (or don't) because the system is so unavailable?
The healthiest countries in the world if statistics like e.g., cancer, high BP, diabetes are used are actually the poorest countries because they tend to eat less and eat "poorer," meaning vegetables instead of meat. Their death statistics are worse than industrialized countries because of worse prenatal care and less availability of vaccines, but hopefully thanks to people like Bill/Melinda Gates and George Farmer, those statistics are changing too. The only way to positively impact long-term disease is to be honest about what causes it and then prevent it, not create more opportunities to head to the doctor for allopathic treatment. J.P.

According to Senator Tom Harkin, "The fact is, we do not have a health care system in the United States; we have a sick care system. If you're sick, you get care, whether through insurance, Medicare, Medicaid, SCHIP, community health centers, emergency rooms, or charity. The problem is that this is all about patching things up after people develop serious illnesses and chronic conditions.
     We spend a staggering $2.3 trillion annually on health care; 16.5 percent of our GDP and far more than any other country spends on health care; yet the World Health Organization ranks U.S. health care only 37th among nations, on par with Serbia. We spend twice as much per capita on health care as European countries, but we are twice as sick with chronic disease.
     How can this be? The problem is that we have systematically neglected wellness and disease prevention. Currently in the United States, 95 percent of every health care dollar is spent on treating illnesses and conditions after they occur. But we spend peanuts on prevention.
     It is not enough to talk about how to extend insurance coverage and how to pay for health care -- as important as those things are. It makes no sense just to figure out a better way to pay the bills for a system that is dysfunctional, ineffective, and broken. We also have to change the health care system itself, beginning with a sharp new emphasis on prevention and public health.
     Tom says we spend 95% of every health care dollar on sickness care while you say 30% of every health care dollar is spent on administration. That totals 125% of every health care dollar, which isn't possible. Neither has any relation to health, but which is correct?
     I think what's correct is that universal health care doesn't equate to increased longevity, and in fact, equates to decreased longevity.   That's what the data show. It's good health via a healthy lifestyle that keeps us out of the medical system and creates increased longevity, not universal health care. I don't see how universal health care can change the data unless it puts our dollars into honestly educating the public and creating a reward system for those who stay out of the health care system because they've followed the how to be healthy advice.   But the message must be the truth as unbiased research indicates.
     The problem is that Congress is being asked to create a universal health care system and its members will not do it in a way that creates health which equates to less dollars spent on care. Either will our president. The drug, meat, dairy, and insurance company lobbies are too strong and no one on the receiving end of their messages or dollars (votes) will present an honest message about how to create health. People on the create a health care system committee must be totally neutral and not on the receiving end of the results if a universal health care plan is to work to provide health care for all at a price we can afford. And, I think there must be a limit to procedures that the system allows. Frankly, I'm sick and tired of my 92-year-old mother-in-law's annual mammograms and bone density tests. Taxpayers should not have to pay for that kind of stuff. Even research shows so at my age. I'm also tired of paying to manage the symptoms of preventable disease, especially heart disease, type II diabetes. In my crass opinion, if you don't want to prevent the disease, then I shouldn't have to pay to treat your symptoms. But I sure don't expect people to prevent it until they're presented a truthful message of how. J.P.

Great column. Doesn't universal coverage of some kind seem like a NO BRAINER???D.B.