Common Good
ANNOUNCING the application
of an established CONCEPTUAL MODEL to achieve
BETTER HEALTH FOR AMERICA
H E A L T H P R O S P E C T U S
By a steadily renewed, Quantum informed
DESIGN EPISTEMOLOGY to guide the reform of our Nation’s
POPULATION HEALTH and its PRIMARY HEALTHCARE
4 pages — 1 —
INTRODUCTION
“Never doubt that a small group
of thoughtful citizens can change the world.
In the end, it’s the only thing that ever has.”
Margaret Mead (1901 – 1978)
^
“It’s better for everybody
when it gets better for everybody.”
Eleanor Roosevelt (1884 – 1962)
^
“To create long-lasting change, organizations and
the programs they create must in one way or another
become embedded in the local community.”
Eric Nee (1953 – )
THE ONSET OF MODERN HEALTHCARE
Before 1850, health care usually occurred within the home of each person’s Family. Historically, any exception to this tradition occurred in association with hunting/gathering, wartime, or poverty. After 1850, health care began to occur more frequently at centralized locations within a community. Initially, the need for anesthesia during surgery required this change. And by 1870, a recognition of infection risks became more widely acknowledged as a basis for the sanitation necessary in association with this surgery.
Nearly 175 years later, health care has increasingly become the responsibility of caregivers who have only a cursory ecological or cultural connection with each resident person as a patient. The decreasing interconnectedness of healthcare is notable primarily by the absence of its spontaneously expressible awareness about a person’s Family, their Family Traditions, their Extended Family, and the close neighborhood of their Family Home. Simultaneously, this social attribute of healthcare has been accentuated by family reconfiguration by its sentinel events, such as employment opportunities, affordable housing, marriage stability, disabilities, and each family’s need for two wage-earners.
In effect, the historical evolution of health care and its healthcare mirrors our nation’s increasingly fractured ecological and cultural traditions within every community, viz., social cohesion. Amidst many social, political, and economic changes, the occurrence of these evolving changes has decreased the expression of trust, reciprocity, and cooperation within the municipal life of every community. The subtle decline in the shared expression of prosociality then fragments each community’s Survival Commons, viz., their safety net. Among many contemporary distractions, it is past the time to renew our recognition that we are all better off when we all become intentional about our mutual obligations to care about and for each other.
THE ONSET OF ITS PARADIGM PARALYSIS
The onset of progressive problems associated with our nation’s Population Health and its Primary Healthcare is difficult to pinpoint meaningfully. Two attributes are clearly of great concern. First, health spending represented 5.0% of our national Gross Domestic Product during 1960. By 2019, it was 18.0%. The rate of increase in health spending had occurred at a rate slightly higher than economic growth. For comparison, health spending by most of the other advanced/developed nations was less than 13% during 2019. The difference between 13% and 18% of our gross domestic product (GDP) in 2019 represented $1 Trillion.
Second, our nation’s maternal mortality rate (pregnancy related deaths per 100,000 live births) was ‘21.0’ in 2019. For 2019, the Scandian and the other English-speaking nations’ median maternal mortality rate was ‘3.1’. Comparing 21.0 with 3.1 for the other English-speaking and Scandian nations, the excess pregnancy-related deaths for our nation may have represented nearly 560 women in 2019. There is no reason to believe that our nation’s historical or current priorities for improving our nation’s Population Health or the efficacy of its Primary Healthcare have been improving or will eventually begin to improve. An aphorism from Benjamin Franklin probably applies. — 3 —
“We must, indeed, all hang together
or most assuredly we shall all hang separately.”
Benjamin Franklin (1705 – 1790)
As they were about to sign our nation’s Declaration of Independence in 1776, we can only imagine the profound level of resolve among the members of the Second Continental Congress. The meaning of the words, spoken then by Benjamin Franklin, eventually became prophetic. Amidst our now rapidly evolving and tumultuous era, known as the Anthropocene, we must also stand together or “hang separately.” In view of this imperative, a remotely developed concept would be most helpful for guiding the precision of our priorities. I propose that a newly formed Design Epistemology will be required to guide the reconfiguration of our nation’s Population Health and its Primary Healthcare. With a 15-year strategy, this reconfiguration would have two basic GOALs: 1) decrease our nation’s annual maternal mortality by 70% and 2) decrease our nation’s annual, health spending as a portion of our national economy by 30%.
DESIGN EPISTEMOLOGY – Dino Karabeg, Ph.D.
Within the realms of knowledge that are applicable for improving a nation’s POPULATION HEALTH, I am most indebted to having identified the concept of a Design Epistemology as formulated by Professor Dino Karabeg, Ph.D. Amid a substantial professional academic career beginning shortly before 1990, two papers stand out among many as the basis for originating this HEALTH PROSPECTUS PAGE. Of many references applicable to the NATIONAL HEALTH Proposal, the two by Professor Karabeg offer a sentinel beacon for healthcare reform. (Karabeg 2005 & 2012) From the “Karabeg 2012” reference, I cite one sentence from its page 3. “When for whatever reason and in whatever domain tradition is no longer a reliable way to wholeness (e.g., when changes become too large and rapid to be assimilated through tradition), design must be practiced and relied on.” Given the VINTAGE TRADITIONS (see PAGE #2) of our nation’s Population Health and its Primary Healthcare, we will need a DESIGN EPISTEMOLOGY as a broadly applicable reference to assure that the breadth of progress is not neglecting an enabling component for one or more linchpin components.
To guide the reconfiguration of our nation’s Population Health and its Primary Healthcare, I offer a 30-component DESIGN EPISTEMOLOGY. It may be found as a Sub-Page of this HEALTH PROSPECTUS PAGE. See the Site Directory for the Sub-Pages of this PAGE listed below.
This page has the following sub pages.