H E A L T H P R O S P E C T U S
a PROPOSAL to apply
a newly informed CONCEPTUAL MODEL to achieve
” BETTER HEALTH FOR AMERICA “
^
by using a quantum-informed
DESIGN EPISTEMOLOGY as a guide
to improve our Nation’s POPULATION HEALTH and
its PRIMARY HEALTHCARE
5 pages — 1 —
INTRODUCTION
“It’s better for everybody when
it gets better for everybody.”
Eleanor Roosevelt (1884 – 1962)
“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)
“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 – )
“In times of drastic change, learners shall inherit the earth
while the learned shall find themselves perfectly equipped
to deal with a world that no longer exists.”
Eric Hoffer (1902 – 1983)
“…electric light did not come
from the continuous improvement of candles…”
Oren Harari (1949 – 2010)
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. By 1870, the 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 any 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 Culture, their Extended Family, and the close neighborhood of their Family’s Home. Simultaneously, this social attribute of healthcare has been accentuated by the family instability related to its sentinel events, such as unstable employment, unaffordable housing, neighborhood violence, marital fatigue, health disabilities, and each family’s survival based on two wage earners.
In effect, the historical evolution of health care and its healthcare mirrors the increasingly fractured ecological and cultural traditions within our nation’s communities, viz., their 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 better off when we all express the ‘shared intentionality’ that binds 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 annually at a rate slightly higher than our 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. — 3 —
Second, our nation’s maternal mortality rate (pregnancy-related deaths per 100,000 live births) was 21.0 in 2019. Among the Scandian and the non-USA English-speaking nations in 2019, the median maternal mortality rate was 3.1 . Comparing 21.0 with 3.1, 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 current priorities for improving our nation’s Population Health or the quality of its Primary Healthcare will eventually begin to improve our nation’s maternal health OR its annual cost. An aphorism from Benjamin Franklin probably applies to this HEALTH PROSPECTUS.
“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 could 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 three GOALs: 1) decrease our nation’s annual maternal mortality by 70%, 2) decrease our nation’s annual, health spending as a portion of our national economy by 30%, and 3) acquire a participatory commitment by each State to promote their community by community, collaborative acknowledgment of a DESIGN EPISTEMOLOGY for improving our nation’s Population Health and its Primary Healthcare.
DESIGN EPISTEMOLOGY
Within the realms of knowledge that are applicable for improving a nation’s Population Health and its Primary Healthcare, 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 36-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. Any of the PAGES OR SUB-PAGES may be accessed by using your computer’s cursor to locate the Subject Title and double-click on it. Located on the right-handed edge of the screen, the entire list of subject PAGES and their SUB-PAGES is available on the first printed page of each respective essay. — 5 —
This page has the following sub pages.