tidal basin
EPILOGUE
A REFLECTION
INTRODUCTION
“I am certainly not an advocate
for frequent and untried changes in laws and constitutions.
I think moderate imperfections had better be borne with;
because, when once known, we accommodate ourselves to them,
and find practical means of correcting their ill effects.
But, I know also, that laws and institutions must go
hand in hand with progress of the human mind. As that becomes
more developed, more enlightened, as new discoveries are made,
new truths disclosed, and manners and opinions change
with the changes of circumstances,
institutions must advance also, and keep pace with the times.
We might as well require a man to wear still the coat
which fitted him when a boy, as a civilized society to remain
ever under the regimen of their barbarous ancestors.”
Thomas Jefferson ( 1743 – 1826 )
“I see one-third of a nation ill-housed, ill-clad, and ill-nourished.
The test of our progress is not whether we add more
to the abundance of those who have much;
it is whether we provide enough for those who have too little.”
Franklin D. Roosevelt ( 1882 – 1945 )
“The ultimate measure of a man is not
where he stands in moments of convenience and comfort,
but where he stands at times of challenge and controversy.”
The Reverend Doctor Martin Luther King, Jr. ( 1929 – 1968 )
All three quotations may be found inscribed in stone at their respective author’s Memorial, as arranged around the Tidal Basin in Washington, D.C. Each of these Memorials can be easily viewed during a walk lasting about 2 hours. The time really depends on the impact that you experience while integrating the expressions of these three giants within our nation’s heritage. Amid this awareness, one can only worry about the risks to our nation as we encounter the associated turmoil occurring throughout the world-wide community.
Given the heritage of these three men and the challenges of their time, may we now acknowledge that a growing tragedy is occurring within our nation’s HEALTH. This growing tragedy may be defined by the combined occurrence of child neglect/abuse, childhood obesity, adolescent suicide/homicide, maternal mortality, substance abuse/suicide, homelessness, mass shootings, adult disability/depression, and decreasing longevity at birth (four years in a row). All of these problems have generationally interconnected causes that generally lack a clearly definable healthcare solution.
What then is the true role of healthcare reform as we refurbish our nation’s destiny for the benefit of each person’s HEALTH? Basically, the traditions of our nation’s healthcare industry are valid. A new strategy will be required to modulate these traditions for substantial healthcare reform. This new strategy would be integrated with a means to invigorate our nation’s social cohesion.
Referring to the social cohesion concept, our current healthcare institutions must participate locally in their respective community’s promotion of social capital. This commitment should apply the Design Principles that have already been defined for successfully Managing a Common-Pool Resource (CPR). For healthcare, its CPR represents the portion of our national economy devoted to health spending. Professor Elinor Ostrom, Ph.D. (first woman Nobel Prize awardee in 2009) proposed and validated these Design Principles more than 20 years ago.
A new semi-autonomous institution, Chartered by Congress, should be established to incubate community based, collaborative processes for mobilizing sufficient levels of social capital in cooperation with their communities. The Design Principles would define the functional character of this new institution, NATIONAL HEALTH, with GOALs to solve the cost and quality problems of our nation’s healthcare. NATIONAL HEALTH would be Chartered by Congress with no accountability for the actual financial disbursement of health spending, and its annual budget would be limited by Congress to $1.00 per citizen, annually adjusted for inflation and population.
Our nation’s future survival will require it. Citing Thomas Jefferson, the cost and quality deficiencies of our nation’s healthcare might now be described as barbarous or “…having a bizarre, primitive, or unsophisticated quality.” (60) Remember again the worsening trends of our nation’s maternal mortality and health spending. Now 50 years later, a renewal of the “MISSION TO THE MOON,” repurposed for healthcare reform, is over-due!