Healthcare: broken promises, broken state, broken healthcare system

Tribfest 2014 UT Tx vs healthcare panel


Michael Burgess 
Garnet Coleman  Sarah Davis  Kyle Janek  Charles Schwertner  Charles Ornstein (mod.) 

(Update: This panel was packed and during the open questions section, the audience was extremely energized over the issues, going from laud applause to outright boos to panelists who were opposed to the Affordable Care Act. One audience member added that he was surprised that even the state of Oklahoma was ahead of Texas in finding a way to fund Medicare to meet the needs of its citizens.)

Some people just don’t deserve healthcare, according to an increasing number of GOP politicians. Everyone agrees that the U.S. needs healthcare reform but opinions vary wildly about how that should be done. Using tax dollars to fund a government healthcare system for all citizens, as has been done by many countries, is not a reform that Republicans oppose. Meanwhile, no GOP healthcare options have been put forth as alternatives to universal healthcare. It’s easier to criticize an initiative than to work in a bipartisan manner to solve the healthcare crisis that is hobbling the American economy.

To be eligible for healthcare subsidies and assistance in Texas, you have to earn less than $200 a month. But some GOP are concerned that a person who qualifes for healthcare support might somehow, during the time they are insured, might earn more than $200 a month and therefore no longer qualify for assistance.

The only way to qualify for assistance for yourself or your family is to be without any source of (legal) income, whether you need food or healthcare for your children. While you are apply for food assistance or healthcare, do a drug test for good measure. If someone has a drug problem, the last thing we want to do is to provide them with any kind of help.

Regulations were passed to forbid government workers from providing information and instruction to the disadvantaged on how to sign up for healthcare. The reasoning was to avoid non-experts from providing inaccurate or misleading information to clients. Better that they provide no information at all.

Garnet Coleman: “We all understand that people need healthcare. Texas constituents want us to provide this service for them….and with cancer …we have made a commitment to cancer [treatment] but not to those who need the cancer treatment!”

Opponents claim that Medicare expansion is not an option, that we can’t add “able-bodied” people into a system that is already providing healthcare to a current set of Medicare recipients. What does “able-bodied” mean in this context? Able to go out and pay for their own healthcare? Or able to go “get a job” in an economic environment where most people can no longer obtain a full-time job that offers the benefit of healthcare?

Kyle Janek, Commissioner of Texas Health and Human Services, suggested that people don’t need “a healthcare card.”  If they get sick they can just visit certain clinics that will provide health services to those without insurance. It’s understood that most uninsured delay seeking care until they are in crisis. Then, they go to a hospital emergency room. They are billed for services, but hospitals receive a federal kick back for services rendered as “charity” — if there was a universal healthcare system, there would be no bill to the patient and the hospital would be paid by the healthcare plan.

Coleman: “There is a difference between showing up at a clinic for care, and having an insurance card in your pocket and being able to have a primary care physician…. it’s called certainty.”

Janek talked about a “safety net” that is currently dispelling the old myth that the only place you can go for help without a card is the hospital, as there are clinics that “stay open late” to provide healthcare to the uninsured. He admits that there is a “terrible” nursing shortage in Texas. (Update: After the Covid pandemic, there is a terrible nursing shortage everywhere!)

The children’s healthcare act is scheduled to be sunsetted as the affordable care act was supposed to take over for this type of care. It’s not yet in place to provide that coverage.

Again, like every other failing system, right-wing anti-government spokespersons decry how Medicare is overburdened and underfunded – but it’s the standard and well-understood operating procedure for Republicans to starve a program of needed funds for decades and make a campaign to shut down a “failing” system when appropriate funding would keep the system running effectively. This has been demonstrated with the cynical starving of funding for the mental health facilities in Texas, such as the state hospitals, followed by presentations to the Lege to close them and replace them with private, for-profit systems. One of the notable results: surging homelessness and homeless camps throughout the cities.

Panelists suggested that the Affordable Healthcare Act was extraordinarily “disruptive” to the system. Unlike the typical “pro-change” tech conference culture, there is a lack of understanding about the positive potential for disruptive change. – Disruptive change is what is needed to correct a shockingly broken and corrupt system.

So, it costs tax dollars to provide better healthcare to those least able to pay for it? And could this increase the costs of healthcare insurance? Hold the “surprise and dismay” about having to pay higher premiums. The very folks who can afford to pay more are the ones complaining the loudest. If healthy people pay into a “healthcare for all” system, the insurance will be there for them when they need it. Anyone who works for a state agency that keeps and invests a percentage of their salary as part of a pension fund understands that some employees will not stay in the system long enough to retire with a pension. Everyone working full time at a living wage is paying into the Social Security pension fund, too. Not everyone will live long enough to retire and draw social security benefits. But the value of these benefits are understood and workers are required to pay into retirement systems. In contrast, almost everyone would benefit from having healthcare insurance and it would benefit everyone to pay into a healthcare system.

Those with significant health issues refer to people who are currently healthy the temporarily able. Ilness and disease do not prey upon immoral or lazy people. Even the hardest working person can fall ill, perhaps be faced with the loss of their job. Since most Americans’ healthcare is tied to their employment, a catastrophic illness can cause the loss of their home, create overwhelming debt, and place crippling burdens on themselves and their families.

Cynical or myopic obstruction of “Obamacare” is delaying the only workable solution available for affordable healthcare. Some blame the “budget deficit”, saying that if we appropriately fund the system, we are borrowing from our future. But proponents like Garnet Coleman say that more people are invested in shouting inflammatory rhetoric than working towards a realistic and ethical solution.

Texas transportation and High-Speed Rail: more of a wish than a plan, but the money is there

Tribfest 2014 Transport Pickett 4 more

Transportation what’s next?   Robert Eckels  Clay Jenkins  Bill Meadows  Jonathan Stickland 
Marc Williams  Aman Batheja (mod.)  (speakers not seated in order of names listed)

I’m not as excited as the panelists about the “existing opportunities” for Texas transportation, as it has been implemented over the last decade. Honestly, with the demographic data in hand, and the politics imposed on what should be a clear-eyed effort to provide decent infrastructure for every citizen – not just those who can afford to pay to drive on toll roads – a fantastic amount of resources are now needed to build Texas out of the pothole it has fallen into, thanks to a lack of vision or political will for decades.

Gimlet-eyed communities who looked askance at high-speed for fifty years are waking up to the urgent need for mass transit options.

There is an interesting initiative for high-speed rail from Mexico to states above Texas. This is exactly the direction that planners should go in, as this mirrors the I-35 corridor. TxDOT should facilitate this project and stop thinking of itself as a builder of roads. TxDOT should be a provider of transportation infrastructure in whatever shape or form is needed for future travelers.

Oklahoma is now in “project-level” development with Texas on a plan to consider high-speed rail for the corridor, from Oklahoma to South Texas. Mexico is interested in building and linking a system to that proposed system.

These are some of the types of visionary ideas that should be funded. Builders and bureaucrats want this to be funded through private investment – because apparently, it is no longer appropriate or possible to get basic transportation needs funded by the United States government.

Starting with the corridor between Houston to Dallas would be an interesting direction for development.

There are scoping meetings planned for areas most tangent to the proposed route for high-speed rail. Smaller towns along the way understand that, if the train does not come near their town, it never will, so communities understand what is at stake economically if they resist the plan.

The state’s role in high-speed rail is diminished by the entry of private players. The argument is that there is such stringent opposition to the use of government funds, in part to the ongoing, toxic war between fundamental conservatives and progressives that taking the funding private does an end run over political gridlock. It is also an admission that Texas is bankrupt, as far as transportation funding for rail goes.

Get ready for roads and rail built by private companies who will be involved in making decisions that involve bulldozing areas that are in the way of the straight line needed for the rail to travel. Voters, who have not been able to see their own needs as their transportation system started to crawl, will take a back seat to the industry now –  and it’s full speed ahead for the folks with the bags of money to invest in a system that the rest of us seem to have given up on.

Weirdly enough, I feel sort of hopeful. These guys don’t want to see future failure and they seem pretty psyched about this plan.  We are at the breaking point  – TxDOT has a five million transportation funding deficit. Too bad venture capitalists are not as excited about funding high-speed rail as they are in Uber, AirB&B, and grocery delivery apps. But between the twin devils of politicians and private investors, maybe it’s time to back the player who can actually build a high-speed rail.

Where there’s a weirdo, there’s a way: why weird wins over vanilla every time

SxSW 2014 Michael Lazerow weirdo quest

Michael Lazerow wants you to be weird. Because weird is good. He’s in the right place: he’s at South by Southwest Interactive in Austin, in a vortex chock full of smart chocolate chip weirdos rolled up in a big all of marketer and VC goo. But even burnt — and we are all pretty burnt after three days of non-stop SxSW activities — it’s still tasty.

Michael gets messages late at night from Gary Vanderchuk telling him that he loves him. He offered to pay Michael’s two sons $200 bucks apiece to become Jets fans. (they declined. They came back hard at Gary, asking for $5,000 to switch. Gary came back with a $1,700 offer. See Vimeo for the full story.) He thinks differently. He’s living the life he wants to live. It’s working out just fine. 

(You can read Micheal’s entire post on the topic here: http://www.lazerow.com/2011/09/gary-v-offers-5000-to-cole-myles-to-like-jets.html )

Or take James Atucher (see his Twitter for samples of his tweets: crazy stuff  pops out there at 3 am. https://twitter.com/jaltucher ). He went on television to suggest that everyone should quit their jobs immediately. Since all companies are firing every employee, anyway, just go ahead a quit preemptively …because you should know that employed people are “like the living dead.”

Or consider Cyndy Gallup. Michael says that Cyndy is one of the most successful and happiest people he knows. She’s head of an ad agency. She’s known for her fabulously decorated home in Manhattan. She’s half Chinese, half British and spent some time in the socially oppressive  Brunei. She has a Chanel machine gun art on the wall, a Gucci chainsaw, and erotic Jade sculptures on the coffee table. She got a Ted talk without telling them her topic. She discussed her sexual experiences with men in their early twenties. She observed that young men are so immersed in hard-core porn that they believe that sex, as it is depicted in the fictional world of porn, is reality. This leads to some bizarre and hilarious ideas of how men think they are expected to behave in bed. She launched Make Love, Not Porn, and encourages healthy discussions around the topic of sex. See her Ted Talk on Youtube: https://www.youtube.com/watch?v=FV8n_E_6Tpc  (Or check her twitter site https://twitter.com/makelovenotporn )

Michael posted a piece with LinkedIn on why weirdos are better than normal people that got more than 700 comments. Some said that embracing their weirdness was the turning point in their lives, where they really began to live in an authentic way. (Full article is here: http://www.linkedin.com/today/post/article/20130324141810-1714080-why-weirdos-outperform-normals )

His point is this: everyone is born different. We grow up with some powerful motivators to tuck our heads down, get in line, and fit in. Next thing you know you are a lawyer or an accountant – and then it just gets worse, going forward. Forget passion (unless of course you have a burning desire to operate as a CPA or patent attorney).

During the 1950s,  psychologist Solomon Asch performed a conformity experiment and found that most people were willing to deny the evidence of their own eyes and conform to the incorrect responses of planted subjects who gave the wrong answer deliberately. And you know, intuitively, that you’ve done this yourself, so don’t lie: under the right circumstances, most of us will avoid the confrontation of going against the crowd. (See Wiki on the experiments here: http://en.wikipedia.org/wiki/Asch_conformity_experiments )

There’s survival at stake on this conformity thing. Growing up, most of us get a LOT of practice at following orders. Stepping out of line is risky. And yet it might be the most important thing you do.

In the Milgram experiment, another classic early psychology research test that is now considered by most to be unethical, subjects were coerced verbally by an authority figure to shock a person, while screams went on the adjacent room. (See wiki: http://en.wikipedia.org/wiki/Milgram_experiment ). Turns out that most of us are conditioned to obey.

None of us can sit in judgment on the casual cruelty that goes on all around us – in institutions, in corporations, in any power dynamic where authority is surrendered to another person who tells you what to do. Ethics start with institutional structures, because once the average person is dropped into a structured system, they all pretty much behave the same, whether for good or ill.

So, how could we build in nonconformity into the process of education? Currently, the entire system is set up to drill students on required material for standardized testing and teacher salaries and school system allotments are based upon the results of those tests.

Check out Alfie Kohn: how do grades reduce quality? Grades reduce an interest in learning; they encourage you to pick easy tasks, easy classes, instead of taking on challenges where failure is possible, and they encourage lazy thought. The end product, for society, is an army of average Joes, doing the same thing day after day, performing  Homer Simpson quality work, and drifting from one low expectation to another until they drop into the grave. (See Kohn’s article: http://www.alfiekohn.org/teaching/tcag.htm )

Look at how conformity has affected music, something we used to think was a place where you might expect to encounter creativity. Now, a huge contingent of listeners are hearing the same top 40 songs on Spotify.

So, how did all this boring stuff happen? The sad answer: chasing the brass ring.

Americans have become excellent at being average. How do we get out of this situation? Try getting in touch with your inner weirdness.  Find out what makes you NOT a commodity, what makes you special and unique, give that weirdness a big hug, and don’t be afraid to stick out. Because being weird is better. And being weird is easier. Because you get to be yourself. At last.

So, how can we, as individuals, deal with the pressure and the challenges? Michael gave us a  bullet list on what being a weirdo could look like (in bullet points):

  • Social influence: weirdos are comfortable sticking out in a crowd. They are comfortable about who they are.
  • Influence: weirdos are willing to question common beliefs publicity with conviction.
  • Authority: weirdos listen to their gut and are follow their nose, motivated by their own desires and unafraid to pursue their dreams.
  • And do it now. There’s never been a better time to stand up for your own weird self.

So, to get back to James Atucher: is it time to quit your job? What would be an authentic life – for you?

Links

More images from 2014 South by Southwest Interactive
http://www.flickr.com/photos/clairwiloh/sets/72157642467963724/

http://eventifier.co/event/sxsw14/photos

2014 SxSW Interactive Presentations on Soundcloud 

Find out more about the South by Southwest Interactive Conference in Austin Texas

http://sxsw.com/

Personal tracking with Ed Hunsinger: part big data, all man

SxSW 2013 Ed Hunsinger Big Data

Playing with your own big data: Ed Hunsinger at South by Southwest Interactive 2013. 

Ed Hunsinger: part man, part machine; does this equal…cyborg? Not quite. It’s all perfectly normal and you will see more and more 2000 Men and Women soon, tracking their bodies’ performances with data selfies, using such devices at FitBit,( http://www.fitbit.com/ ), Storm, latitude tracking, RunKeeper (http://runkeeper.com/ ), Foursquare (https://foursquare.com/‎ ) to post and track your own whereabouts,  and a blithering host of apps that allow you to monitor every square inch you occupy and every breath you take.

Hunsinger is tracking his body and everything he does, and he’s leveraging SPlunk, his company’s IT log analysis software, in this project. He’s pulling down Twitter data and analyszing it with SPlunk.

There’s tons of apps that you can use to gather data, Hunsinger said, highlighting Bioblogger as one app worth testing out. The challenges lay in pulling the date out of the apps and tracking sites and massing it to measure and track the aggregate data.

“I want millions of data points, ” Hunsinger said, darkly hinting at APIs and ISO time-date stamps and a script he wrote to pull data from FitBit. For those who want to play along, check his Github, which is under the name Ed Rabbit. Look for biblogger.

Hunsinger noted that the act of tracking data affects the data. So he tries to work with trackers that collect data passively, as much as that is possible.  He directed interested parties to look into Lumo (LumoLift, LumoBack) and ZEO (now defunct: http://en.wikipedia.org/wiki/Zeo,_Inc. ).

You put on the headset, hit button, and the device knows when you dreams at night and when you are awake. Hunsinger uses a six-month battery on the device so that it runs passively without needing his attention.

He challenges developers to come up with more effective tracking and reporting software, apps that work silently to gather data.

May the best software win. And let the Data Hunger games begin.

Links

More images from 2013 South by Southwest Interactive
http://www.flickr.com/photos/clairwiloh/sets/72157632980772104/

http://eventifier.co/event/sxsw13/clairwil

2013 SxSW Interactive Presentations on Soundcloud 

Find out more about the South by Southwest Interactive Conference in Austin Texas

http://sxsw.com/interactive

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