Following Paulina’s recommendation, I’m heading out now to Iona Beach to catch the meteor shower! It’s 11:55 PM. Thanks to my giant backpack, I’m able to carry plenty blueberry, raspberry, a banana or two, apples, water, a mat, warm clothing, pen and paper, my laptop, something to take pictures with, and a good book to keep me company (doubt if I’ll be able to read or use my laptop, though).
Good morning, good morning…
I heard the bells on UBC’s clock tower singing in the distance for the first time at 4 PM yesterday, and again at 2 PM today. Twice in two days? Where have I been for the past two years? Did the bells just start ringing recently or have I been camping on other parts of campus too often? For a moment, I felt like I was in a small European town.
Speaking of Europe, which has a relatively better health care system, here’s another passage or two from Worst Case Bioethics:
As Franklin Roosevelt first noted in 1944, just before D-Day, denying healthcare denies equal opportunity and is an assault on human dignity. Concurrently, the language of social justice should be employed, especially by using stories of real Americans denied needed healthcare, to convince Americans — who probably don’t need much convincing — that it is simply unfair to deny uninsured and underinsured (and even many insured) Americans decent healthcare, as it is unfair to deny decent education to Americans who cannot afford it. Healthcare is a moral issue and denial of healthcare based on inability to pay is immoral.
Since we’re on the topic of morality, let’s talk about torture. Lawyers and physicians working for the United States government and military played essential roles in ensuring the torture of suspected insurgents. Physicians had (and still have) the “licence to torture” from the sanction of lawyers, while lawyers and law-makers made torture legal, despite the result of the Nuremberg trials and Geneva conventions, through the supposed “medical evaluations” of physicians.
Read the following statement from the former White House Counsel, Alberto Gonzales:
…the war against terrorism ushers in a new paradigm… Our Nation recognizes that this new paradigm — ushered in not by us, but by terrorists — requires new thinking in the law of war.
And compare it with Hitler’s policy:
The main theme [of Hitler's instructions] was that this was the decisive battle between two ideologies and that this fact made it impossible to use in this war methods as we soldiers knew them and which were considered to be the only correct ones under International Law. The war could not be carried on by these means. In this case completely different standards had to be applied. This was an entirely new kind of war, based on completely different arguments and principles.
At this conference the Fuhrer stated that… since the Russians were not signatories to The Hague Convention the treatment of their prisoners of war does not have to follow the Articles of the Convention.
What I am inspired by, though, is that such critical remarks and analyses can be freely discussed and even published in America and much of the Western world.
The American healthcare system is a mirror, reflecting the basic characteristics of America. To the extent this is true, it will take more than a new metaphor or a new frame to change our healthcare system. It will take a fundamental change in America itself, or at least in our perception of ourselves. George J. Annas, Worst Case Bioethics.
Some unsurprising results are published in the 2010 update of Mirror, Mirror on the Wall: How the Performance of the U.S. Health Care System Compares Internationally: European countries lead the way with the best overall health care system performance but not with greatest amount of health expenditures per capita, while America protected the rear flank with the greatest expenditures and worst performance.
What I find surprising, however, is Canada’s performance. According to the report, Canada is second-last in overall rankings, followed closely by the United States. Furthermore, in a number of categories, such as effectiveness and timeliness of care, Canada comes in last place. On a positive note, Canada ranks second in having Long, Healthy, Productive Lives.
I was recently challenged to think about the factors that may contribute to America’s fractured health care system. My response — though brief and limited to 300 characters — is as follows (borrowed the second paragraph concept from Annas):
Among many factors that contribute to the discrepancy between America’s health expenditure per capita, quality of care, and quality of life, one which is of significance is the lack of collective will to address social inequities and guarantee health as a right.
Also, American health care is wasteful, technologically driven, individualistic, and death-denying. An better system would focus more on “upstream” factors such as the social determinants of health.
What about Canada? That’s a question worth thinking about.
Not long ago I became aware of the differences between health care reform and health system reform.
On a side note, I registered myself today as an organ donor. Can you imagine how many people die while waiting for organ transplants?
Although, by definition, Hurricane Katrina was a natural disaster, a sociological examination reveals that historical, social, environmental, and political factors within New Orleans and the United States were all contributing factors to the city’s destruction.
New Orleans emerged from its unique cross-cultural background as a relatively egalitarian society but eventually became a city of income disparity and racial segregation. Founded by France as an access route to Canada, New Orleans was a city in which freed slaves were employed in skilled trades positions. However, after its sale to the United States, as more white Americans migrated to the city, African Americans were gradually subjected to increasing discrimination, such as the segregation laws, which resulted in the concentration of African Americans in poor, low-lying areas.
A number of social factors placed vulnerable citizens of New Orleans at a particular disadvantage. Leading up to Katrina, the city had higher than normal levels of poverty for African Americans than the national average. This was demonstrated through the lack of transportation for large numbers of individuals, the highest homicide rate in the country, as well as an educational system that was deemed “unacceptable” by the US Department of Education. These factors were compounded by the fact that poor African Americans were concentrated in flood-prone areas of the city which rested below sea level.
Environmental factors also played an important role in the eventual destruction of the city. Natural wetlands, deposited in the coastal areas surrounding New Orleans from silt accumulated over time, were destroyed for commercial development. Wetlands would have acted as a natural barrier to the hurricane, reducing its intensity before hitting land. Furthermore, levees surrounding the city were constructed in the 1920s, which were dangerously inadequate to withstand hurricanes of the strength of Katrina. Finally, climate change had also contributed to the increasing intensity of the storm.
There are numerous political factors that resulted in the death of citizens and destruction of property. George W. Bush, the former president of the United States, cut funding for a water pumping project, a levee improvement project, and a wetland restoration project. Furthermore, the head of FEMA, Michael Brown, had insufficient experience and knowledge to serve in such a capacity, which resulted in insufficient response.
A comparison with Cuba illustrates a startling difference in the collective will of preventing death and damage from storms. Education of the public focused on the interpretation of weather/storm reports, an annual, two-day emergency preparedness conference across the country, and the well-publicised knowledge of evacuation routes. Networks of civil defence volunteers and women go door to door in order to check on emergency rations of food and water, and make lists of the weak, vulnerable, and elderly. Finally, storm evacuation in Cuba is organised, mandatory, and publicised: valuables are to be taken with evacuees; doctors are to accompany evacuating populations; logistical supplies, such as buses and tents, are in adequate supply; water in evacuated locations is to be shut down to prevent disease.
In contrast, the victims of Katrina in New Orleans lacked education, in comparison with cities not filled with poor populations. The city lacked evacuation plans, even for hospitals and nursing homes. There were no planned emergency routes and no mobilisation of buses. Even an AMTRAK offer to assist with the evacuation was declined. Combined with the the gallivanting of public officials, there was a very slow federal response. With the interest of businesses and markets in mind, Mayor Nagin did not immediately declare a mandatory evacuation. The Superdome acted as a temporary shelter in unsanitary conditions without food, water, or medications. A “toxic soup” filled the streets: its ingredients consisted of decaying bodies, sewage, and toxic heavy metals from industrial contamination. Families were separated with one-way tickets to unknown destinations.
New Orleans is now more white and more affluent.
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