Valuable Personal, Political and Health Reform Lessons, Courtesy of the Federal Government Shutdown

Coming to consensus
the old fashioned way

The Disease Management Care Blog views the federal government shutdown with the same morbid fascination of watching personal injury lawyers justify their double digit malpractice suit contingency fees: it's so awful, it's hard to look away.

The good news is that that doesn't mean that the shutdown doesn't hold some important personal and political lessons.  They can make DMCB readers better citizens and our political class a credit to our Republic. 

To wit......

When the DMCB spouse expresses consternation over the boneheaded actions of her husband, the DMCB can now respond by:

1. changing the subject,
2. retreating to the DMCB World Headquarters and blogging about the spouse's unreasonableness,
3. referring to the alleged lapse as a "glitch."

Things don't go well in the opening day of a widely anticipated unveiling of the largest health care achievement in the history of the United States.  If you were in charge, you would respond to the health insurance exchange breakdown by:

1. recognizing the problem and promising to fix it,
2. reminding the public about the painful gap between lofty campaign promises and disappointing bureaucratic reality,
3. shrewdly drawing flattering comparisons to Apple, the most widely admired brand in the world.

As the leader of a political coalition, you are stymied by the division of powers in the world's longest lasting democracy.  In response you:

1. seek consensus
2. deploy ad hominem attacks in press conferences
3. offer to compromise by allowing the opposition to do things your way.

Wanting to be an informed member of the electorate, you regularly watch either CNN, FOX News, MSNBC, PBS, CBS, NBC or ABC because:

1. These broadcasts' news editors subtly frame their closed information loops to meet your own political biases,
2. You haven't discovered BBC or Al Jazeera
3. There aren't any movies on TV featuring svelte vixen vampire babes having their way with their mesmerized male victims.

By pointing out that Obamacare is "the law of the land," you are really saying:

1. Our representative democracy passed legislation that was signed by the President and upheld by the Supreme Court, so get over it,
2. Now wait a minute, our representative democracy can modify or even roll back health care laws.
3. Enough with the debate, time to move on and figure out how to make preschool education, low interest mortgages and low-fat frozen yogurt protected federal entitlements.

Being a Game of Thrones fan, you wonder if the following might not be useful in settling the budget impasse:

1. Asking what the honorable Ned Stark would do, until you recall that he was beheaded.
2. Invite the opposition to a Red Wedding
3. Call up your elected representative and say "Hodor!"
4. Call up your elected representative and hear him or her say "Hodor!"

A Fictional Salladhor Saan's Game of Thrones Insights About the Patient Centered Medical Home

Mr. Saan weighs in

Along with millions of other fans, the Disease Management Care Blog is delighting in George R. R. Martin's A Song of Fire and Ice book series.  In its reading (now up to Volume 3, A Storm of Swords) the DMCB especially looks forward to running into Ser Davos Seaworth's flamboyant Lyseni smuggler-friend Salladhor Saan.  While he's a brigand, he's also an astute observer who is willing to share his shrewd insights with kings and commoners alike.

Yes, he's a self-serving peacock but his syntax makes it all worth it.

So, with apologies to the creative genius of Mr. Martin, the DMCB offers up a fictional Salladhor's insights about the patient centered medical home:

Who has served more of the unwell than the practitioners who minister in medical homes?  They seek remuneration and esteem, and that they deserve, I am thinking. True, it is vile calumny to insist on a “return on investment,” but empty coffers command the attention of royals everywhere more than the mewing of babes or the lamentations of the old, is that no so? Alas, budget fever has cooked our collective wits.

Screwy talking, I have also heard, of statistical medical home legerdemain foisted upon an unsuspecting public by clever math maesters. The medical home community takes no denial of proof of savings, while skeptics cleverly vex at their measures like sharks at a bloated whale carcass. It is, I am telling you truly, a miasma of chicanery that rivals Joffrey Baratheon's subterfuge to ride the Iron Throne with his bony Lannister bottom.

I, Salladhor Saan, who has benefitted often from a friend's guidance, consider well the benefits of congenial advice to those who have both need as well as a receptive heart.  If a diseased person's costs diminish and we cannot see that, I am thinking that measuring what is not seen is no different than missing smugglers in the night.  The problem, I am believing, has less to do with the smugglers than with our skill at finding them, is that not so?

Image source for Mr. Saan can be found here.