Friday, August 28, 2009

Out of the box

Out of the box

I appreciated what my state assemblyman Bill Monning said at last night’s healthcare discussion and decided to email my appreciation as well as a comment about parity for those he called ‘the mentally ill’. I composed carefully, went to his website, reluctantly accepted a category (For ..., Against ... Appreciations, ... ), pasted in my comments, and, ... was refused.

“You’ve exceeded the maximum,” said a bold red message. Exceeded. Ah, but no hint of what the maximum is. I’d worked hard. This felt disrespectful to me, a constituent. I was already resisting being channeled into a category, thinking only the tally would be read, not content. I had something I wanted to say, wanted heard, about language and politics and ‘the mentally ill.’

And as I saddened even more, I realized I was grieving the loss of electronic access, the triage of the comments page, this marvelous internet tool not as available, mediated.

I typed up my input, didn’t revise content for hard copy, printed it, and faxed his office, links I carefully chose not useful on a page, ... I wonder if a staffer will even read.

I’m feeling overwhelmed by systems, the only way I know to cope is to withdraw.

Saturday, August 15, 2009

End of life advance directives

Why did CMS not just issue a regulation permitting advance directive counseling as a billable service?

If I were drafting, I’d require every insurance policy to include advance directive instructions from the policy holder. I’d insist on a requirement that each of us think about how we’d like to live and how we’d like to not live. Whatever instructions the policy holder wants. But instructions.

Why did the issue become not ‘who receives’ or what one receives but ‘who pays’ ?

Who introduced the reimbursement option into the health care legislation?


Was the motivation provider greed? Or uproar creation?

Is this a Trojan Horse? That backfired?

The result was to be a payment for a service to providers, and the chance for counseling twice a decade, for seniors and people with disabilities, if one wished. But the first reaction was a scream about killing seniors, forcing people to choose to die, euthanasia, Nazis, ... And then a counter, it’s counseling, it’s optional, ...

And now the country is having a discussion of end of life, planning, advance directives, extraordinary interventions, ...

What was the hoped for consequence, and what the unexpected?

How did that clause get into the suggested legislation?

Thursday, August 13, 2009

Editing errors

Even books from university presses have a typo or two. Newspaper stories, blogs, TV trailers, ... The number of errors seems to be rising. In addition to the carelessness that comes from being fast and first, I think it might be because the copy editors have been taught to read using look/say, not phonics, so the word looks right enough to them, despite the error.

Sunday, August 9, 2009

The End of Search

Before the internet, before search, I had a big dictionary and a library look-up list and not everything I wondered about got pursued. Alta Vista, Yahoo, and now Google have quenched a thirst I didn’t realize was so strong. But search is now full of junk, intermediary hits leading to vendors and worms, deceptive metatags pointing me to marketers. Today, searching for the telephone dial codes to a small city in Spain, the first two dozen links were for software to download and try or buy. And I remember a few years ago learning that I couldn’t use the word ‘hotel’ in a city search for accommodations because I would see screens of vendors and websites, not links directly to a local hotel. It’s disappointing to see even Google spoiled, as spam spoiled email.

I don’t mind ads that are clearly ads. I’d pay a small amount for search software that vetted the metatags, screened out the intermediaries.

The competition for my attention is invasive. I wonder if I will just turn away.

Saturday, August 1, 2009

Expand the WHO definition of health to include spirituality

At, there’s a request for ideas to rethink mental health, move past narrow perceptions, expand our understanding and collective involvement.

I have an idea. I think it could create global change. But when tried to use the online application form, the required categories weren’t a good fit and the software wouldn’t accept my input, so I am posting my idea here. (So much for expanding perceptions!)

WHO asserts that “health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” The definition has not been amended since 1948.

I’d like to add spirituality to the idea of wellness, so that “health is a state of complete physical, mental, social and spiritual well-being and not merely the absence of disease or infirmity.”

The very suggestion for reconsideration would start people thinking, generate consequences that I can’t anticipate and reconsideration matches current social trends for health integration.

To make this happen, a committee would need to learn the WHO process and then:

develop arguments
differentiate from religious/theology
consider a proxy for community well-being from data already being collected
for instance: adults - changes in % voting
for instance: changes in teen pregnancies rate
create media event
include world spiritual leaders
collect implementation stories and disseminate
review impact in 2 years, 5 years