Christmas in the ER
As Bill Simpich --a friend -- writes, the U.S. healthcare system is broken. He and his partner Joanne had the misfortune of rushing to various hospital emergency rooms in the San Francisco Bay Area during this holiday season. But their horrific experiences got him thinking: what if our medical system was actually, you know, healthy? What if the U.S. spent its vast wealth on helping people instead of killing them? It's the time of year to think big. Here are Bill's thoughts:
Merry Christmas to you, some of my favorite people in the world!
My present is a short brainstorm on health care in the USA during the winter solstice and how to deliver some of the simplest solutions in the right package. All feedback appreciated.
My partner Joanne was in six emergency rooms in eleven days this month, almost all with at least two hours time in the waiting room ...and that's how we got covid for the holidays...Pax Terra and Paxlovid!
These were all Sutter hospitals - Alta Bates Berkeley (the worst), Summit Medical Center (marginally better), and Sutter Novato (which we went to because we correctly figured it was less crowded - it was early morning in Marin County).
Joanne was really ill, for a variety of chronic and undiagnosed reasons - the most difficult for the emergency room to investigate. ERs are designed for a quick solution to keep people alive and whole. Not a place for someone suffering from unsolved miseries and not about to die - but convinced that would be the best way to go.
The very worst of it was that she was extraordinarily dizzy and nauseous, but the authorities wouldn't let her lie down. "There are no beds available and no place to lie down." Joanne is a former Sutter nurse herself, and let them know it, to adverse effect. When she almost fainted at Alta Bates, she was accused by the coordinator of faking it to get a bed. I wound up getting her prone between two chairs and had to advocate against the coordinator's demands for her to get up. I told them that we weren't mad but we weren't going to comply. They left her alone. The chairs at the other facilities were designed so that you couldn't even do that.
Which got me to thinking...my friend Katya shared with me this wonderful Latin phrase inscribed on Roman buildings - "Salus Populi Est Suprema Lex". The health of the people shall be the whole of the law.
What if there was a "Peoples' Emergency Room" - kind of "urgent care-plus", where no insurance plans were necessary? Where there was no waiting room, but dozens of spaces separated by curtains where people could lie down when ill while waiting for assistance for their physical, mental and emotional distress? Where they could get compassionate care - with solidarity and without blinking lights and whirring machines and alarms? De-emphasize without eliminating prescription medication, to reduce the need for a prescribing doctor? The facility could be run by the local health department. If the health department won't touch it, a big-time Kickstarter with the stakeholders could get it started - health care workers, techs, community members and more.
What if the cafeteria offered - as one example - burrito bowls with only-healthy local ingredients in reasonable quantities, better proportions (easy on the rice, amigo) and affordable prices?
What if a portion of the cafeteria had a jukebox with contemporary young people's music, vintage pinball machines, and looped videos about Medicare for All, College/Trade Schools for All, and all the other "nice things" we could have if we diverted half of the US military budget and imposed death knell taxes on fossil fuels?
What if a Sort-of-Socialist Supermarket adjacent to Peoples' Urgent Care was run as a nonprofit educational by the local health department - featuring not just local produce, but health care workers stocking healthy produce and educating consumers on the best food choices before they get to the registers? Wouldn't it be sweet to see blood sugar tests stationed by the bakery? How about blood pressure machines stationed by the meat department?
How about on-the-spot appointments with doctors after these sudden discoveries? An attractive venue with soft lights, designed for people to pursue their health goals rather than high-calorie purchases? A spot where people can learn about ways to shift their purchasing power to local farmers - again, with a lounge offering videos, music and art providing alternatives to the military budget and fossil fuels?
No matter how you feel about government or the lack of it - and I vacillate back and forth, as a confirmed big-government anarchist - there is no substitute for prefigurative politics - building the world we want to live in. There is nothing like the power of leading by example. Even Santa figured out that the way to get a package into the right hands is by going down the chimney.
