Category: Bloggery

Diamonds in the Rough ‘n Tumble Webternets: What Med-people of Conscience Are Blogging (Part 4/4)

Posted by – August 19, 2014

Part 4 of 4 of the series When Life and Death is “A Matter of Policy”

For part 2, I wrote an overview of some of the bad things that have occurred when people in medical settings follow policy strictly even when it leads to horrible consequences, or in the case of Eric Garner, they don’t follow anything (aside from what the cops said) with horrible results.  In part 3, I covered the psychology of obeying.
For the last part, I look at what some med-people of conscience have said about obeying bad top-down mandates, the VA kerfuffle, and related issues as our medical ecosystems undergo tectonic shifts in the U.S. with very mixed, highly debatable, results.

I’ve always been drawn to posts blogged by nurses, doctors, RTs, et al…

Cartoon description: Just like the iconic photograph of five helmeted WW2 veterans working together to plant an American flag in a muddy clearing on Iwo Jima, but in this iteration, the five famous GIs struggle to foist forward a tower of VA paperwork instead.

“VA Red Tape” by John Darkow, Columbia Daily Tribune.

and for understanding the complexities of the overlapping universes (univerii? the multiverse?) of health care models and their rules and regulations, the medical bloggers out there are invaluable.

Dr. Marc-David Munk, blogging from his unique vantage point as “Chief Medical Officer” of an ACO in Central Massachusetts, explains the paradox behind the epic fails seen at the VA and other “big healthcare” institutions: the more top-down mandates, rigid accountability rules, and abstract “performance metrics” are imposed, the more you accelerate crapification¹, enable unaccountability and cooking the books, remove front-line staff’s decision-making powers, and lessen patient-focused medicine.
Dr. Munk deftly unpacks the weirdity:

It’s a common story to anyone who has been around big healthcare: senior management attempts to respond to a business problem by implementing a series of high level mandates that remove front-line management’s ability to think and make operational decisions.

…A cascade of things happens with high-level mandates: Senior management becomes obsessive about setting and measuring metrics. The degrees of freedom for people to make patient-focussed care decisions diminishes and every manager along the way starts to feel squeezed on all sides. Some find work-arounds such as the secret set of “waiting lists” kept off the books at the VA and the false reports generated by some.

See the entire blog post: The VA, Laws on Healthcare and the Dangerous Business of Replacing Front-Line Thinking with Corporate Mandates

Dr. Roy Poses, blogging fearlessly at Health Care Renewal, takes on the issue of top-down mandates from corporate managers with uncommon boldness, questioning the ability of the MBA managerial class to understand medical care long-haul at all, even pondering the role corporate psychopaths helming our big health care conglomerates might be playing in the present state of affairs. I applaud you, Dr. Poses! Your candor and insight (and pure gutsiness) is desperately needed. PLEASE keep bloggering on – KBO!

Dr. Michael Hein (linked to by Dr. Munk) sheds light on the 90% of the iceberg underneath the VA scandal we’re not seeing or addressing: the crisis of woefully scarce primary care.  Most civilians wait much longer than 14 days for an initial primary care appointment; 30 days if you’re lucky, up to 6-9 months depending on which part of the country you’re in.
Dr. Hein also linked to the always insightful OB/GYN Dr. Jen Gunter reining in “metrics madness” at the VA and elsewhere with her lasso of truth.

I hope to blog more about the issue of the supply of health care in the future.  The Affordable Care Act and Medicaid expansion (see my post explaining the Medicaid expansionboost access to insurance (and ostensibly health care) without a corresponding effort to expand the supply of doctors, nurses, hospitals, and so forth.  Though I disagree with libertarian sources like Reason Magazine on most issues excepting civil liberties and bad, counterintuitive regulations being bad, I gotta give ’em a big tip of the hat for addressing the supply of health care and the many unnecessary choke-points in the supply pipeline head-on: Video: How to Grow the Supply of Health Care RIGHT NOW!

Paul Levy, a former hospital CEO whose bloggings at Not Running A Hospital led me to Dr. Munk’s blog to begin with, is running down part of the health care supply problem: monopoly. Embedded in the Bay State, Not Running A Hospital is giving much needed scrutiny to the recent deal with Partners HealthCare and the Attorney General Martha Coakley, the behemoth corporation that owns Massachusetts General Hospital and Brigham and Women’s Hospital, both affiliated with Harvard, allowing them to eat South Shore Hospital and related doctors’ practices and ultimately become more scary and behemoth-y, the prices even gougier.  “…it cannot be in the public interest to permit a dominant provider to become still more dominant” Levy points out in his letter to the trial court set to rule on Coakley’s “anti-trust settlement”—read his full letter here.
He deserves not only an award for activism but an award for blog journalism, as he has pulled together an excellent collection of factual information about Partners HealthCare and the ongoing anti-trust dispute in a way spin-doctored news media don’t, and examined things, like Gov. Patrick’s unserious “wait and see” lip-service, that the news media won’t.

And this brings us full circle back to the concepts I began this series with: rules, regulations and policies decided in boardrooms, courtrooms and back-rooms have an enormous affect on all our lives, especially when you’re a “patient.”

Like Lambert Strether at (terrific blog critical of big finance) naked capitalism wrote, the way the corporations code their systems—the computer code, the 1s and 0s—increasingly is becoming the law. Notably in cases of big banks’ mortgage databases that perpetrated mass-scale fraud, the courts just assessed penalties per offense, “cost of doin’ bidness” for banks, and the big databases roll on, slapped on the wrist but essentially made legal after the fact.

Step one: Code the system. Step two: Rewrite the law to match the code, and grant immunity. It is, after all, better to ask for forgiveness than permission.

Code is law.

See the whole post here: “Code is law.” Literally. | naked capitalism

It’s symptomatic of a weak state and broken legislative branch(es). More and more, we need to lobby the corporations, the guys who control “the code” and the related bureaucracies—my focus is medical bureaucracy —just as much or more than the public officials who ostensibly run things in a democracy.
We’ll need good bloggers, good advocates, good blog-journalists and blog-activists. The aforementioned blogs are great examples of what that can look like.  I hope to be a part of it.

Nick

 

Part 1: the introduction/weird ventilator rule

Part 2: Paramedics, the VA and obedience gone wrong

Part 3: The Milgram experiment, the tendency to obey and medical contexts

 

Footnote:
1. crapification – coined by Yves Smith (nom de blag of Susan Webber, head of naked capitalism) to describe the ever crappier quality of consumer goods and services as everything inexplicably succumbs to “the race to the bottom”… “…long-overdue and largely futile backlash against the crapification of almost everything“…

The Coler Chronicles: Collected Bloggings of the Institution Days

Posted by – July 24, 2014

Dispatches from Ventboy Alcatraz

From inside the walls of the institution, Coler-Goldwater, I continued to create content, to blog, and we added video blogging from the inside.

I wrote the following blog posts about the institution, where I lived from August 28, 2008 to September 10, 2009:

All nine video blogs can be found here: First Video Blog Series From Inside An Institution

these video diaries/rants are me speaking on camera about the institutional experience and related policies… the commentary on the formative “stakeholder meetings” that shaped the Affordable Care Act is one of my most important videos, I think.

Note: the respect I have for the staff and bond felt with the other patients is very real, and though these diaries vent frustration and the heat felt at the time, their intent is to shed light not heat and to educate about the real world conditions and actual lived experience of disability in public long-term care hospitals.  Please understand that I blame policies not people.   I want to give Love to the human beings within the surreal constructs I’ve described.
In addition, you should know that the unit A13 I describe and the hospital Coler-Goldwater itself no longer exist in the forms I encountered, having closed/dramatically shifted at the end-of-2013 without the best transition plan for the people there…

I collected everything here for convenient access for readers who’d like an intimate look “on the inside.”

Nick

New news items related to my blog posts, November 2013

Posted by – December 1, 2013

Updates on stories I’ve presented

As we say goodbye to November, here is a summary of November news items that add to, echo, or relate to, past posts from my blog.

1. Tea Partier fears about being in China’s debt

On November 11th, I published an essay on the blog: Beijing’s Marshall Plan for the U.S., about the weird China-U.S. economic relationship and the domestic uneasiness, tension, even rage, it’s causing, and how it’s driving Tea Party activism on the debt and deficit.

That day, video came out from Sarah Palin’s Nov. 9 speech at the Iowa Faith and Freedom Coalition, and her “this isn’t racist, but…it’ll be like slavery when that note is due. We are going to beholden to the foreign master [China]” comment got lots of attention in the news cycle. Unfortunately, the “this isn’t racist, but” quip was like a flashing, neon sign “ATTACK RACISM HERE” and media took the bait: it was deliberate, jiujitsu messaging, suddenly the media is delivering a message about Palin and about the left to her specific audience without even knowing they’re doing it… diabolically clever. She is constantly doing backhanded ways of delivering red meat to her base via outrage-peddling news media, in this case Palin’s delivering the message “I hate the racism police too, I’m like you” with media doing the delivering for her. So, with the journalism guard dog pointlessly chasing a car, debating whether the word slavery is inappropriate (I’d say it is very inappropriate when being used for publicity-baiting but the concept of “debt slavery” merits legitimate discussion) and batting about different ahistorical viewpoints, the China part of the comment was lost in most media accounts.

This is the meat of the comment:

“Our free stuff today is being paid for by taking money from our children and borrowing from China… when that money comes due – and this isn’t racist, but it’ll be like slavery when that note is due. We are going to beholden to the foreign master.”

Here’s a video of the comment in context:

You can also watch/hear the video of Palin’s speech in its entirety.

This underlines the points I made about the anxiety around potential “debt peonage” to the PRC. The structural long-term debt isn’t the only issue, which liberals need to understand. Right now the left talks past the right and visa versa, ships passing in the night, liberals and liberal-ish budget wonks are saying that the deficit is on track to be a historically low 2% of GDP, when, for the Tea Partier grassroots, the real crux of the matter is being “beholden to the foreign master,” and whether we are beholden by $200 billion or $200 million is immaterial or, at least, the numerical specifics of the debt are not as important to many on the right as WHO we’re in debt to. The dependence on (economic and military rival) China raises very legit problems for “American exceptionalism.” It makes a paradigm shift that topples the U.S.-led unipolar economic and military order a real possibility for this generation of U.S. leaders down the road a decade or two, not just anxieties for the great-great-grandchildren.
An effective liberalism would address the fears of debt-slavery under a foreign jackboot head-on. I hope actual dialogue can happen instead of the continuous talking past each other, engaging on completely separate issues.

The 11 cultural “nations” of the United States: diversity (and devolution?)

The new book describing the 11 nations or socio-political cultures that rub up against each other in North America (Mobile should be categorized with “New France”) being frequently blogged about in November, brought to mind an essay I blogged in May 2010, one of my more vitriolic posts after the Affordable Care Act passed several months previously and the Tea Partier groundswell was peaking, a post chock-full of ranty disillusionment: Nick’s Essay on America’s Decline, with Big Solutions.
Given our system’s seeming inability to seriously address national problems, with the tepid, insurer-friendly ACA nearly impossible to pass as “too socialist,” I offered three “big solutions,” 1. strictly banning bribing candidates with “contributions” 2. Proportional Representation via STV (“Instant Runoff Voting”) 3. if all else fails, let states group themselves into federated republics with near-complete autonomy on domestic policies like super provinces (still within the United States) for each regional political culture. My concept is similar to devolution as done in Spain (Catalonia, to name one such region, is given broad powers to govern itself). Federal Republic of Central America should be noted as an example of what not to do.

Click to enlarge the map!! In this vision of the future, South Carolina even secedes from the Southern Republic, because, hey, let her finally satiate the 200+ years of secession-hunger.


My map, instead of the 11 cultural nations, has seven federated republics and South Carolina. If nothing else, the essay takes on the serious difficulties with our federalist system directly, difficulties that too often get swept under the rug.

Note: I’m different from the Nick that wrote the “Big Solutions” essay almost three years ago. My views aren’t necessarily less vehement, I still dislike the ACA for what it doesn’t do, and I still think root-and-stem reforms and big constitutional questions should be foreground issues, I’m just more interested in understanding and dialogue than before, more keen to write things that further understanding of ideological opponents than to write diatribes like the one above. Though I still want to cry out against injustices, I feel an urge to love (and grok) thy enemy, and get a grayer, less absolute picture of reality. With that shift, I look back on the South (and Mobile in particular) with increasing fondness as I reflect on the good things that came with the bad.

Religious Literacy and Understanding

In the first weeks of November, The Atlantic‘s post Study Theology, Even If You Don’t Believe in God by Tara Isabella Burton was widely shared and blogged about, and I highly recommend it. Burton’s piece is the most powerful and succinct defense of studying theology I’ve seen to date, an excellent refutation of recent calls (from Richard Dawkins, et al) to deep-six theology departments in UK universities as he doubts theology offers “any real content at all, or that it has any place whatsoever in today’s university culture.” Burton nails it with the assertion that theology offers a unique “opportunity to get inside the heads of those whose beliefs and choices shaped so much of our history, and who—in the world outside the ivory tower—still shape plenty of the world today.” This piece really re-enforces what I was saying in my 2010 essay Religious Literacy and Understanding, For Our Own Sake,
where I argued:

You can’t really form productive relationships with many every day folk in the U.S. (nor Mexico, South America and Africa) if you’re completely ignorant of Christianity, and, increasingly, its more charismatic groups, which are seeing explosive growth. Unless you can get where people are “coming from,” you won’t understand them, and the spiritual is a huge part of that. The spiritual will always become more a focus when material things fail, and they are failing on a massive scale unseen since the ’30s.

As the U.S. falls, others prosper. You can’t understand what is going on in China right now (their return to their once-familiar role as #1 global superpower) if you have no clue what Confucianism is, and the role it is playing in Chinese policy and politics.

You can’t understand how cultures across the globe are responding to the rapid changes happening, a revolution in technology and society and the economy unprecedented since the Industrial Revolution, without religious literacy.

click here to read the rest of the essay

In a world that is roughly 80% religious in some form, religious illiteracy isolates you. Burton’s article goes even deeper; if you only have time to read one link from this post, read her essay, especially if you’re in an academic field.

50th Anniversary of JFK’s assassination

November 22nd marked 50 years since President Kennedy was assassinated in Dallas. My 2008 blog post about Lee Harvey Oswald speaking at Spring Hill College in Mobile mere months before the assassination, explaining Soviet life to Jesuit scholastics gathered in the rotunda, may give you some new insights into this surreal story. I’ve added a recently published study of Oswald’s time in the USSR to give the post better backing.

Hello December,

Nick

Insightful Blogging in the Wake of the Gov’t Shutdown

Posted by – October 22, 2013

October 2013 Roundup: Acts of Bloggery in the Shutdown’s Wake

My picks for the blogosphere’s most valuable insights into the shutdown insanity:

Moral lens:

The 8 immoral ways the government shutdown is hurting the needy On Faith – the shutdown inflicted pain on people already struggling and making due on government aid amidst the post-2008 “economic realignment,” cutting or threatening to cut already weakened social programs, though this has been badly underreported. 

The Day After | Talking Philosophy – The Philosophers’ Magazine Blog –  applies the measures of philosophy to the shutdown crisis, who has the moral responsibility and perceived “moral blame?” It’s a strenuous task to be sure, but valuable.

Unexpected impacts:

Government shutdown hits comics | The Comics Beat – the government shutdown’s impacts seemed to leak into every nook and cranny of American life.  Even comic books were impacted, new books delayed, stuck at the docks waiting to be cleared through customs.

Student projects interrupted by US shutdown | Nature – because of the shutdown, Siddharth Hegde’s extremophile PhD experiment at NASA Ames, after carefully nurturing and growing his extremophiles, might have died off for want of feeding since the Lab was locked up and 98% of NASA personnel were ruled non-essential and furloughed. It’s not known whether the extremophile experiment survived the extremophiles in Congress (I put the question to Hegde) but if the cell samples died he won’t be able to re-do the experiment, as his visa is only for three months.

Cartoon:

“Shutdown” by POLITICO’s Matt Wuerker

“Shutdown” by POLITICO’s Matt Wuerker

Political assessments:

In Washington and in Lansing, tea party zealots are costing us a fortune as they waste our hard-earned tax dollars | Eclectablog – “This is what happens when you elect people who hate the government to run the government.”  Eclectablog’s Chris Savage chronicles the heavy economic price paid for the shutdown shenanigans that were advertised as helping ease the deficit but did the opposite.

Lessons Learned? | Official Artur Davis – in this interesting assessment by (deeply strange black ex-Democratic Congressman—7th district—from Alabama) Artur Davis, who—after losing the black vote in Alabama—has re-made himself as an advisor to Republicans on winning the black vote, he says “The haziness of wishful thinking, overshadowed by a deeper failure to appreciate that shutdown itself validates the obstructionist label, the impression of being too inflexible to govern, that so threatens the party nationally and is even starting to creep into red states like Georgia and Louisiana.”   and “…conservatism has been painfully slow to distance itself from the radicalism that has surged in the party…”

Historical perspective:

The Philosopher’s Stone: A REPLY TO ANTHONY TSONTAKIS – philosophy professor Robert Paul Wolff reflects on the right-wing’s fierce opposition to the Affordable Care Act… are there core philosophical differences?  Wolff doubts there are deep ideological underpinnings to the opposition, noting that “the central features of the ACA entered public discourse in America as a set of conservative Republican proposals put forward by the right-wing Heritage Foundation…”

History Unfolding: How Much of a Victory? – after the shutdown ended, historian David Kaiser tried to put the House Tea Party guys in historical context, difficult given the unprecedented events involved.   “I have tentatively decided, after much thought, that perhaps the best historical analogy for the Tea Party are the Radical Republicans of the post-civil war era.   I must apologize for the analogy insofar as I admire the goals of those Republicans, namely, the full enfranchisement of freed slaves, while I feel the Tea Party is trying to undo all the good that the US government has accomplished over the last century.”

And this is just a slice of the ongoing discussion.  Will keep ya’ll posted.

Nick

The Path of the Disabled Man

Posted by – May 3, 2012

I had originally intended to write this for Blogging Against Disablism Day, BADD, 2012. Obviously I’m WAY late for that, over two days after the deadline. But since I’ve participated in BADD in the past, I said hey, why not?! Maybe BADD readers will still find this post, and may, along with other audiences, find “The Path of the Disabled Man” of interest. I’ve never written about gender before. This is an attempt to convey something of the disabled male’s lived experience, and I hope it works.

The Storms Within

People forget, but though humans DO have a spiritual core, they’re coming from tens of thousands of years in the cave as well. Certain things are in-born, hard-wired in the base end of the forebrain, or reptilian brain or whatever you may call it; right next to things like fight or flight, territoriality, hunger and other instincts in the lower brain are our sexuality and some fundamental guides of human attractiveness, passed straight down from the caveman/cavewoman experience.

Those looking for a good cavewoman to pair with, knowing all too well that the pairing would need to produce like eight kids within a decade before the end of your life expectancy at age 30 to have maybe two of your offspring survive in a bleak era of horrendous infant, child and adult mortality—something that would continue to be a huge factor in the everyday lives of humans until the emergence of modern medicine in the 20th century, would automatically look for a cavewoman with a healthy look like she could carry eight babies, full breasts that look like they could feed two babies at once, nice skin signaling health, and a good-looking symmetrical face (a subconscious indicator of good genes in all humans). This is hard-wired in the brain as guideposts pointing toward female attractiveness, as shown by its prevalence today across cultures on all six inhabited continents.  A deep, bedrock thing in the mind; though largely subconscious, it remains ubiquitous.

Those looking for a quality caveman to pair with would automatically seek out the strongest, most battle capable male, who could kill wildebeests and rival tribesmen so the she and the offspring can survive (ironically, with acts of violence, including literally beating an adversary’s brains out, an act of protection and love for the woman). The images of males that women are interested in tend to feature images of strong men, not naked as men like to look at women, but in clothes that convey a status or role as providers and/or protectors, e.g. men in uniform, firemen calendars, etc. What’s attractive in the human male (for most) is more subtle and complicated, but it’s no less hard-wired.

So where does that leave men with permanent disabilities? I’m a guy who’s continually trying to find my way as man, and be a good man alongside severe disabilities in the mix, things like needing a ventilator and intact breathing tubes an inseparable part of my lived experience day-in and day-out and a real barrier. So I’ll speak to that—not meaning to say the path of the disabled male—I include the gay male here, similar challenges—is harder than other paths. And no denying it can be super difficult for women with disabilities given the ableist society we live in, and ambitions today rightfully dwarf the cavewoman’s (and not meaning to discount the struggles of those on transgender or gender queer paths either, which, in my view, is no less hard-wired a position than mine, as evidenced by the cavemen AND the animal kingdom). Of course, regardless of gender, everybody wants the same basic foundational things, to feel safe, wanted, needed, like they matter. This is just “write what you know,” about the lived experience of gender, not “gender theory,” and not intending to say the path of the disabled male is harder, but it is different, very different.

Evidence-Theory cartoon

Cartoon created by Nick, May 2nd, 2012

Women with disabilities, predominately, can still have the fundamental elements of female attractiveness society expects, there is obvious beauty abundant here (I admit, I’m biased in favor of disabled women) while men with disabilities have an incredibly difficult time being providers and protectors. Gimpy RomeoIt’s an uphill battle feeling valuable in any sort of male gender role a disabled guy has attempted to carve out. Men can have physical attractiveness too, no question, we can rock the good-looking symmetrical face with the best of ’em; but while that may open doors, it won’t take you far beyond that because everybody tends to, consciously or unconsciously, want men to be protectors and providers, and frankly so do I.  I don’t think women who want that from men are “superficial,” I see it as a legitimate, totally valid need. And focusing on what the man offers and actually does is, truly, less “superficial” than how men size up women, which, until a guy matures, will heavily tilt toward the body. Anyhow, to be useful in that way, protecting, providing, being a doer, taking specific actions, physical or not, that matter to someone, is a core thing in the male psyche (granted, “writing what I know” here does involve projecting forth my own feelings and perspective, but I do think a lot of this is universal across men).

More

Best Of Nick’s Crusade Blog, So Far

Posted by – April 10, 2011

I’m happy that some of my blog posts have become particularly well-trafficked resources on the interweb. I’ve often written about historical topics that interest me, and, oddly enough, those posts get more hits than posts about disability, politics and injustice, the main subjects of my Nick’s Crusade Blog.

This is a survey of the most viewed posts ever on this site…

China’s Age of Discovery: The Voyages of Zheng He

This post, about the explorer Zheng He and the voyages of his grand treasure ships, is usually the most viewed post for any given week. Not only does the post shed light on the way-ahead-of-their-time ways that the Yongle Emperor projected power and influence with technology like the printing press and an enormous Navy (techniques that would seldom be used with such sophistication until the 19th century) but it also remains very relevant because it details a Chinese period of prolonged international engagement, trade and wealth only rivaled by the high water mark of Chinese power today. The end of the treasure ships, with hardliners burning them as an isolationist backlash swept the empire, illuminates a pattern you see over and over again in Chinese history: after the inevitable bust comes following an economic boom, Conservative Confucians take over and crackdown on trade after a harsh isolationist reaction. Today, China-watchers and investors, and indeed the PRC regime, worry about another cycle of isolationist backlash cropping up if Chinese people in the underdeveloped heartland don’t feel enough improvement in their lives from foreign trade and become angry.

The Griffin Was Based On A Real Creature!

Rivaling “Zheng He” for the Top Search term leading people to my blog is “griffin” or related key words. This post is shockingly well-visited, and it’s one of the quickest ones I’ve written. I saw a program on the History channel about mythical creatures that suggested the Griffin came from ancient Scythian warriors who came upon dinosaur skulls and spread stories about Griffins to intimidate enemies, and decided to blast a quick blog post. I guess people really like Griffins.

Donald Duck As A Nazi. Really.

This post, coming in a distant third in views, generates hits from the sheer bizarreness of the video it highlights, a war propaganda-era Disney short with Donald Duck dreaming he is a Nazi. Even though the film is clearly meant to mock and underline the failures of the Nazi system, seeing Donald in a Nazi uniform is still WEIRD!

Special mention: Vigorously Insisting On A More Perfect Union: Fighting Cuts, Demanding Universal Health Care

This blog post of mine was published by the Greenhaven Press imprint of Gale Publishing in their Opposing Viewpoints Series, which is heavily used both in libraries and high school and college courses, to introduce differing views of the issues. it’s in the 2008 edition of Opposing Viewpoints: Health Care, if anyone is interested.

Also check out my comic art, Theodore Roosevelt and the Rough Riders vs. Zombies over at Superdude.org — it’s can’t miss!

Nick

ADAPT Blogswarm, Fall Action 2009

Posted by – October 14, 2009

The ‘swarm has arrived! Bloggers across the globe have united to shine a light on rampant unjust institutionalization and segregation of people with disabilities and ADAPTs Fall Action in Atlanta confronting it!

On Disability Unity

NextStep blog
WE ARE ALL IN THIS TOGETHER

Finding My Way: Journey of an Uppity Intellectual Activist Crip
Human Rights

Whose Planet Is It Anyway?
Supporting Allies

Insights

Sanabitur Anima Mea
Look Closer (my favorite post in the ‘swarm)

Metamorphosis (Bob Kafka)
On the discrimination behind the institutional bias

Documenting The Action

PhilosopherCrip
Atlanta Action Days 1 & 2
Atlanta Action Day 3

The Roving Activist’s Blog
I am excited
Live from Atlanta

Today.com’s Official Disability Rights Blog
Action Day One: Conversations with Self
Action Day 2

Finding My Way: Journey of an Uppity Intellectual Activist Crip
Power is sexy and…

Composite: thoughts on poetics & tech
ADAPT in Atlanta kicking ass, taking names

Comment below to add a post to the ‘swarm!

ADAPT Blogswarm, Fall Action 2009 Participants!

Posted by – October 8, 2009

I’ve been excited by the response to my call to blog to end institutionalization around the Fall National Action!

I’m honored to announce the following blogs will be participating:

PhilosopherCrip
Announcement post

The Roving Activist’s Blog
Intro

Crippled Under The Law

NZ Accessibility

The Center for Disability Rights

Sanabitur Anima Mea

Today.com’s Official Disability Rights Blog

Composite: thoughts on poetics & tech and Hack Ability

LTC Reform

Empowering People Changing Lives

If you’re not yet listed as a participant and would like to be, please comment below. We need all the help we can get.

FREE OUR PEOPLE!!

Nick

Nick And The Not So Happy Hospitalist

Posted by – August 5, 2009

I’ve inadvertently stirred up some shit controversy at one of the major medical blogs, Happy Hospitalist (a hospitalist is a relatively new term for a doctor specializing in the care of hospitalized patients).

Don’t get me wrong, this story is not black and white; there’s plenty of value in much of what “Happy” writes, I’ve gained a lot from his posts explaining the medical payment system and have learned about how government is skewing the incentives toward procedures and the many other failures of government health policy. So, I’ve found it informative,

THATS 15 UNCOMPENSATED MINUTES!

"THAT'S 15 UNCOMPENSATED MINUTES!"

and the frequent discussions useful, and stimulating me to think more and write more. But “Happy”‘s writings often seem the opposite of happy; he routinely complains about doctor’s pay, about being overtaxed by the government (when taxes on the rich are the lowest since the 1920s), about how he has to spend 15 minutes of uncompensated time with this patient and that patient. And how any uncompensated time is SLAVERY. After a paid evaluation is over, if the patient waylays him for 15 minutes asking questions, that’s SLAVERY! He rants about how people, heaven forbid, “feel entitled” to his time! I pretty much ignored that, until he juxtaposed all this with the ostentatious display of wealth in his hospital’s parking lot, revealing that doctors at his hospital ain’t struggling in the least. Then I blew up at him, and earned myself a new post from him focusing on what I’d said.

I may have been too strident in my initial response; I’m sorry for that. And you know what they say about fighting on the internet…. But my point was, you can’t expect me to buy into the “poor uncompensated doctor” shtick, nor can you expect the American people to support loan forgiveness or payment reform, right after showing “Drive Your Lexus To Work Day.” For most laymen, a lot full of Lexuses = doctors at that hospital are doing JUST FINE with the current system, and don’t need us increasing the fee schedule or other government help. Pleading poverty after that is going to go over like a lead balloon. If docs are really united in trying to convince the public to support their agenda, ostentatious six-Lexus-in-a-row displays should probably be avoided.

Not that some doctors shouldn’t complain; primary care physicians are grossly underpaid by our notoriously bad reimbursement system, to the extent it’s reached crisis levels. But primary care docs are mostly objecting to how they only have 10 minutes with patients, how the system harms patient care, how it hurts doctors and their patients; I don’t see many family doctors bitching about being “uncompensated” as they’re sauntering to their BMW and filing their nails. But “Happy”‘s no family practice doctor, and plenty of his posts give off that vibe.

Reading “Happy” complain is more akin to seeing the insurance companies claim poverty. I was accused of jealousy and hating the rich, but that was not my point. My point was that when (relative to most people) you’re swimming in a vault of gold, don’t whine about how unfortunate and enslaved you are! It’s too much, and sticks in my craw. And though there’s a lot I respect about the man (including how he’s built such a popular blog through sheer persistence to post 2-3 times a day) I couldn’t help but speak up on this one.

Nick

Nick’s Crusade Statement of Inalienable Rights

Posted by – May 15, 2009

I’ve permanently added the “Nick’s Crusade Statement of Inalienable Rights” to the site, because human rights are the backbone, the underlying premise of everything I post here.

It’s a work in progress, so please comment and suggest changes or additions.

Nick’s Crusade Statement of Inalienable Rights

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