Direct Democracy as a "Tool" For Healthcare Reform

Yes I can imagine readers shaking their heads already! This post is mostly about more "daydreams", but I really need them right now as anyone who read the last post might gather, given my present frustrations with the limitations of hospital systems. (I've also been in the somewhat odd position of having observed them up close regularly in the past decade, all the while knowing I don't really have the means to access them myself). In some capacity, whatever work we would choose for our lives, we still need to take some active part in healthcare provisions in and for the places we live, if we can ever expect to receive the health related assistance and support we actually need for ourselves (here in the U.S.). And that doesn't mean the inadvertent or default help we find ourselves trying to provide for one another as a last ditch effort as we get older.

What's more, when we are artificially separated from both illness and aging in general by our institutions, these normal parts of life tend to hit us like a ton of bricks when we get older, and can eventually isolate us all the more by the process. If the people who are around us when we falter are the same as other times of life, such transitions do not have to be so jarring. However, in order for economic and social integration to be possible, we have to recreate both our environments and our work obligations to place the most vital elements of our lives into closer proximity to one another. To do so requires direct democracy in services, where we would be free to choose and to use skills sets that we learn in the course of our lifetimes.

In the present it's all but impossible to even imagine what direct democracy for services might look like, or how it could function in practical terms, even though we already have the digital capacity for it. Just the same, we need to take many services, especially healthcare, out of the endless struggles of the representative democracy where they are only getting reduced over time in our present institutions. By equalizing our time coordination with health practices of every variety imaginable - both traditional and alternative - we can fully integrate healthcare knowledge at local levels that include our participation for the full course of our lives. That way, we are invested in community to a degree where municipal bankruptcies might be less of a problem, for one thing. Perhaps our elected officials can concentrate on something else for a change that they're better equipped to deal with (whatever that is).

Unfortunately, representative democracy has become mostly a bad joke in service based terms, as government increasingly uses the limitations of money in services to arbitrarily divide people of all walks of life from one another. In recent decades, it has only become more difficult for government to force the resource sets of limited groups, institutions and suppliers into the demand sets of entire populations. What's more, most of those resource sets are shifting to the most economically successful parts of the country, which only continues to slow mobility and economic dynamism elsewhere. The result is entire populations and municipalities being left out of the process of wealth creation, altogether. That is a situation which can't be reversed until knowledge use becomes a more central part of wealth creation processes in general.

Until that happens, we struggle to use knowledge as a sort of wealth based "backwater" in a larger societal sense. In other words, the knowledge we think we can "afford" is highly rationed through its attachment to domains of capital use formations which are supposedly primary. Or, knowledge is held hostage to the supposed "makers" of "true" wealth, in spite of their lack of any organized focus in any growth based terms for the larger society. In that backwater, we get various pools and eddies of knowledge use in the cities which often amount to highly specialized afterthoughts that don't coordinate with much of anything else.

Our fragmented bits of knowledge get served up with laws, to "make up" for what we have increasingly come to believe we can't pay people to accomplish with their minds. I suppose all we need now is the humanoid robots (pardon the snark). But if we don't start making much better use of people and far less use of the actual outdated laws still on the books, any potential coordination and marshaling of the actual scarce resources of this earth will only make less sense over time. Detroit is but an early example for the U.S. in particular.

What is it in particular about healthcare, that currently distorts monetary valuation of other knowledge so as to appear semi-worthless? As services have become the most important component of the economy, the primary service default for all of us is critical care, if and when our lives are endangered. And, it just so happens we've defined that default setting as necessarily tended to most every time, by a highly selective group of individuals with highly paid skill sets.

What's more, we expect those skills to take place in environments that are extremely limited in the world by their very nature. Over time this combined set of factors has usurped many other aspects of life that money and human imagination might actually be allotted to. Not only has this left individuals and governments unable to tend to the growing imbalances, it increasingly causes people to question the value of large sets of educational possibilities that supposedly don't "contribute" to anything. It's time for these economic and social imbalances to be addressed by reform that makes us all a part of healthcare itself, before we all become convinced that nothing in the world is affordable but healthcare. Not to mention the limitations of population access the current system still implies even with the sacrifice of other wealth based educational values and goals.

For healthcare needs, we could start anew by reclaiming the areas of healthcare options which our institutions have little room for, through entrepreneurial terms in coordinated local markets. We would use freedom of speech to make certain that alternative options once derided and then silently reclaimed through pharmaceuticals would be brought back to light. That also means freedom in knowledge use and participation, and education both formal and informal. What's more, we need to be able to tap into knowledge sets by way of interchangeable means in both larger and smaller economic settings, for the most efficient outcomes possible.

Rather than individual specialization (in less populated areas particularly), our primary choices for healthcare participation (alongside other areas of learning), could likely come from several areas that are of interest to us when we are young. In other words we can actually put our high school "classes"  - however they might be structured, to good use. Over time we would be able to utilize skills at different levels of engagement and priority, so as to coordinate with the multiple skills sets of other locals to perform many of the functions now associated with decades of learning. Plus, no more "down" time necessary (unless desired) just because of an arbitrary graduation point.

Intensive care of any kind especially needs to be approached in terms that allow community coordination with other ongoing economic activities. When entire communities are able to plan for healthcare in as many of its important aspects as possible, no one need bear too much of the burden, either financially or in terms of societal expectations. There are aspects of healthcare that are intuitive and ongoing, and there are other aspects that are needed in specific timeframes and careful specifications. This last designation is the one that could benefit immensely from both just in time knowledge use and careful evaluation of aptitude and potential on the part of all community participants.

Each of us has a unique capacity that is helpful in health based terms, and our actual possibilities for participation go much further than anything that exists in the health based options of the present. When we can all provide through our own unique capacity; time or resource cost, complexity and always greater choice are organic and implicit to the system itself. Whereas, under the current system, growth is perceived as a negative and choices have to be constantly pared back. The choice for a way forward is clear.