Healthcare in the U.S. is a prime example of missing markets for lower income groups. Nevertheless, more than costs are at stake, since other income groups with greater access to healthcare are still dubious about its actual value. Texas ranks highest in limited healthcare access, where in recent years the uninsured are approximately 17 to 18 percent of its population. I am among them since Medicare in the U.S. (which is gradually transitioning to private insurance) is becoming more costly and less predictable for retirees - regardless of income. However, once I retired, I started setting aside money every six months in the event of future healthcare emergencies, rather than paying Medicare premiums.
For many healthcare consumers, careful budgetary responsibility means a high level of frugality regarding any kind of professional assistance. People still believe that healthcare is important, but some of what is missing now, is a matter of regretful consumer choice. How is any of this rational? Two issues in particular stand out: What have people come to expect in terms of healthcare, and how have those expectations fallen so short of the mark? Even though much healthcare dialogue is framed in terms of costs, the very nature of personal interchange in healthcare activity is crucial as well.
Meanwhile, many individuals increasingly take a personal management approach to healthcare, in hopes of successfully addressing whatever problems might arise. While this approach can be successful, it does has good and bad aspects. The good - of course - is increased personal responsibility for one's own health prospects. The bad? Alas, there are moments in life when it's not feasible to arrive at a clear diagnosis. Worse, there are emergency situations when we are in no position to tend to ourselves without assistance from others. Yet not all nations are fully committed to this elusive ideal of mutual assistance, or even the importance of community in general. Unfortunately, both happen to be the case in the U.S. Hence we are approaching the point where there is insufficient monetary support for healthcare's existing institutions. As the reality of this starts to sink in for healthcare professionals, perhaps they will eventually try new approaches for the preservation and use of vital knowledge - at least one can hope.
Personal healthcare management is an unalloyed plus. For one thing, consumers and patients have far more time to dedicate to preventative maintenance than do physicians. Also, there's no "one size fits all" for decision making in applied knowledge. Each individual is unique in their personal makeup and approach. Likewise, consumers can maintain personal healthcare histories, and at the very least, AI might be able to do so in the near future. After all, AI is not subject to the same time scarcity constraints as are healthcare professionals. Also, as patients age, they tend to devote much more time to healthcare self management than is generally necessary in one's younger years. In all of this however, traditional media can feel insulting when reporters and journalists stress the dangers of self diagnosis and personal care outside the attention of professional physicians.
If only personal management were enough to take care of healthcare issues. Instead, sometimes our survival depends on the help of others, even if we cannot afford it or worse, end up belittled by the processes involved. For instance, several years ago, an ambulance crew convinced my father to ride to the hospital after a bleeding episode to make sure everything was okay, only for my father to be berated by the physician who complained his time had been wasted. Instances such as this are why people think twice about help in dangerous situations, since one seldom knows whether mutual respect is feasible. People would likely feel better about mutual assistance as taxpayer obligation, had societal skill levels not become so extremely unbalanced. There will be no institutional reform, if possibilities for mutual respect aren't somehow restored.
Finding better balance in skills levels between individuals, means finding ways to make our time value economic in markets for time based services. How do we create mutual interdependence which is also economic in nature? I get that physicians and other healthcare providers no longer have sufficient time for their patients. In all fairness to healthcare providers, healthcare today shares similar time product scarcities with other secondary markets for applied knowledge. The biggest problem in this regard, are situations which call for mutual time based interaction, yet too few groups in society are able to effectively coordinate the skills involved. Further, additional layers of management in too many instances, cannot make up for time scarcities in crucial skills. Instead, excess management often adds needless complexities and costs, not to mention lowered ability for providers and recipients to find reciprocity in their interactions.
Without direct relationships in time based assistance, societies are losing their ability to effectively manage the demand and supply of time based product in the marketplace. These losses could explain much of society's current dissatisfaction with its existing institutions. Despite this disillusionment, getting down to specifics regarding how to move forward in common purpose, is proving to be the hardest part. Neither experts or laypeople are in a suitable position to implement institutional evolution in the 21st century.
Though this is one time when solutions are not about "appropriate" credentials, even professionals tend to be criticized when they step out of their immediate domain of expertise. In this environment, how is it even possible for outsiders to be taken seriously? As it turns out, social media gives plenty of permissions for wide ranging complaints regarding why things go wrong, whatever that may be. What social media hasn't been willing to do, and what particularly disappoints me, is its lack of online promotion for suggestions as to how problems can be addressed. We simply can't can't afford to hide anymore from the specific hows of institutional change, despite the fact they are unbelievably difficult and frustrating to confront. For a while, I'd also become reluctant to write about how. But I can't hide my head in the sand any longer.
