The Past Month Should Not Have Been Eye-Opening

This is a repost of what I wrote for SMARTMD in June 2020.

What we’ve seen, we’ve been seeing for centuries. With technology evolving over the past decade, we’ve seen it with devastating clarity, but the story is the same.

A person is killed because of the color of their skin. They are targeted because they are black. They are treated harshly because they are black. And, ultimately, they are killed because they are black.

We say “Black Lives Matter”, and we think “of course Black Lives Matter.” But, it’s not that simple.

The foundation of our county was laid and nurtured for centuries at a time when Black Lives were not a consideration aside from their value as chattel.  If this makes you uncomfortable, good. It should. It’s your humanity showing.

The issues of race in our country are deep and difficult. With many not even being aware, we have operated within a racist system. One where individuals of good conscience unwittingly perpetuate racist constructs. Think about things like standardized testing, financial redlining, policing techniques, or school financing to name a few. These things can’t be changed overnight. But, they must be changed.

The question many ask: “What can I do?”

The first thing we need to do is get comfortable being uncomfortable. The conversations we need to have are not easy. The realities we need to face can be gut-wrenching. For decades, people have avoided dealing with the issue of race because it is difficult. But, if we care as much as we profess, then the clarity of the story brought to our conscience by modern technology means we can no longer justify our inaction with falsely comforting thoughts like “it’s not that bad,” “it doesn’t happen that often,” or whatever other narratives we’ve clung to. It is that bad. It does happen often. It does happen in my town.

The next step, keep (or start) talking. Getting to know people and their experiences is an important step. Empathy is a powerful motivator. But, you have to be exposed to the realities of others. Conversations are the gateway to understanding and empathy.

By engaging people regularly, each conversation becomes less difficult. Not because the topics get easier, or we become numb. It gets easier because we get to know people better, more deeply, and our motivation, our empathy gets stronger.

These hard conversations, the ones that make you uncomfortable, also make you stronger. They make your connections stronger. They give you the strength and motivation to do what’s next.

When you see something, say something. Inertia is tricky. Little things can lead to big things and this goes in both directions.

Letting things go, whether off-handed comments or plainly racist comments, gives tacit permission to the speaker to continue to speak (and think) in racist terms. It gives others who hear permission as well. It gives other listeners (and yourself) permission to accept the unacceptable.

Addressing things as they happen drives the wave in the other direction. Perhaps the speaker will check not only their words but their thoughts going forward. For those who hear and say nothing out of discomfort or fear, they will see that they are not alone. They will see that we can challenge the thoughtless or outright racist comments.

In numbers, there is comfort and courage. But, someone has to initiate the wave.

Do Something.

This often trips people up. We get tied up because we don’t think there is much we can do. We think the problem is so big, no actions we take will affect anything.

The problem is big. It is ingrained. It is going to require us to overcome inertia to make things happen. So, don’t start trying to move the whole mountain. Use what you have, and start there.

The Vote

We all have the power of the vote. Use it. Be aware of candidates’ positions on policies and institutions and vote for those who align with your beliefs. Policymakers have to be on notice that racial injustice is not an issue that you will let get brushed under the rug.

Once you’ve voted, follow policies locally, state-wide, and nationally. Write letters, send emails, and make calls to encourage representatives to follow up on promises made. Don’t stop with the vote. Hold them to task.

The Workplace

There is no single answer to the workplace.

Some organizations do really well in promoting diversity. If you are fortunate to be employed in such a place, be vocal about it. Share your experience to encourage other companies to follow suit. Spreading the word about your company will show support for the policies and be an example for others.

If your company is lacking, bring up the topic. It doesn’t have to be contentious. Racial diversity, opportunity, and proactive policies are good for companies. Broach the topic with management or human resources. Have specific items that can be addressed, and be prepared to participate in creating the solutions. Don’t just complain, help with positive actions.

Social movements

There are organizations in almost every community that you can join to help publicly promote policies, address social issues, or help disadvantaged groups. The extent of your activity will be based on the organization’s mission and your role. Look for those whose focus aligns with your passion.

Want more ideas? Here are some real-world examples from around the country…

From every level, people are taking action. From pointing out issues to creating programs to directing investments, we are seeing actions all around. These aren’t all monumental steps. But, they are all important steps.

  1. Point out areas that need to be addressed

harvard medschool protest

Medical Students Highlight lack of diversity and mistreatment.

LaShyra Nolen, a first-year student at Harvard Medical School, works to bring mistreatment to the forefront of the administration’s priorities.

Read more..

White Coats for Black Lives.

In Indianapolis, and elsewhere, White Coats for Black Lives, brings the message to the street. Working against police brutality, and the healthcare disparity to which minority communities are subjected.

Read more…

2. Create programs for the disadvantaged

Leading the way to bring healthcare, and health education to Houston’s poor communities, Ashley Howard works to end the health outcome disparities in minority communities.

Read…

Standardized testing has a bias against poor & minority communities, making entry into the healthcare profession difficult.  Monash University has developed a program to address this by relying more on interviews and personal traits to determine entrance to the program.

Read more…

3. Directing investments & marketing

We see some civic and company leaders taking a stand. Some are driven by their conscience. Others, by the market (why #1, pointing out issues, is so important). Here are some examples of money talking and leaders directing.

Major companies that have long supported racist brands are finally coming to terms with overdue change. And so is the public that has long accepted them. Though too long in the making, the tide is turning and companies not willing to face the uncomfortable truth will find themselves on the wrong side of history.

Read more…

Access to capital is a challenge for any business. But, Black-owned businesses have an exceptionally hard time getting loans, and the loans are at a higher interest rate than their white male-owned business counterparts. Civic leaders and local business communities are taking steps to rectify this issue.

Read more…

4. Being a thought leader/voice

There are people who have only their voices, but they are powerful voices. You don’t have to be a celebrity or national figure. Local voices initiate change that can become national. Little things lead to big things.

Dan Dunlop speaks up on the health outcomes disparity that is based on race and calls on us to change. His white paper is an example of the growing chorus calling for change.

Read more…

Marcus Whitney, a Nashville based healthcare entrepreneur, calls on other healthcare leaders to lift up Blacks among the ranks of senior executives and investors. As a leading Black investor, his voice is sought out and heard.

Read more…

Final thoughts

Racism has lived long in our country. It has done so because too many people have been too afraid to speak out, to have conversations, and to speak their hearts. We can be better than we are. We can be what our hearts and souls know we should be.

Perhaps the past month has been eye-opening in some way. We have seen more courage from quarters that would have been silent just a decade ago. We have seen a force that challenges the inertia of systemic racism in new, and profound ways.

Our streets are filled with people of color and white people in the same group, not on opposing sides. Though not enough, we did see areas where law enforcement put down the shields and weapons and joined demonstrators in the streets. We are seeing companies take a stand with the people. We are having large, public conversations, and small intimate conversations about race and our responsibilities in correcting the wrongs.

The tide of racism is still on the move. But, many have joined the opposing movement. Though small at the moment, we have glimpsed it’s power to make change. We have seen that we can stand against the racism ingrained in our systems, and even instilled in our own thoughts.

As we continue the conversations, the small steps, and perhaps even some big steps, we will see the number of people joining the movement against racism grow. It will lend courage for others to follow. Solutions will not come swiftly, but they will come.

Paths that come together

Your happiness depends on no other; the responsibility is yours alone.

But recognize when your path to happiness joins the path of another, that is when the magic happens.

The highs are much higher and the lows are much softer.

Where these paths join together is where love happens.

AMA Argues Against A Single Payer System

Medicare For All is a hot topic. To be clear, this is not a health care provider debate. It’s how health care is paid for, a single-payer system. These are two different (though related) things.

The AMA is against Medicare For All. The primary reasons for their opposition as they stated are:

Lack of choice for patients

Higher costs (taxes)

Choice.

The vast majority of us do not have choice in the current system. Our insurance companies dictate to us who we can see, what they can do, and how much we pay. In many places, we do not even have a choice of insurance companies. For our family, the only company in our area is BC/BS. That’s it.

We don’t really have a choice of services. When my doctor said I needed a brain MRI and a neurologist, I had to wait for a week before the insurance company to evaluate and give permission, then I could schedule the MRI. Think about that. Even our doctors’ choice in the course of diagnosis and treatment is subordinate to an insurance company’s dictates.

Cost

Taxes will go up. They’d go up as a replacement for our premiums. For our family, our premiums have just about doubled over 3 years, and we cover one less person. The argument against Medicare for All based on the idea that a single-payer system will cause an increase in costs assumes that costs have been steady with insurance companies. For most people, they haven’t. And for many that have, stable costs are the result of their company increasing the support, not stable prices.

In addition to skyrocketing premiums and higher deductibles, surprise medical bills are appearing all over the place. Some small, some huge.

Costs have been going up for decades. Since the ACA, insurance companies have had a stranglehold on our medical payment (and decision) process

If the AMA doesn’t want a single payer system, that’s fine. Their organization, their policy. But to argue that we’d “give up choice” when we don’t have any choice, or that costs will increase when they’ve been increasing dramatically under the current system rings hollow.

 

https://www.chicagotribune.com/business/ct-biz-american-medical-association-medicare-for-all-20190610-story.html

Brexit – the empty bucket

Brexit
 
A bunch of guys (politicians looking for an edge) got together and decided to convince the British populous that all their problems could be blamed on someone else… the “them.” And, if they simply pushed “them” out of their lives, everything would be great.
 
But, along the way, they forgot to mention all the things the “them” were doing for the populous.
 
And, another but, they didn’t actually have a plan to replace the “them” once they were kicked out.
 
The populous, moved forward by stump speeches, catchy slogans, and empty promises of a universally better life, agreed. They told the “them” to go screw off.
 
What did the bunch of guys do?
 
They sh!t their collective pants. “We won? The populous bought this crap? What do we do now?”
 
What they did was quit. Figuratively and literally, they, to a last, just quit.
 
Theresa May was left holding the bucket of emptiness trying to fill it with stuff that just doesn’t exist.
 
There are no simple answers to happiness or a better life. Most certainly the answer is not “them”.
 
 

Pork industry safety to be more self-regulated

The current administration is shifting the responsibility in the pork industry for food safety from the regulators to the companies.

The Obama administration made a similar move with poultry.

There is an interesting difference between the American perspective and the European perspective.

In the US, policies tend to be a “wait and see” if the industry will do “it”, whatever “it” is (be safe in this case).

In Europe, policies assume companies won’t “do it,” and enforce more regulations, or take action.

In Europe, before drugs or new foods are approved, they have to be proven safe. This is a burden on the companies.

In the US, drugs or new foods are more likely to be approved with lower/no safety standard and then pulled once proven to be dangerous. In other words, people have to get sick or die before the burden shifts to the company.

As a general mindset, the recent events with the Boeing 737 Max are a good example. The rest of the World grounded the plane immediately (nearly) until it could be proven safe (still hasn’t). The US waited as long as it could, until pressure was too much, to ground the plane.

As a priority, the US wanted to lessen the burden on the company where Europe wanted to protect the people.

In the US, we assume:
1) That companies have the same rights as people
2) That companies operate with a conscience and they won’t hurt people (perhaps because they are run by people?)
3) That business growth is the most important thing

With this as a premise, it is easier to accept a loose regulatory environment.

Unfortunately, history shows that companies are willing to literally kill people to expand profit. From the dawn of the industrial age to today, this holds true.

– Slaughterhouses in Chicago ca 1900
– Railroads importing and abusing immigrants 1850-1900
– Mills in the Northeast and East.
– Mines throughout the Southeast, even today
– Superfund sites across the country (residential areas too polluted and now abandoned). 1950-1970s
– Koch bothers pipelines blowing up and killing people
– Firestone 1996-2001, hiding defective tire issue (270 dead)
– Enron shutting down access to electricity in CA to drive up prices.
– Mortgage companies knowingly writing fraudulent loans and literally initiating a worldwide economic meltdown.
– Epipen hiking the price of life-saving drug 5x with no cost-basis, just profit.
– Pharma increases the price of insulin for greater profit.
– Boeing wanting to keep planes in the air despite knowing there was a lethal problem, even after a crash and many reports of problems.

These are just a few that I am aware of. Some were cases of people deliberately planning or covering up. Others were done in the name of profit over people.

Perhaps the pork & poultry industries will do a fine job self-regulating the quality and balancing profits w/ safety. Unfortunately, we won’t know until people get sick or die. Our own history shows us that we’re likely heading for trouble.

Europe passes online copyright rules, benefiting large publishers (they think)

Venture Beat published this article about the liability of linking to publisher content (or anyone’s really).
 
Two issues with the law
According to the new EU rules, which must be adopted by EU countries by 2021, sites must pay publishers to publish excerpts of their content.
 
Okay… not sure how much constitutes an excerpt. But, I get the notion. These are their words, creative property. If you can’t come up with your own words, then you shouldn’t take someone else’s (? even if you attribute it?).
 
But, here is the real kicker…
No Linking Without Payment
They have to pay them to even LINK TO THE CONTENT.
 
Under the copyright rules, as explained in the article, this very post that you are reading violates the new EU rules even if I don’t have images and the article title included, the very hyperlink above makes it a violation.
 
If this same content appears on Facebook,  I am not to be held liable. Facebook (or any other platform) holds the liability. 
 
Neutering the Internet
Google’s search platform is rendered as one huge copyright violation, as are virtually every social media platform or other search engines.
 
This law is akin to removing all the highways from the continent, disabling GPS, illegalizing printed maps, and then telling people to find their way to… anywhere.
 
Left as is, this law essentially means you will only find content that you already know exists and where it is. It kills the sharing of ideas in any broad sense. 
The Beneficiaries
One of the proponents says this says the rules modernize the internet. I am not sure how that conclusion fits. This ruling effectively negates the very core function of the internet and does so in the name of large publishers who simply could not keep up with the changing times.
I also wonder how shortsighted this is. Do the proponents/publishers believe Google or Bing users will simply come directly to their sites to find content?  If they dismiss the traffic driven by social media and search platforms as trivial, then why is the rule even necessary?
If this rule is not overturned, the biggest proponents will likely be the biggest sufferers in the short term.

Coffee Inhibits Prostate Cancer

More good news for coffee drinkers. This article in the New Atlas tells us that drinking coffee has been linked to a reduction in prostate.

The findings come from a study presented at https://uroweb.org/ conference in Barcelona. There are two compounds that the researchers linked to the effect of inhibiting prostate cancer in animals.

But, this aligns with observational studies over the years that have appeared to show a connection between coffee consumption and lower growth for prostate cancer in humans.

Coffee may reduce risk of lethal prostate cancer in men

https://www.sbs.com.au/news/study-finds-italian-coffee-cuts-prostate-cancer-risk

 

https://newatlas.com/prostate-cancer-coffee-compounds/58896/

 
So, drink up coffee lovers. You have one more reason to enjoy your morning brew.
 

Illinois to be First State to Tax Human Waste By Weight

Illinois legislators are taking up legislation to tax human waste.

The proposed measure will tax households based on the weight of the sewage discharge. Weight and consistency will be analyzed with new “smart waste sensors” installed at the junction where each residence waste discharge pipe joins with the municipal sewer system.

The legislation calls for the sensors to be installed by the fall of 2021. While the installation job will be put out to bid, the estimates range from $2 billion to $6 billion. A special Bond issue is expected to cover the cost of the new system.

When challenged about the effect of additional taxes on Illinois residents, the bill’s sponsors said the tax burden can be reduced quite easily by simply eating less. One legislator went so far as to suggest that taxing human waste will lead to less eating and healthier residents, therefore they are doing residents a great service by taxing their waste.

A satirical article on a fictional tax so close to our experience that people should be forgiven for believing it is real.

The Economy: The best thing the president can do is stay out of the way.

In the image, there are
– 3 ways of looking at unemployment
– The GDP
– Federal Budget Deficit

Since 2010, things have been improving.
The trend line from Obama through Trump term to date is steady.
The only difference so far is the deficit.

While the budget deficit can be, and is, drastically affected by the administration at the time (along with Congress), the economy does not follow nice, neat 4 year increments.

The presidents are neither to blame nor to be credited with the economy in any short period of time.

It is us, the American people who are responsible for the economy.

The best thing the president can do is stay out of the way.

BTW, the stock market is a terrible metric for our economic health. If it were a good metric, we would not see the bubbles or rallies and inexplicable big drops. The market is a speculators world and goes up and down accordingly.

economy

Administration changes formual for drug payments. Its not enough.

The Government, despite being the largest payer for meds, does not negotiate price. We simply agree to pay the average going rate in the U.S.

We passed laws that prevent the Government from negotiating drug prices in Medicare and Medicaid. Guess who pushed that law?

Since the U.S. has the highest drug prices in the world, the Gov pays a lot (we pay a lot).

The Trump administration says it plans to change how Medicare pays for some expensive drugs to bring the costs more in line with the prices paid in Europe. This is a good first step.

But, we are only factoring in their costs, not trying to meet or beat it. For a country that says “we always win”, this sounds like we’re giving up pretty easily.

This has been going on for decades now; Rep and Dem administrations and Legislatures. The drug companies got their law, and “our” representatives seem fine with it. Yes, they complain about drug prices, but they don’t take the very simple step of overturning the 2003 law (or at least part of it) and allow the biggest payer of drug prescriptions to use its power to lower the cost.

“For decades, other countries have rigged the system so that American patients are charged much more,” President Trump said Thursday

While the president says other countries “rigged the system” (in his tendency to play the victim), the reality is that the U.S. removed itself from the equation a long time ago.

The proposed changes are small but more than we’ve done before. I only hope it leads to someone taking up the next step of letting the government negotiate the cost of the drugs for which we all pay.