War is Not Healthy

Today marks the 5th anniversary of the Iraq war. Although no official body has kept count of the total dead, it is estimated that up to one million have lost their lives in Iraq during this time. Almost 4,000 American soldiers have been killed and 60,000 have been injured in combat or in what have been deemed non-combat accidents or illnesses. No one knows how many troops and Iraqi civilians have been exposed to depleted uranium that seems to act as a ticking time-bomb in their bodies.

The physical and mental health injuries will cause pain and suffering for years to come for American soldiers and those who love them. As a psychotherapist I have treated many people with post-traumatic stress disorder, mostly from early abuse. I know the suffering they endure for years before they find help and heal. Reports that the military downplays PTSD and that there are long waits to receive help for it from the Veteran's Administration hospitals and clinics trouble me immensely. At the very least this nation can and should support our wounded troops to recover from their injuries and heal from their wounds. Such support should be available to each of them and include support to their families as well. It is the least we can do.

I cannot even imagine the situation of the people of Iraq. This war has done a better job of terrorizing that population than Saddam ever thought of doing. Injuries, PTSD and a generation of orphans and refugees are what the war has brought to the people. If the reports of the health consequences of depleted uranium are anywhere near accurate, the damage will extend to unborn generations of Iraqis and also to the children of Iraq war veterans of the United States and its allies who have served there.

Stop this war now! Bring war criminals and profiteers to justice! Heal the people and the land harmed during this war by providing health care, and economic assistance/reparations, and pledge "never again."

See other blogs posting in opposition to the Iraq war at: http://march19-blogswarm.blogspot.com/

The Health Care System is Complex

I have been researching the issue of health care recently, as readers may know. It all started with the "unbinding" message of the story of Lazarus, Jesus and the role of the community. This issue has so many tails and tales! In this post I try to sort out a few tails to grasp to begin to understand how it could happen that all would have health care when they need it.

The first tail. Let's begin with the person who needs health care. This person has to know that they have a need, that there is someone/somewhere to meet their need, that they can actually receive services to meet their need and that they can afford the care. The person also has to know what they can do for themselves and what they cannot.

Yesterday, I heard this story. A woman of about 65 years old who has a very low income receives health care services from a local clinic. She recently had what was probably influenza and has ended up quite ill with a sinus infection. She called the clinic and told them that she is very ill, too ill to use public transportation. (She doesn't have a car.) She asked them to prescribe antibiotics for her. The clinic refused and said they needed for her to come in. She said she was too sick. There was an impasse. The clinic does not make house calls. Taking an ambulance is not an option. The woman resists the idea of paying cab fare, because she is so poor. She is angry and feels left out of a system that she views as uncaring.

However, in our area there are non-medical transportation services, potential volunteers to drive people to medical appointments and agencies that would probably pay for cab fare in such a circumstance. However, this woman doesn't know how to access any of these services. Moreover the clinic receptionist did not provide that kind of information, and perhaps didn't know that information. Nor did the receptionist connect her with someone in the clinic who could help her access those services, listen to her distress or help her find a solution to her dilemma.

The second tail. Service providers, whether they are clinics, hospitals, wellness centers, individual practitioners or group practices, whether they are completely medical or integrative health care, for- profit or non-profit, large or small, all have a multiplicity of pressures and demands to satisfy. There are governmental licensing requirements, professional standards to meet, cost pressures both like and unlike those of any other business, competitive factors, and the need to make enough money for a surplus (whether that is called 'profit' or not).

As an example, let's take a local clinic which provides training to medical residents, and which treats many low-income people. It is not-for-profit, and has a well-trained medical staff, most of whom have been at the clinic for many years. This clinic receives much of its funding from insurances, the medical assistance program and private pay. It also receives some support from educational institutions which place trainees in various disciplines there for internships and practical experience. This clinic has had to cut back in some "non-essential" services because of budgetary constraints. It must generate some kind of surplus from some source if it is to incorporate anything new or improved, as it must have the funds to add staff, equipment, technology or space. Whatever is required to make the improvement will cost money.

The third tail. Health care financing is perhaps the tail that wags this dog. It is this tail that requires the making of difficult decisions by those who need health care services and those who provide them. Health care financing comes from many different sources: out of pocket private pay, health insurances through employment or private purchase, governmental programs such as medical assistance and medicare, private foundations, and local governments. There is considerable debate about what needs to be done in relation to health care financing to increase access to health care services and to provide sufficient revenue to service providers so that they will continue to provide those services. Further, there is much discussion about how to reduce health care costs within the whole complex system. United States health care costs are extremely high, and health outcomes are fairly low compared with those of other industrialized nations.

The fourth tail. Governmental regulations specify who will be covered for health services paid for by government funds; who can provide health care services at all, and under what conditions; and how the various funders must conduct themselves. There are governmental regulations regarding health care services, providers and funders at all levels of government: local, state and federal.

The fifth tail. Health care information and education is provided to consumers by an array of service providers, public agencies, the media, and governmental organizations. Professional training in providing health care services takes place in colleges, universities and technical colleges operated by governments, private non-profits, church institutions, and foundations.

The sixth tail. Health care knowledge, technology, information and mystique also play a role in what health care consumers know and want, what service providers make available, and what funders will pay for. There are some fairly strong trends towards, for example, use of complementary, supplemental, integrative or alternative therapies, much of which consumers are paying for outside the usual health care financing system. Health care professionals are increasingly being trained to offer or to work within integrative systems that include alternative health care services such as massage, therapeutic touch, herbalism, energy healing modalities, hypnosis, acupuncture, etc.

Image is from http://necsi.org/projects/mclemens/viscss.html

Healing and Health Care for All

Since the dawn of human consciousness, it is likely that we human beings have turned to healers when sick or troubled in our minds. Through long prehistorical periods up to the present day, the healing arts and sciences have continued to develop, elaborate, fragment and be brought together again. In my own community, I know people who are dedicated conventional medical personnel, alternative healers using energy healing modalities, and those who bridge the body/mind/spirit divisions and whose very presence brings comfort.

Within my community are huge health care non-profit corporations which are big business for a relatively low-income area. Oddly, our medical/health care costs are high compared to other states and other parts of our state. But, we also have a free health clinic, started by a few dedicated people and staffed by hundreds of volunteers over several years.

I have a friend who received care from the free health clinic for years. Finally, her high blood pressure and diabetes destroyed her kidney function. Then she was able to get on medicare because she now had end-stage renal disease. At the time she was going to the free clinic, she was so grateful to it and to the doctors who volunteered their time. She and others would stand in line for hours, waiting for the clinic to open because there were so many people needing to be helped, and only a certain number could be admitted, first-come, first-served. Now, my friend goes to dialysis three days a week, and each time she goes, it takes about 3-4 hours. It can take a lot of time and energy to be ill. I am so glad she has more comprehensive health care available to her now, but so sorry she had to get to this point in order to receive it. I can't help that feel that if she had had good access 15 years ago, perhaps she would not now be "end-stage."

In my practice as a psychotherapist I listen to people who sometimes talk about their experiences with the medical health care system. Many of them speak of doctors and nurses who don't listen to them and don't pay attention to their reports of pain or other sensations that aren't "quite right." They feel disregarded and simply "pushed through the system." Others, who are nurses or doctors, talk about the pressures they experience. They are expected to see more and more patients in less time, while also learning more complicated ways of recording medical data, and keeping up with the latest medical advances.

How can all this be different? How can the focus become a focus on healing? Not a focus on medicine per se or on shaving off dollars from patient care so as to afford the latest in medical technology. How can all the various people involved become more respectful of each other, and more aware of how they are being perceived by others in encounters that could be healing encounters? How can those who in health care systems who are not involved in direct contact with patients know the consequences their decisions have for the patients their systems serve?

Jesus was a healer. His disciples were commissioned to go out and teach and heal also. Early Christians seemed to take for granted that they would engage in healing ministries and provide for the sick. The development of healing practices in the western world was based in spiritual communities. Both Christian and tribal cultures contributed knowledge and methods of providing healing. Many hospitals and clinics still have religious roots. Let's explore how these roots can be strengthened and the systems unbound from concerns for wealth.

How will we unbind each other from the strangling bonds of unhealthy habits, ill health, sickness, lack of access to health care and unhealthy systems of dollar-driven health care delivery? Over the next few days, I'll be looking for models, solutions and suggestions. Then I'll let you know what I find out.

Unbinding

"Unbind him and let him go. Unbind her and let her go." So, quoted Reverend Lynn Scott at Sunday's Taize worship at First Congregational. She went on to point out that Jesus says this to the gathered community. At Painted Prayerbook, (www.paintedprayerbook.com) Jan Richardson makes the same point:

"Jesus enacts Lazarus’ raising, but he does so in the context of a community. Jesus calls Lazarus forth, but he calls upon those around Lazarus—sisters, kinfolk, neighbors—to unbind him and let him go."

The idea that we of the community are required to unbind our brothers and sisters from those things that bind them in "death in life" resonates within me like a deep tolling bell or a slow but insistent drumbeat. If we have been commanded, certainly we will receive the power to do what has been commanded.

We could unbind people from their bonds of curable diseases - think of access to health care for all. The bonds of economic exploitation could be unbound and people set free - think of the "cheap labor" of undocumented immigrants and labor camps "offshore." And then there are those pushed to the margins of society by disability, discrimination, poverty or illness. Think of those who are homeless, or those who live in "elderly/handicapped" housing, who could be unbound from their isolation and their experiences of being unloved or simply not even seen.

In such unbinding, we as a gathered global community would provide access to health care for all, living wages and freedom from hunger and homelessness, a joyful community of care and celebration for all of us. There are models for each of these kinds of unbinding. In the next few posts, I will write about some of them.

Alms

I looked up the dictionary definition of 'alms' today. It was quite interesting to note that the word's etymology links back to the Greek word, 'eleos' meaning pity and related to 'eleemon', meaning merciful. The Merriam-Webster online dictionary defines alms as: 1. archaic : charity, and 2. something (as money or food) given freely to relieve the poor. www.merriam-webster.com/dictionary

Several religious traditions either advocate or require almsgiving as an obligation of belonging to that tradition. Wikipedia has a good discussion. www.wikipedia.org/wiki/Alms
As a Christian, I've been told about tithing, giving to the church and so forth, and I've read and heard about the plight of the poor both here and globally for all of my life. Yet, in recent weeks the sufferings of those who are poor, or disabled, or sick and in want, have been on my mind so much more. I think it has to do with something changing inside me. In the past, part of my response to "the poor" or "the least of these" has had to do with feeling guilty for not being among them and for not doing enough for them. In my thinking and feeling now, it isn't about guilt as much as it's related to 'mercy' - that quality of desiring to alleviate suffering itself. My gut twists, thinking about how it would feel (or has felt) to be homeless, hungry, ill, or abandoned. I don't want to alleviate suffering so my gut won't twist, but because it is suffering.

Perhaps this all has something to do with my main prayer these days, often called the Jesus Prayer. "Lord Jesus Christ, son of God, have mercy on me a sinner." So much of the time I end up focusing on that word 'mercy.'

Jesus clearly had a great love for those who were poor and outcast. Responding to their needs and suffering filled his life of teaching, healing and prayer. As the risen Christ has sent the Spirit of love and mercy to all creation, my prayer is that I may be given grace, strength and wisdom to follow in the steps of Jesus. I am looking at where and how I can increase direct giving, whether I can shift my therapy practice to accommodate more people of less means, and how I can better work for social justice, as injustice vastly increases human suffering.

And, may all who are able, also be aware of where they can make some small inroads in the suffering of the world.

Death? or Life?

This says so much! What do we want to buy with our tax dollars?

http://www.youtube.com/watch?v=Wnq6cD5jk1Q