Showing posts with label health care. Show all posts
Showing posts with label health care. Show all posts

Thursday, March 12, 2020

A pandemic is not a deliberative moment

As I shift my teaching this semester from face-to-face to online (thanks Zoom!), I'm thinking about the learning opportunity that comes when you're teaching about dialogue and deliberation theory. Foundational to deliberative democracy is the idea of citizen participation and engagement with a wicked problem that requires people to wrestle with the tensions and trade-offs on a particular policy decision.

While there are many reasons engage people in decision-making processes that inform an appropriate response to this crisis as it relates to the distribution of resources, COVID-19 is not a deliberative problem. Instead, it is a classic example of a technical problem. It's helpful to remember that "technical" is not "simple." This pandemic is an urgent and technical one. So when we're thinking about something like public health, it's important to defer to expertise within the particular domain. It can also highlight how technocratic approaches can be very helpful in such challenging times. The example from Iceland is something many other countries could benefit from.

In short, there are times when deliberative processes are essential and necessary. And, as is the case with our current pandemic experience, advocacy for informed public health strategies based on expertise rather deliberation is the way to go right now on this particular issue.

Finally, make sure to wash your hands and don't touch your face!
from Coronavirus GIFs via Gfycat

Friday, January 20, 2017

In the midst of a new community in the Big Red Barn with Obama

Cornell University's Big Red Barn
In January 2009, I had just started my PhD program at Cornell University. In December 2008, I completed my MPA degree at the University of Dayton and made a winter move to Ithaca, New York. As someone starting an academic program mid-year, I was out of sync with most people. I didn't know others in my program well at that point. Like most of us have experienced some point in our lives, I had a sense of being in the midst of the unknown.

The inauguration of President Obama was a big event. The university had a watch party in the Big Red Barn (BRB), an old carriage house for the university president turned into a graduate student center. It's a great place for various events like the ever-popular T.G.I.F. (Tell Grads It's Friday) with $1 beer and snacks. So, just a few weeks after moving to a new place I was standing in a very crowded BRB watching President Obama be sworn into office for his first term. Many people were emotional. The gravity of the setting and situation spoke to what I recall being a very diverse crowd. What typically was a loud and lively space was celebratory yet solemn that day. I think people realized how significant the moment was for our history and for our future.

I was excited for my own new adventure at Cornell and beyond in the academy, but I was also excited and inspired by the possibility and promise of a democratic life that was/is engaging, meaningful, and inclusive of people from all walks of life and backgrounds. I saw a bit of that diverse America standing in that wonderful gathering place known as the BRB. We would walk out later in our varied directions via snow-worn paths to return to labs, offices, and classrooms. We had a charge and I feel that many people saw themselves as part of something larger that day.

President Obama's inaugural speech acknowledged the many crises we faced at that moment--terror networks, economic catastrophe, rising costs of health care--but he asked us to grow up a bit and choose a better path. In his words:
On this day, we gather because we have chosen hope over fear, unity of purpose over conflict and discord. On this day, we come to proclaim an end to the petty grievances and false promises, the recriminations and worn-out dogmas that for far too long have strangled our politics. We remain a young nation. But in the words of Scripture, the time has come to set aside childish things. The time has come to reaffirm our enduring spirit; to choose our better history; to carry forward that precious gift, that noble idea passed on from generation to generation: the God-given promise that all are equal, all are free, and all deserve a chance to pursue their full measure of happiness.
And what might be more a historical footnote from that day in 2009 is the poem offered by Elizabeth Alexander, entitled Praise Song for the Day. It remains, to me, the most beautiful poem I know. I include it here as people amass in Washington, DC for the inauguration as well as the march to follow the next day. Alexander spoke of possibility and love. We need that more than ever.

Saturday, January 7, 2017

Yes We Can: People Share Their Most Memorable Moments from the Obama Presidency

As President Obama completes his second term, it is helpful to be reminded of the authentic and genuine commitment and compassion that shaped his politics. I don't think the White House will be this warm for a while.

Tuesday, September 13, 2011

When do we care?



Last night during the Republican debate, a question was asked about a hypothetical situation.

If a man who is 30, healthy, and free to make the decision to decline having health coverage suddenly needs intensive health care for an extended period, who is supposed to pay for it? I think we have a number of responses to this including something along the lines of "well, you should have insurance" or "it's your choice."

The CNN/Tea Party sponsored debate's audience would presumably take a position that was opposed to the idea that government might have a role to play in health care. To be very honest, I'm disgusted by the way we think of health care in the United States first as a market and only secondly as a way to ensure the health of our society. I think health care is a fundamental human right and making it something that is outside the role of the government is uncivil. But the response to this hypothetical question left me feeling even more aghast at what we're embracing as normal.

A number of individuals in the audience yelled very energetically that our hypothetic citizen of the United State should die. Is this what happens when we disconnect "freedom" from a shared sense of identity and citizenship? So many people today, especially those who identify as part of the Tea Party, claim they are returning to our founding principles. But what is glaringly absent from that partial reclamation is the commonwealth. Where is our concern for the other? Ron Paul mentioned that the "churches" should step up to take care of this man. This statement received applause. I would agree that civil society has a role to play in the health of a democracy and there is something about a religiously-affiliated hospital caring for those without because that is part of their mission and identity. But to lay that expectation on these types of institutions doesn't show me freedom of choice. What it shows me is that "freedom" often masks an ardent individualism that trumps care for the other. It's not about personal responsibility, it's about selfishness.

Sadly, such honest language won't appear during any of these debates nor will people admit that is what's behind their beliefs. We have a number of responsibilities to one another and health care is one of the most fundamental of those responsibilities. Sadly this hypothetical question is very real. And as we continue to see the poverty rate increase and businesses responding to this new disparity with novel approaches to marketing rather than appealing to the (now increasingly shrinking) middle class, maybe that otherwise healthy 30 year-old citizen has difficult choices about what's worth the investment of a smaller pool of wealth.