Tuesday, February 24, 2009

Sustainable American Health Care

Eliminating Confabulation
From The Issue
Of Sustainable
American Health Care



I am sick and I don’t want to talk about it, I don’t want to hear you talk about it and I don’t want to hear anyone else talk about it. I don’t want to hear experts on health care talk about. I don’t want to hear medical financial analysts talk about it. I don’t want to hear medical lawyers and medical lawmakers talk about it. I don’t want to hear medical educators talk about it. The reason why I don’t want to talk about it or hear anyone else talk about it is that for the many decades I have had to deal with my illness, virtually no one in the medical industry ever listened to me in the first place.

As I have come to realize that I know my body just as well as I know myself and part of what I know is that I actually do need professional medical assistance to solve what I consider to be the physiological problem I have with my body, those who think they know my body better than I have more or less come to the conclusion that while they may be medical experts, the capacity they have to actually celebrate that fact is hopelessly fumbled by the obsessively short sighted financial and legal bureaucratic expertise they were trained to focus upon instead of the actual medical needs of those they were supposedly trained to care for as medical architects whose entire life purpose is supposed to be dedicated to finding the solutions to the physiological problems I and many others have with our bodies here in America.

Why the practice of medical law and the practice of medical financial management has become more dominant than the actual provision of medical care is of course the dominant question driving America towards a much more conscious approach to holistic environmental healthcare, but, the fact that environmental healthcare continues to be only half heartedly addressed clearly suggests that we as a nation have many more miles to travel before we come to the realization that such concerns properly addressed will indeed reshape both the legal and financial management of our national health care model.

Having said this, I honestly don’t want to hear old ladies talk about their medical problems any more than I want to hear old men talk about theirs, I don’t as well want to talk about what is wrong with my penis and I don’t want to talk about what is wrong with a woman’s breasts. I also don’t want to talk about Medicaid. I don’t want to talk about childhood immunization programs. I don’t want to talk about A.I.D.S. I don’t want to talk about strains of influenza. I don’t want to talk about cancer. I don’t want to talk about Alzheimer’s. I don’t want to talk about exposure to radon. I don’t want to talk about upper respiratory ailments. I don’t want to talk about hip replacement surgery. I don’t want to talk about emotional problems. I don’t want to talk about psychological problems. I don’t want to talk about anything at all even remotely related to conventional American health care concepts as virtually everything that is discussed has absolutely no bearing whatsoever on the dynamic future potential of American healthcare.

In fact, until the dialogue on American healthcare invokes a remarkably broad and engaging conversation about the future of American architecture, the American medical community will remain an insolvent essay on its own financial and legal incapacity to view itself as a driving force behind that future. As within the future of American architecture is indeed the ultimate prescription for American industrial health, the moment we choose to view American healthcare professionals as the architects of applied and sustainable 21st century American industrial health will be the moment when we also focus on the construction of healthy American architecture. In turn, the moment we focus on the construction of healthy American architecture, we will as well focus on the sustainable physiological home environments that assure Americans that health care lawyers and health care financial analysts have successfully moved themselves away from institutionalized thoughts about health care.

In other words, the moment we remove lawyers and financial analysts as well as doctors from the hopelessly sterile, institutionalized environments of hospitals and allow them to walk freely into the communities they serve for the singular purpose of enabling them to become architectural advisors who are intimately involved with the design and construction of the very homes their patients live in, will be the moment we realize just precisely how mobile American health care can actually become.

As the real problem with talking intelligently about the ultimate portrait of 21st century American healthcare we as a nation are most capable of painting is of course the fact that portrait is still so remarkably intertwined and suppressed by our views on both 20th century healthcare and 20th century architecture, the real solution is indeed having a conscious discussion about how technological advancement in both the health care sector as well as the residential construction sector have moved both discussions into a far more advanced industrial and economic realm. Whereas our 20th century American healthcare model more or less embodied a refusal to address the positive physical lives we had the potential to live within 20th century architecture, the fact remains that living behind the closed doors of that architecture more or less assured that we would as well live behind the closed minds of American healthcare. As 20th century healthcare became the foundation from which our refusal to acknowledge we actually had bodies prevented us from creating architectural environments that would enhance the physical health and performance of our bodies, examples of forward thinking, technologically advanced and economically as well as environmentally sustainable American architecture were none the less brewing and maturing in our collective architecturally closeted mindsets.

Due to the unfortunate fact that the vast majority of American healthcare professionals still today don’t physically live in such forward thinking 21st century expressions of American architecture and the vast majority of their client base does not as well, we as a nation are collectively plagued by the much larger American social disorder of “mass erectile dysfunction”. As this disorder (dysfunction) is characterized by a monumental fear on the part of us all to embrace technology, our medical community does not in any manner whatsoever understand how to see the human body as a wholly organic physical mechanism that is of course intricately tied to the equally organic body of organic, manmade architecture we as an American society are capable of producing.

American architecture today is just as American healthcare is today, a field of remarkably diverse and remarkably broad and dynamic portraits of our equally remarkable capacity to see ourselves as master carpenters, master surgeons and master caretakers of an organic health care concept we as compassionate master visionaries are fully capable of producing for ourselves, our families, our communities, our nation and our industrial economy. Yet before we can collectively come to realize and embrace as a nation the remarkably positive dynamics of our collective potential, a blueprint that enables us all to see ourselves with all of our potential for actualizing industrial brilliance must first enable us to see ourselves as a society that is simply living an ordinary life. Benchmarked not by the extraordinary technological knowledge we have amassed but by our larger social ability to convey ourselves as simply ordinary, the moment we see ourselves as ordinary is indeed the moment when introverted social dialogue will be replaced by extroverted social, economic, industrial and technologically based medical accomplishment.

As far as I am concerned, architects from a variety of professional fields began the process of defining the organic mission of national healthcare more than forty years ago here in our America. Although we collectively today are seemingly in the midst of chaos when it comes to defining for ourselves such extraordinarily simple essays on our collective vision of health care, it is the complexity of varied architectural mindsets seemingly unattached from one another that are creating this chaos. Hell bent on defining what we as obsessively compassionate architects have mastered in our isolated fields, this chaos is a direct result of how hard we as isolated dreamers have unfortunately kept our selves isolated. None the less, conveying to all others in their own isolated architectural fields is today in 2009 paramount in finding an opening as opposed to a closure to our non isolated dreams.

In a nation of such remarkable potential, why now as we are upon the threshold of such remarkable medical and environmental breakthrough, do we consistently pester ourselves with the future portrait of Medicaid? It is because we have the potential to do so.

As I am one with a penchant for seeing how words play upon words and as I view all words as socially active architectural elements, within the footprint of remarkably brilliant examples of down home dialogue is of course the architectural dialogue of national healthcare.

Medicaid is an architectural word. In and of itself, this word has very little significance and in fact has come to represent here in our America a term that represents nothing other than a definition of social architectural confusion over the future of national healthcare as opposed to representing either a positive concern or proactive prescription for long term national healthcare policy. When the word Medicaid is included with other contemporary and socially relevant architectural words or terms such as health information technologies, or health facilities and applied medical research, this word takes on an entirely new architectural meaning. When the word Medicaid is combined with the word infrastructure, the meaning of healthcare takes on an entirely new architectural context and in doing so, a much more dynamic architectural element.

Within that architectural element, other words such as education and energy also come into play and in doing so serve to add highly specific architectural detail to the concept of national healthcare.

National healthcare does not in our nation today have anything at all to do with providing healthcare for every man, woman and child in America. Instead, it has to do with an evolving social consciousness that is more or less benchmarked in our ability to combine various architectural terms for the singular purpose of removing the concept of national healthcare from the mindset of being fearful of becoming sick and attaching it the much broader concept of both staying well and living well. In as much as each and every one of us do have or are fully aware of all sorts of health problems, the vast majority of these health problems have solutions due to the remarkable advancements in applied medical research. All of these advancements are most clearly environmental in nature.

While in the past we felt comfortable going to our doctor to complain about a certain physical ailment, today, the vast majority of these ailments do have a unique blend of medical, financial, technological and of course purely human architectural remedies all of which are quite monumental in scope as they are, purely human in nature.

If you were suffering from upper respiratory breathing problems in the past, a visit to your doctor would provide you with a pill or a medication that would relieve the symptoms of that ailment. While the symptoms would persist, there would be found a certain amount of emotional comfort in the act of being prescribed a pill by the doctor you had come to trust. Today however, the prescription of a pill has as much validity as financing a new car or refinancing an old home. As the pill is a panacea designed to hide a larger architectural (physiological) ailment, so to is the car an escape from that ailment as the old home refinanced for the umpteenth time, is not a remedy for the deeper longing we have in our American hearts to do something much larger with that home, something other than use its supposedly increased property value to pay for yet another pill.

Medicaid as the word actually implies, aids medics. It does as well provide some sort of aid for those in need of medics. Although it has certainly come to mean so in our America today, Medicaid is not medicine aid. As much as the larger goal of Medicaid was to provide some relative form of national healthcare, today it is nothing other than a convoluted set of revolving doors that once entered, bring to the hapless soul unfortunate enough to be caught in them, a lifetime devoted to the addiction of pharmaceuticals derived in large part from ancient architectural blueprints. The mantra for this ancient system of national health care was simple, spend enough time living on pills within the confines of your equally ancient architectural dwelling and sooner or later you would become healthy.

While living in such an environment you were essentially abusing your body, although you never actually knew you were. None the less you were financing a national health care system that rewarded you for doing so. As long as you went to work in an industry that was in all likelihood contributing to that illness it was okay just as long as you went to work, visited your doctor on a regular basis and of course, paid your taxes. In the 20th century, you were motivated by an assurance by your government, your employer and your doctor that eventually you would be able to retire. Once retired, you would be able to reflect upon the fact that the industry you worked in and the government you worked to support would indeed continue to support you as your doctor would in turn continue to assure that your health was in order. Abusing your body in the first half of your life was at the time, the American thing to do and you like everyone else did it well all the while knowing that in the second half of your life you would be rewarded with a retirement plan that was for a lack of a better term, made in heaven.

As time went on and the golden years began to actually reveal themselves, your government and your employer together with your doctor all of whom had been working diligently to assure that these years were going to be great, began to evolve their collective vision of that greatness and low and behold, life long prescription of pills and a subscription to Dysfunctional Architectural Healthcare Digest, the retirement magazine that highlights the potential of your 20th century American retirement dream were sent to you once a month in the mail.

The glossy pages of this magazine would of course be filled with all the remarkable architectural embellishments you had spent your entire life dreaming of but living entirely without in your 20th century home. Yet as the retirement dream of a retirement home went by the wayside of idle pill popping while sitting in overstuffed recliners, you found yourself becoming a medical statistic with an age stamp plastered to your forehead. Eventually, your response to taking pills and reading glossy magazines would be studied more than the actual physical illness that was ignored and the actual architecture you were capable of creating but failed to create in the first half of your life.

Alas, as your health diminished, your overstuffed recliner began showing signs of flat lining and those glossy magazines you had been collecting for years were now used as insulation stuffed into gaping cracks in your 20th century home, your journey beyond that home was always done in disguise. Heading out to see the doctor dressed in a trench coat and hiding behind dark sunglasses for the singular purpose of leaving your architecturally dysfunctional home only to restock the bathroom medicine cabinet, you none the less continued to contribute to the growth of America’s 20th century industrial economy. Fueling that growth was of course the home improvement items you read about for years in that glossy magazine that were now readily available for next to nothing in the discount stores America had come to worship. Residential home improvement products such as pill boxes, disposable diapers, light weight aluminum walkers, plug in electric foot massager’s, fully adjustable vibrating electric beds and plastic vases filled with plastic flowers sprouted across America’s bizarrely forming green economy.

At the same time all of this was happening to you the same was happening to your children and low and behold, due to your remarkable insight into America’s equally remarkable human condition, you were able to convince your children to invest in these home improvement projects knowing full well that if they did, the future of your good health as well as the future of the industrial economy you believed in would continue to flourish and all once again would be well in your America.

In your altered state of social overconfidence you decided that it was time to become a writer and of course, what you began to write about was sociology and genealogy. In journals purchased at the same stores that you purchased discounted home improvement products you began to essay the discounted versions of American life you and your ancestors were unfortunately forced to live but were none the less proud of. As time went by and you began to share with your children what it was you were writing in your journal, they began to use the insight into the words you had written for their financial gain. In no time creative commercial ad campaigns began to sprout up enticing an entirely new generation of home improvement consumers to shop for toothpaste, plastic sandwich bags, feminine hygiene products, aluminum walkers with built in cup holders, plug in room deodorizers and of course an entirely new generation of vibrating electric gadgets designed to alleviate everything from gallbladder surgery and kidney stones to sexual dysfunction.

All the while this was going on, the 20th century house you had built for you and your children and your grandchildren was being filled with more and more pages of glossy magazines that were continually being stuffed into the ever widening structural cracks that essentially turned your castle into an environmentally unstable wind tunnel through which radon, carbon monoxide, odors from deodorizers would blend with genealogical mildew growing for decades inside the walls mixing with the human sweat that dropped from bodies exercising once every nine months on electric treadmills tucked secretly away in closeted basement work out rooms collecting even more genealogical dust while also serving as convenient coat hangers for multiple generations of pillbox holding trench coats.

Watching the remarkably dysfunctional state of our American healthcare system and the economy that is supposedly designed to support our national healthcare policy continuously deteriorate, I often wonder what it would be like if people in America as a whole would begin to author journals filled with essays on growing organic tomatoes in one’s greenhouse, or living in a physical environment fully supportive of one’s whole life or whole health medical consciousness. What would it be like if the time spent in a doctors whole health medical clinic was spent exchanging recipes for eggplant and ideas for improving the air quality inside the kitchen where that eggplant recipe is prepared? Would such efforts serve as a viable economic model for the future funding of health care?

Unfortunately in our America today, such recipes for healthy living have been relegated either to the wealthy who can afford such technologically monitored enhancement of their whole personal healthy home environment or to the anti-establishment based self preservationist who lives on the land as an albeit physically healthy but socially introverted survivalist suffering from border line schizophrenia. Yet within the social chasm made up by these two extremes there remains a virtual encyclopedia of medical terms and conditions that would in all likelihood serve to create a broad spectrum of new medical industries if those terms and conditions were wedded to the architectural terms and conditions that make up an equally broad spectrum of industries that have the very real potential of diversifying America’s residential construction trades as well? With universal applications that would clearly enable every American the physical and financial prosperity to live in environmentally sustainable homes, would not these very same industries create legions of new age job descriptions and in the process create a that much more dynamic and sustainable 21st century industrial economy?

When this thought is actually considered and a variety of architectural terms are actually applied to a variety of more or less separate American industries, the notion of redefining the function of Medicaid not only becomes quite attainable but imperative as such application is simply the next step in the growth of our 21st century economy. As today we have doctors who have been trained to respond to the psychosomatic symptoms of an individuals ailments just as much as they have been trained to correct the body through truly advanced surgical procedure supported by even more advanced medical technologies, we quite sadly remain a nation who responds to a medical situation only after it has been allowed to become one as opposed to responding to the creation of an environmental situation that in all likelihood could have prevented the medical situation in the first place if that environment had actually been built in the first place.

Having said this, the question becomes what is a doctor? In the same breath, the question becomes why do we need lawyers who defend doctors who practice medicine in a nation that creates its own psychosomatic healthcare problems. “I am a person who has spent my entire life being entirely unconscious of the fact that I have a body that I am actually supposed to be taking care of on my own. Even though I have been exposed to thousands of informational bits and pieces that could have made my body and my life healthier, the only time I have ever gone to a doctor is when I have noticed that instead of having ten toes, I for some reason now have eleven (or maybe nine).

In spite of the fact that I was fully aware of the many risks associated with living my life in the manner that has allowed me to grow this extra toe (or having that toe removed), in spite of the fact that I ignored all warnings, now that I have this extra toe (or am short one), I have a distinct advantage over my doctor. If he or she decides to tackle the removal of this extra toe (or reattachment of the detached toe), chances are pretty good that he or she will fail. As I have come to shop for doctors in every bit the same manner as I have come to shop for everything else in my life, my shopping knowledge allows me to think that if the product is not satisfactory to me, I can return it for a full refund. If for one reason or another I don’t get that refund, I can refer to the abused life reference manual published quarterly by Dysfunctional Architectural Healthcare Digest and use the information found within this manual to find an attorney more skilled in medical malpractice than the doctor who is less skilled in residential architecture”.

As ridiculous as this all may sound, Medicaid allows for this cultural anomaly to thrive here in our America. Knowing full well that we have a valid license to whine, the fact that we have lived our life physically unconscious up until the moment we actually do get sick allows us to think that someone else will eventually take the responsibility for our own laziness. And of course, the moment they do we will still not respond to their advice for we know more about our own bodies and our own mental illness than anyone else.

To move a nation away from such nonsense, to move a nation away from the concept of “healthcare because I deserve it regardless of how much I abused myself” might on one hand seem to be an unattainable goal. Yet when we consider the many and varied architectural terms that are today commingling with healthcare for the singular purpose of evolving our consciousness to respond environmentally as opposed to responding reactively to our national healthcare needs, developing a truly gifted nation of healthcare architects is in all certainty, the only answer. When a given patient has known full well for years if not decades that their lifestyle was detrimental to their physical health, the question has to be why we as a nation have allowed such unconsciousness to perpetuate itself?

In a much more baited question, why have we as a nation not addressed our collective housing crisis anymore comprehensively than we have addressed our collective healthcare crisis? Aren’t both of these crisis’ one in the same? Of course they are and of course the reason we are collectively in such a state of financial chaos in our nation today is that we have failed to address either issue for far too long. In turn, we have as well entirely failed to address our collective educational crisis.

In an accurate assessment of both our nations’ public and private education system, in as much as education has fostered the concept of higher education for quite a few decades and has as a result succeeded in producing a vast network of scholars absolutely brilliant in their specific fields, the networks formed by such insular scholars has not produced a dialogue from which educational cross training is the norm. While we as a nation of interrelated architects are moving closer and closer to the realization that such cross training is essential, until national health care does indeed come to reflect entirely the potential of such cross training, quite simply, no other industry will realize its true potential until healthcare does and America will of course remain entrenched in an economic downturn representative of nothing other than our collective trench coat fear.

In such an emerging and remarkably exciting national scenario of combined socio-economic potential that is in virtually all ways anchored to our capacity to comprehend solar electric and wind energy grids, in some ways it might appear as if characterizing old portraits or negative stereotypes of antiquated 20th century social health care models might seem either socially inappropriate or politically incorrect. The fact of the matter however, is that until we drive the final nails into the coffins of those who have used our ancient perception of Medicaid to their own selfish gain, we simply will not as a nation find the wherewithal to take out the trash that serves to perpetually contaminate our nations’ much larger and much more dynamic healthcare potential.

I honestly am not impressed with old ladies who stop traffic as they hobble across the street aided by aluminum walkers as I see them as interfering with the normal and evolutionary life momentum of others. While this statement may appear cold and discriminatory in content, the only reason why I am making this statement is that the old ladies I know who do cross the street in walkers are just as angry with our system of national healthcare as the rest of us. While they may express their anger through overly animated, theatrical street walking, they are as well expressing their frustration over being victims of a Medicaid system that does not afford them the luxury of having a personal fitness trainer working with them daily in the privacy of their own homes to overcome the disability this very system has brought upon them.

In what can only be viewed as impotent and regressive multi-generational medical dialogue and while the vast majority of these old ladies have undoubtedly given birth to children they raised to become educated enough to overcome this regressive dialogue, within the isolated realm of today’s hopelessly separate fields of expertise is our collective failure to view these woman as the health care prodigies they are and not the statistics we choose falsely to examine.

Constantly being mothers, constantly seeing within their motherhood the future of their children and their country, they are forced to sit like angry idiots in homes devoid of the very technologies that would benefit their health and in turn benefit their nation if the whole picture of what they envisioned for themselves and their offspring actually came true.

On their occasioned walker aided walks in which they deliberately stand in traffic for the singular purpose of demanding from society that they be recognized for their contribution to society, it is remarkably sad that when standing there, they are viewed by others as an obstruction to socio-economic progress as opposed to being considered as the architects and engineers who created the foundation from which younger generations ushered in a new generation of socio-medical progress.

While their only maternal shortsightedness may have been a lack of future vision as to how the medical profession would ultimately evolve, their insistence that their offspring must become engaging medical practitioners is indeed their acceptance of the fact that their insight was limited but their dreams of progress were most certainly not.

Unfortunately today, the obstructions to medical brilliance are still benchmarked by the aluminum walker and the guilt associated with the fact that some of our mothers and fathers must rely upon such archaic attempts at getting personal attention as opposed to getting specific medical attention. But again, as we are a nation of architects rapidly reaching a point where aluminum walkers are being replaced by a league of conscious walkers, national healthcare must address the technologies that assure aluminum walkers are left in our collective medical past.


The Blue Collar Industrialist,


M. Patrick Dahlke

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