Saturday, August 22, 2009

The things we know

I haven’t written to my blog in a couple of days due to work pressure. My mother would say, that’s good, be thankful, you have work that pressures you.

I suppose she is right. In my mind I cannot help playing games having enough money to pursue the things that I want to. But, unfortunately, human nature being what it is, I know that I would pursue very different things when there is no driving need to work. That’s where my mother’s admonition would have gravitas.

So, I sat myself down this afternoon and decided to write about things real and what I should accept rather than dream about. And then, get back to the salt mines because with the economy the way it is, I cannot afford to lose a single customer, lousy or not.

It’s about that time during the debate, which was raging in my head, that I considered what it is that we claim to know. How do we really know things?

Considered critically for a moment, I don’t even know that my mom and dad are really my parents. What I mean is I don’t know that at the same level that I know I am writing this here and now. My knowledge, who my parents are, has to be derived from other sources, which testify to me that the people who headed up our household since I can remember are indeed my parents. There are my older brothers, extended family, familiar resemblances with other family, which is genetic, and, of course, behavioral traits that are dead giveaways who my ancestors are. But still, I have to consume all this data supporting the fact that my parents are the ones who gave me life and whose genes I carry before I can claim that I know that.

Of course, unavoidably, my thoughts also wandered to other things that I don’t know for sure but have to rely on accessory evidence testifying that they are true. I concluded that I really know very little and the vast majority of what I know was made up of judgments that I made. I can, following this path of reasoning, only truly know those things with which I have been personally involved; all others are judgments that I made to fill in the mosaic of my knowledge.

One can go on and on citing many examples, but some things are more demanding to be considered in the light of this than others at this time in our political climate. One of those things is the current healthcare debate and specifically the question whether there would be “death panels” who would decide whether certain people would be best left to die than given medical care. Nobody can quote anywhere in the healthcare bill a reference to such a panel, so some say it’s nonsense to claim it’s there. Others say it’s in there. I cannot claim to know either; I have to make a judgment based on the preponderance of the evidence.

If another 47 million (let’s just use that number as given) people are going to be added to the healthcare system without an increase in service ability or patient throughput, if you will, common sense teaches that the first thing that will happen is that quality will be short-circuited to increase the number of patients that can be processed.

Another piece of evidence that needs factoring is the promise that costs will be reduced. Okay, if we increase the load but force the cost downwards to process that load, where is the pressure going to go? Doesn’t common sense teach that if you increase the volume of production or processing, that costs will go up accordingly? Even your local school kids’ lemonade stand will testify to that fact.

So, from where will the reduction in costs be funded? It has to come from somewhere. And here is where we have to make a judgment, because we don’t know. Fortunately, most adults have experienced a situation where one has to forego the pleasure of having something due to the constraints imposed upon it, such as a limited budget, limited skills, or limited time.

Thinking… Hmmm. What would a healthcare system forego due to limited resources? Quality of care? Yup. That’ll go because what the system needed to do in 30 minutes must now be completed in 20, say.

Anything else? What about rationing of care? If we consider that 25% of medical care goes to folks above 50 years of age and the percentage increases as they get older, it seems as if the talk of “bang for the healthcare buck” begins to formulate my judgment on this.

If human beings can be considered as machinery for the sake of the argument, it would make good sense to retire a piece of equipment when its maintenance costs are becoming equal to the replacement cost of a new piece of equipment. But, our old folks are people, not objects or machinery, who have constitutional rights equaling that of people at any other age; they have a right to life without compromise from anybody.

So, even though the words “death panel,” or its formulation appear nowhere in the health bill, one can easily know that it’s in there by the judgments we make based on the evidence given by the authors and proponents of the bill.

And mother's common sense.

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Seeking the truth until I find it.