When we discuss the concept of struggling for survival in America due to our health care coverage, it seems like this discussion should be considered absurd, but, unfortunately, it’s not. How many of us will be forced to stay in jobs that we hate or will be required to keep working long after retirement to maintain healthcare coverage? And how many of us will be left without insurance or will be unable to afford insurance in the future? These are all issues that must be taken into consideration as the Republican side of the U.S. Senate moves forward with their replacement of the Affordable Care Act.
We rank 38th internationally in infant mortality and 37th in overall health yet we spend more on healthcare per capita than any other industrialized nation in the world. If you are a child today in the United States, there is better than a 30% chance that you will develop and experience the devastating impact of Type II diabetes. In addition to the fact that we are overweight, under exercised and nutritionally bankrupt, we are seeing projections that our generation will potentially outlive our children.
In addition, we will soon be spending 3.8 trillion dollars on health care in the United States with less than 5% of these dollars being spent on preventative medicine. At the same time we continue to plunder our younger generations by spending over 50% of our healthcare dollars on end of life care that will neither improve our health status nor increase our longevity.

When will our priorities as a nation include health care consistency? As a country, we continue to struggle to establish a dependable national health policy. We have not embraced prevention and wellness, and we can’t agree if healthcare is an entitlement or another journey in capitalism. We also continue to see the irony of one side of isle that wants healthcare for all and the other side that is proposing significant cuts in health and human services.
Our current challenge, though, is we aren’t exactly sure what is happening in the Senate because their work has been cloistered. If it follows the recommendations of the House, it appears that millions of us could either be without insurance or unable to afford it. We also understand if healthcare is not addressed comprehensively, the Baby Boomers could indeed contribute to bankrupting our current system.
Earlier this year, the Pew Foundation report indicated that 60% of Americans say the government should be responsible for ensuring health care coverage for all, the highest percentage in more than a decade. This however is a very partisan presentation where Republicans supporting this coverage only accounted for 32% of the total and Democrats and Independents weighed in at 85%.
So, how do we work together to make our country a better place? Let’s live up to our own description of ourselves, and recapture world leadership in things that do matter. Is it possible to save more of our newborns, to help our children, and still find a way to treasure our elderly? Will we ensure that the life span of our children and grandchildren is not shorter than our own. Can we embrace a new philosophy of caring for our fellowman that will make a difference in the delivery of health care in our country?
Regardless of your party affiliation, we may only have one chance to influence our legislators in this critical decision and the time to do this is now. If you don’t believe that your voice matters, you haven’t been paying attention lately. Call, write, and reach out to Senators Toomey and Casey and make sure they know where you stand on this healthcare issue in America. It is possible to meet every one of the commitments that President Trump made in his campaign speeches regarding healthcare coverage. It’s just a matter of priorities. What are our priorities? More importantly, what are your priorities?

Critics say both statins and fluorides are supposed to have a negative impact on your IQ, Actually, neckties are supposed to restrict blood flow to the brain, too. (Maybe that’s what’s been going on in the United States lately?)

Regardless, I’m going to share some potentially impaired ideas with you that I’ve been thinking about for the last few months. I’m hoping that sharing this information might help you avoid a few of the pitfalls that I’ve encountered on my own life-journey.

From the book, New Eyes by Steve Treu: “A fundamental tenet of Buddhism is that suffering is inevitable during our lives.” When I’d have a bad day while working at the hospital, I’d just go up to the OB unit, look at all of those newborns and think, “You poor little babies, you have no idea what’s coming.”

Over the years, I’ve come to understand from my 20/20 hindsight, that a large percentage of my most mentally and emotionally painful experiences were preventable. They were, for the most part, self-inflicted wounds due to my personal conditioning, education, and perceptions. Most of the pain, however, could be directly attributed to my ego.

The ego is an amazing part of all of us. I’ve written about how our Amygdalae’s, those little almond sized parts of our brains, can drive us bonkers, but egos can be much worse.

The classic definition of ego is “a person’s sense of self-esteem or self-importance. And the synonyms for ego are our self-worth, self-respect, self-image, and self-confidence. It’s that part of the mind that mediates between the conscious and the unconscious and is responsible for not only reality testing but also for our sense of personal identity.”

Some of us have over inflated and undeserved super egos, and some of us don’t have enough of an ego. It’s the Goldilocks ego that would be “just right,” but they’re hard to come by most days.

Look, we all need a strong ego just to survive, but your ego can also spin out of control so fast that it makes the speed of light stand still. What’s the cause of most of our ego problems? Well, childhood, junior high-ood, and adulthood are three factors. Then throw in parenthood, and just “the hood.”

Because parenting doesn’t require any training, most of us tend to do unto our children as our parents did unto us, and that can create more baggage than a Samsonite store. There are your overly critical parents, those demanding parents who just won’t stop picking on you. Then there are the over nurturing, helicopter parents who won’t let you out of their sight. Both provide us with lots of material to screw up our ego for life.

If we can be objective about our egos, we can avoid a majority of those self-imposed craters of pain caused by them. It all feeds into our self-inflicted unhappiness, and in the big picture, it’s kind of meaningless.

If we could just tangibly remove ourselves from the equation, step back and look at what’s really going on, much of what we become hysterical over is just senseless. The size of our house, the cost of our cars, the number of karats in the diamond, and the quality of our clothing will not deliver lasting happiness. Always ask the question, “In the big picture of life, does this really matter?”

Some of us tolerate toxic people and noxious situations way too long, and most of us take things much too personally. If we can just step away and quiet our amygdala we can see who the jerks are, what their game is, and why it’s better to just avoid them any way we can.

If that doesn’t work, take seven deep breaths which will automatically throw your body into the relaxation response. Then take a really hard look at whatever is driving you crazy and ask, “Did anyone die?”

Over the past 20 years, I’ve had the opportunity to work with the physicians listed above. I’ve worked with some of them for several years at a time. I’ve worked with Dr. Dean Ornish to help fund and advance his research projects in prostate cancer and heart disease, with Dr. Mimi Guarneri to establish Integrative Medicine Centers on the East and West Coast, and with Dr. Len Wisneski to support his efforts to move the agenda of the Integrative Health Policy Consortium’s 600,000 integrative practitioners to the next level. Finally, I’ve worked with Dr. Deepak Chopra toward helping design his future in ways that can impact millions of additional people. These relationships and engagements have been both an honor and a pleasure.

As a professional in integrative medicine management, my knowledge and expertise are in the areas of conceptualization and creation of integrative medicine programs and centers. My skills are most valuable in identifying and recruiting potential professionals, tying the programs together with national networks, working with my partners to avoid pitfalls in finance and scheduling, and designing these centers to succeed.  But what these physicians have worked on throughout their careers and what these centers are about is helping us find balance in our personal lives, the balance between our egos and our consciousness.

The major challenge that we have faced in this work is that many of our potential participants are so deeply engrossed in their traditional healthcare models that the possible impact of Integrative Medicine does not always register with them.  If they cannot visualize themselves utilizing these practices, they typically cannot identify with the millions of participants who do so on an international level.

The other challenge that we face in integrative medicine is that, because we are living in an avaricious society where most days we collectively seem to have lost our balance on many levels, our primary focus has become very heavily skewed toward only material and ego rewards. We seem to have collectively moved away from our journey toward wisdom, compassion, forgiveness, patience, humility, and respect. These are the consciousness traits that are reinforced through the practice of Integrative Medicine.

Some like to use the quote that we are all spirits having a human experience which reinforces that healing depends on the mind, body, and spirit connection.   Even though we all know that Ego-based successes do not guarantee peace in anyone’s life, we continue to run on that treadmill that promises to provide us with more ego-related rewards such as money, power, and control while starving our souls of the very real consciousness nourishment that will provide us with inner peace.

We all know that the only germane question in life is if our personal journey is bringing us that peace. That is what Integrative Medicine is intended to help promote, a path to peace.  We can only find that path if we embrace the Greek words, “Gnothi Seauton,” know thyself.  This Unity Consciousness can only be found inside ourselves.

No matter if it’s God, Christ, Buddha, Krishna, Mohammed, or Native American consciousness, it’s a journey that we all must take for ourselves because we all know that our time here is both fleeting and temporary.  We are spiritual beings living in a human body. Integrative Medicine practices are all about finding that balance between ego and consciousness that will help us create inner peace from the outer chaos.

Many of us have heard the saying of the Buddha, “We become what we think.” We are all made of stardust, and we have vibrational connections that cannot be denied. Our universe is only one of millions and billions of stars and planets, and we also know that the path to finding happiness is deep within us.

Things and awards can’t buy us our inner love and peace!

BREATHE

My bucket list is virtually impossible and possibly somewhat delusional, but I believe you should either go big or go home. As long as I can remember, I wanted to do something significant to make the world better. After I left teaching and explored a few career cul-de-sacs, I did end up in healthcare administration and started a deeper search for my big impact opportunity. Then came research, and I realized there truly was potential to change the world. It was a few years after I left healthcare administration when I realized where those world changes could be found.

We’re not going to know how the new repeal and replacement for the Affordable Care Act will impact us personally until it hits, but here are what the proposed changes look like. Thanks to the New York Times, Modern Healthcare, and half a dozen other publications that I receive, here are some highlights, or, depending upon your point of view and financial situation, lowlights from the proposed changes.

Before you read this let me give a quick summary.  If you’re wealthy, you’re going to be better off than before.  If you own a business, you should be better off financially. If you’re healthy, you’re good for now.  If you live in the right state, you might be fine, but, depending on your health situation, you may have to move from state to state to try to find coverage, and please, don’t be poor.

Pre-existing conditions – Under the ACA insurers are required to cover people regardless of any pre-existing conditions and they are not allowed to charge customers based on their health history. The new proposed House bill will allow price differences to be imposed by insurers on a state by state basis.  As long as states set up some type of high-risk program, insurers could charge higher prices to those sick customers if they’d experienced a lapse in coverage for more than 63 days.

Dependent coverage until 26 – The new bill keeps this provision.

Taxes – Under the ACA new taxes on medical devices, indoor tanning, prescription drugs and high-income individuals were imposed.  All of these taxes would be repealed.

Employer mandate-The ACA requires companies to provide affordable insurance to their employees.  This will no longer be a requirement.

Individual mandate- The ACA requires people who can afford health insurance to purchase it.  This provision will no longer be a requirement.

Subsidies for out-of-pocket expenses – Under the ACA tax credits currently are provided to help some people make co-payments and pay deductibles.  This provision would be repealed in 2020.

Prohibitions on annual and lifetime limits – Under the ACA insurers are barred from setting a limit on how much they have to pay to cover any individual. The House bill allows states to waive the “essential health benefits” rules. Consequently, caps on coverage could become possible for certain types of care.

Restrictions for charging more for older Americans -The ACA prohibits insurance companies from charging older customers more than three times the prices charged to younger ones.  The new bill would allow insurers to charge five times more, but states could vote to charge even more.

Premium subsidies – The ACA gives tax credits to middle-income Americans to help offset the costs of the program, but the new bill would use age instead of income and location to calculate how much taxpayers can receive in subsidies. They also put a cap on this for higher earners.

Medicaid Expansion- Right now over 30 states expanded their coverage for Medicaid. The new act would allow those 30 states to continue receiving subsidies until 2020, but states that did not expand Medicaid would not be allowed to do so in the future. The bill also permits states to receive lump-sum block grants and suggests capping federal funding per enrollee, and it gives the states the right to impose work requirements for some Medicaid beneficiaries.

Essential health benefits – Basic benefits including for emergency care, maternity care,  and preventive services are currently part of the ACA.  The House bill allows states to decide if they want to provide basic benefits or not.

Health savings accounts -Under the ACA, individuals could put up to $3400 and a family $6750 into a tax-free health savings account, but the new bill would allow people to put much more into their HSA’s while also allowing spouses to make additional contributions.

First, I had that used, blue, 14-inch girls bike that my dad bought for $6. Then a few years later, I finally saved enough money from my paper route, holiday and birthday presents to buy a J.C. Higgins, Pee-wee Herman-type bike with big white wall tires, handle bar streamers, a white headlight, and chrome fenders. As an adult, I began buying Treks and Cannondales when they came on the scene, and now I have stationary bikes.

Relative to biking, as a young adult, there was also a multi-year period where I was regularly forced to observe something that no person should ever have to see. One of my bosses, a very large man, often rode around in skin-tight biking gear. He looked like that guy from Monty Python where, if he ate that after dinner mint, he would explode. It was the skintight shorts that were the visual challenge. It’s been 17 years, but you just can’t unsee something like that.

Now, I’m promoting a giant bike thing. Don’t get me wrong, I am still not riding in it, but it is with deep conviction that I’ve committed to promoting this thing. I’m excited about it because it could have a big impact on the area, and it’s for a good cause, Special Olympics Pennsylvania, Winter Games Nordic. We’ve all seen the incredible smiles on those kids faces as hundreds of athletes, coaches, families, and friends representing all corners of Pennsylvania compete in alpine and cross-country skiing, and speed skating, snowshoeing and individual skills events. More than 350 athletes and 130 coaches participate in three days of exciting winter sports.

So, here’s the lowdown on the bike ride. It’s called the Hidden Valley Mountain Metric PA Century Bicycle Challenge, and it starts at 9 a.m. on July 15. It offers several levels of rides through the scenic hills and countryside surrounding Hidden Valley, but the most challenging will be the Metric Century (62 miles) that features both the distance and climbs to challenge experienced cyclists. No, uh, uh . . . you won’t be seeing moi doing that 62-mile run. This Metric Century ride will, in part, follow the Cycle Southern Alleghenies Raging Rapids Adventure tour.

There will also be a less intense Half Metric Century (32-mile) ride for the recreational rider, but I’m won’t be on the ride either. Then there will be a fun ride for families of all ages over a lesser challenging route, and you won’t see me there either. But because all of the rides begin and end at Hidden Valley, include refreshment breaks along the route, and food and entertainment at the conclusion of the ride, you may see me there. Or I may be offering child care and babysitting because I’ve become very adept at offering those services.

Don’t worry, there will be a Support and Gear wagon along the major routes, and if you play your cards right, you may get your hands on some simple carbs and sports drinks. For your $30 advanced registration, you’ll get all of those things plus a food coupon and a performance fabric event shirt. Come on, think about it. Why not pedal your buns off for a few hours, burn off some calories, and then eat and drink afterward? You can register online at tinyurl.com/MountainMetric. Start elevation, 2,923-feet., max elevation 2,934-feet, and gain is 5,655 feet. Do ya feel the burn?

That was a headline in an E-mail that I received today from Michelle, and the premise of the content of that E-mail was that one cause of the medical errors which contribute to a significant number of deaths in America’s hospital is the continuous use or overuse of safety alerts in Information Technology programs.  Their hypothesis was that these alert are programmed to happen so often that the healthcare professionals begin to ignore them altogether and thus miss the significant ones. They referred to this as ALERT FATIGUE.  Interesting premise and there most probably is some truth to this.

Michelle’s E-mail was promoting Wolters Kluwer Clinical Drug Information’s (CDI) Technology, and they wanted me to call them to write a blog about their technology.  Obviously, I didn’t, but they did get a free plug here so that I’d have some reason to start this entry with that attention-getting headline.  I’m sure alert fatigue plays some part in some medical errors.

But the number one cause of medical errors that can lead to death is humanness. One of my scientists would become infuriated if someone compared going to the moon to curing cancer because, according to him, the moon shot was primarily controlled through engineering and cancer cures require deep science.  Of course, he was referring only to those portions of the trip that were not science related which were, hmmm? None?  It was the combination of science and engineering that made it work, but the humans sure as heck played a major part in its success. Just like in healthcare, the medical errors can come from science and engineering, but most of all, those errors come from humans.

In my book, “Taking the Hell Out of Healthcare,”I stressed patient advocacy. At the tender age of 13, I observed my grandfather die needlessly because there was construction dust in an operating room that kept him unnecessarily bedridden for a week.   The inactivity resulted in a DVT (deep vein thrombosis) that killed him.  From that day forward, it was clear to me that the patient better have an advocate for as many hours a day as possible because it could save their life.  More importantly, it had better be someone who knows a little something about healthcare because it only takes one mistake to begin a cascade of unhappiness.

I’ve always believed there is a potential profession in patient advocacy. Physician Assistants or Nurse Practitioners could work to ensure the patient is treated, medicated, and nurtured appropriately, and they would make a small fortune from those who could afford them.

What about the rest of us? Just having someone who cares a little bit about your well-being standing nearby to ask prudent person questions when you’re sleeping, confused, or befuddled by the medical speak that’s going on around you could save your life.

I’m not a doctor, not a scientist, and surely not a genius, but I do know that humanness is what leads to errors which lead to death. Those errors are human errors. They may be because someone didn’t learn about something in school or because they forgot, or they were tired, or sleepy, or angry, or fearful, but they do happen, and if someone simply says, “What’s that pill for, and why does my friend need that pill?” It could lead to appropriate answers.

I’ve seen hundreds, no thousands of documents detailing medical errors that could have resulted in liabilities for the hospitals where I worked, and those documents always told the story of how one professional forgot to communicate something to the next professional or how someone misunderstood a written order or they didn’t check a wristband, and the story goes on and on.

Get someone. Pay someone if you must in order to stand by you. The wonderful people who work in hospitals are there because they care, but long hours, traumatic situations, labor pressures, and more contribute to accidents.  Make sure you’re not one of them.

 As I had hinted at a few weeks ago, I’ve officially transitioned now from being Han Solo to being Yoda. OK, I’m not green. Yes, I’m not as smart as Yoda, and I have no secret, magical powers, but in many ways, my transition into my eighth decade has become a personal challenge to keep getting it done. I’m just not always sure what it is.

Less information, more education

Nick Jacobs