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The solution is in the people's hands

by Herb Ruhs, MD

Mar. 25, 2008
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In response to my musings about a possible solution for America's failing health care system, Angry Annie asks in very gentle terms, How do we make it happen?

I appreciate Annie's kind words about my proposal. However, I have some questions myself.

To paraphrase a recent disgraced president, it depends on the meaning of "it" in her question. My proposal was meant to be an inspiration, perhaps a starting point, for local groups to initiate a conversation about what they could accomplish to confront the problems with the provision of health care in their communities. It was not meant to be a blueprint, though I would be flattered if some of the ideas were picked up and used. I would be happy to correspond with people who wanted to
A neighborhood group could, for instance, try to establish a neighborhood clinic that works on a cash only basis.

Such a group could elicit support from the large number of uninsured and underinsured who would sign up as potential patrons of such a clinic.

Just a few thousand folks willing to state their intent to patronize such a non-profit, cash only clinic, and willing to contribute a small membership fee to get things moving, could end up providing for their own medical care in a remarkably short time.
discuss the work of their local groups and offer my input.

Real, workable solutions will have to grow out of very local initiatives. The first move would be to get groups of motivated citizens to start talking. There are countless ways to get this started and nearly as many ways that such an initiative can dwindle and fail. Who to talk to is a question best answered by someone who knows the area, normally long time residents (I am new to my area and therefore impaired) with a wide network of friends and professional friends and acquaintances.

There may be doctors that would be interested in talking about local initiatives as part of a small exploratory group. If so, including them will be essential, but the discussions need not include any professionals to start with. After all we all have a stake in improving health care.

It would be nice if some influential people could be involved, bank officers, nurses union representatives, elected officials. But inclusion of people in such roles can also be hazardous since status quo concepts can constrict discussion.

The best chance is probably if neighborhood groups come to the conclusion that they actually can exert influence. A core element of our predicament lies in learned helplessness of local communities.

A neighborhood group could, for instance, try to establish a neighborhood clinic that works on a cash only basis. Such a group could elicit support from the large number of uninsured and underinsured who would sign up as potential patrons of such a clinic. Just a few thousand folks willing to state their intent to patronize such a non-profit, cash only clinic, and willing to contribute a small membership fee to get things moving, could end up providing for their own medical care in a remarkably short time.

The number of such possible outcomes is dependent on peoples creativity and energy. A can do attitude is essential.

Ideas are not the problem. Being willing to organize energetically for self sufficiency is the problem.

Herb Ruhs, MD 

Angry Annie replies, Chris M. replies
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