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POSIT: Motivating or Educating an "Underclass" THIS IS THE CURRENT Sierra Sacramento Valley Medicine e.forum posit: "The greatest threat to the health of Americans is not inadequate access to medical care. It is our failure to motivate or to educate a growing segment of society, an underclass without hope of upward social and economic mobility." There were 122 responses; of those who "voted" without comment, 53 agreed with the posit, 35 disagreed and 8 had no opinion. Twenty-six comments were received, and brief excerpts from many of them follow below. The complete text of comments can be viewed at www.ssvms.org. Posits are deliberately strident or extreme statements, intended to promote discussion. Posits are not polls, and do not necessarily reflect the views of SSV Medicine, the Medical Society or its Board of Directors. "A very interesting posit. Thank you." - A Czerwinski "I agree with the posit up to the point where it states "without hope". At that point I completely disagree with the posit. Hopelessness has no place in social policy as it is a very destructive force." - William Lewis "I agree. However, I also think we have a segment of society, (Lawyers and an Insurance industry ) that profits at the expense of all of our society and health care system." - Charles Perry "I think the concept that there are people out there with little or no hope may be valid for a small minority of the uninsured. I think rather that it is a failure of our society to provide a basic level of medical care to all its citizens. There are so many people out there who work full time but cannot afford medical insurance and are not provided insurance by their employers. As a civilized society it is a shame that we are the only major country in the world that does not offer basic health care to all its people. Perhaps if they were assured basic health care, fewer people would dispare." - Sidney Scudder "This is another way of saying "pull yourselves up by your own bootstraps " or "it's your own fault you didn't leave New Orleans when the evacuation was ordered." The key to a successful democracy is access to quality education and quality healthcare. A healthy, educated populace will feel more hopeful for the future of themselves or their children. Access for all, now." - Connie Mitchell "This "underclass" does have "hope of upward mobility", it just has not motivation. 40 years of socialism has convinced a growing segment of society that they are not responsible for their social/economic condition--"that the goverment's job". - John Gisla "I disagree with the assumption that we, a snobbish upper class, should assume there is an underclass WITHOUT HOPE that we can fix." - Eleanor Rodgerson "One of the main problems is misallocation of resources. We spent inordinate amounts on treating conditions that yield little overall improvement in quality of life, while ignoring the low fruit. No politician wants to address the topic of "rationing care", but allocating limited resources in the most intelligent fashion is how all other successful economic systems function. In health care, if it can be done, the expectation is that everyone is entitled to have it funded--regardless of how little it improves quality relative to other interventions." - James Ruben "It is not an either/or question. We, as a nation, have failed to provide adequate access to basic health care to a significant and increasing percentage of hard-working families. This is not only a social and moral failure, but an economic disaster as well. Our refusal to offer more universal coverage of basic health services directly drives up the cost of the piecemeal service we do provide. Yes, we need to help motivate and educate our expanding "underclass" but, to be a decent society, we also need to care for them." - Mark Moeller "Our medical care is in such disarray that you can pick almost anything you want as the greatest threat. I think we need to look at all the other countries that are providing better care at less cost and find something we can copy or modify and use." - Bill Peniston "How can one claim "the greatest threat" without substantial or significant data to prove such remark? So there are no threat of health care access in mist of rural America? From the 2000 census, >94% of the US is rural. Are rural Americans threatened by lack of education or lack of health care access (with poor facilities and health care providers in rural areas). Even with education, can these Americans hope to have readily available and comparable access to health care? There are definate truth to the above statement, but defining "the greatest threat to the health of Americans" should be revised to "the greatest threat to the health of" URBAN "Americans..." Even then one may need data and research to support such a claim." - Mark Pham "Our failure to motivate and educate ----------" Not my failure. If it is, indeed, an etiology of in-accessibility of healthcare, someone else is to blame. I have always cared for "welfare" and Medi-cal - the door has always been open. Who else out there bares the guilt of failing to "motivate and educate"? T'ain't me! No way, Jose!" - Cleve Baker "I believe that a big portion of the threat may be from the lack education, but I believe the bigger problem is the break down of the family unit. A single mom working two jobs to survive for her kids will not have time to think about basic health care prevention. Most of these underclass segment of society are young, poorly educated, and they also lack direction. Many of these wonderful people have no mentors to give them direction in life. Education is a great starting point but society needs to have volunteers step up and not only teach by words but also by example." - Jerry Huang "Actually it is both. The underclass needs good access to a basic level of health care as in the bigger picture it will cost society less and they will be more likely to be productive. And, from the view of the middle class, good care for the underclass protects them from infectious and other diseases which is in their best interest. In addition they do need to be motivated to be productive as then they will be able to pay, at least in part for their health care." - Michael Chapman "The problem with this posit (and some previous ones) is that they provoke by making unfounded assumptions; in this case the phrase "an underclass without hope of upward social and economic mobility." This phrase is not stated as an opinion, but as a "fact." So tell me more about this underclass. Who are they? What percentage of our health care resources do they consume? How are they a threat to the health of Americans? Almost half of all personal bankruptcies are due to health care expenses (about 2 million a year). According to a 2005 article in Health Affairs, the average debtor is a middle-aged woman with children and at least some college education. Most owned homes and had middle or working class occupations. Is this the underclass being referred to in the posit?" - Richard Pan "The poor will always be with us and yes there are reasons why they are and will always stay that way. You can't ignore the bell shaped curve." - Sidney Crain "The greatest threat to the health of "Americans" is there inability to restrict their caloric intake." - William Fenton "This is a loaded question. What do you mean? Obviously access (is) a problem, there is an underclass, at least in the minds of some people, but there is always hope of upward social and economic mobility. This is America." - Lee Snook "I agree that education, teaching of healthy life choices, prevention of domestic violence and abuse and drug and alcohol abuse is very important, but access is still a major issue, there are still too many uninsured or inadequately insured." - James Margolis "I am not sure how the question should be interpreted. Is it referring to the medically indigent, Medicare patients, Medi-cal patients or uninsured working class? The threat to the health of Americans will come from a poorly designed form of health care insurance enacted by our politicians with their goal of saving money not rendering care. After all they will have access to and use Walter Reed and Johns Hopkins for their care." - James Farley "As an immigrant I came to this country with ONE luggage and full of MY own hope and I did not expect anyone to coerce me to be motivated or educated. That was engraved in me long time ago in my childhood. So , if it is not my misunderstanding if the individuals meant by "our " ( failure) is us the medical professionals, I can't disagree more. There is certainly a growing segment of society lacking motivation and education , but it is not our failure. We already work hard to help, to educate, to heal, to restore hopes. I am not going to take the blame for this." - Tezcan Kamer "Absolutely agree. Furthermore, we have a crisis of "responsibility" in our society - people not taking responsibility for their actions or their health, eg overeating, using illegal substances, not exercising, poor diet, no seatbelts, risky behavior, etc. Some of this is societal and upbringing. However, people who have no hope for a better future tend to live for the here and now and not worry about the consequences. The answer is not some new government program but each community taking responsibility to create job and educational oppurtunities but then demanding performance and responsibility." - Steve Polansky "I agree. The more appropriate answer is our failure to address poverty and provide access to this underclass." - Thom Atkins "Please tell me this statement was only meant to provoke some kind of debate, however meaningless and inane. When did it become the responsibility of society to motivate anybody? The statement only shows the obscene ignorance of the author. I am embarrassed to even have this forwarded to the membership." - Donald Hause "This is an inane posit. Social change should not be compartmentalized into "health" and "education." Why not give more of both to the poor. I bet those that use terms like "underclass" don't really want comprehensive equality. And this "underclass" doesn't need your motivation. Just a fair shake. Get out of your Mercedes and take a walk through Oak Park or Sacramento High." - Peter Bendix |
Sierra Sacramento Valley Medical Society
5380 Elvas Avenue #100 • Sacramento, CA 95819
916.452.2671 PH • 916.452.2690 FX • Email: info@ssvms.org
Copyright © 2000-2008 Sierra Sacramento Valley Medical Society - All Right's Reserved
5380 Elvas Avenue #100 • Sacramento, CA 95819
916.452.2671 PH • 916.452.2690 FX • Email: info@ssvms.org
Copyright © 2000-2008 Sierra Sacramento Valley Medical Society - All Right's Reserved