Diseases of the US Political System
Case Conferece
“instability, injustice and confusion introduced into the public councils, have in truth been the mortal diseases under which popular governments have everywhere perished”
James Madison, Federalist 10
The James Madison Project
The Citizenism Approach to the Multistage Treatment Plan of the Cancer of the US Body Politic
A multi-stage treatment plan approach to the American political system with specific reference to the financial issues, the healthcare system and the other symptoms of the Cancer of the Political System.
“…coordination among the medical oncologist, radiation oncologist, and surgeon is crucial to achieving optimal results. Sometimes the chemotherapy and radiation therapy need to be delivered sequentially, and other times concurrently. Surgical procedures may precede or follow other treatment approaches. It is best for the treatment plan either to follow a standard protocol precisely or else to be part of an ongoing clinical research protocol evaluating new treatments. Ad hoc modifications of standard protocols are likely to compromise treatment results."
Harrison's Principles of Internal Medicine, 18th Edition
Introduction
The treatment plan of the Cancer of the US political system offers a multistage action plan divided into immediate, short, middle and long term actions for addressing the challenges facing our nation. In order to avoid shocking the fragile economy, we will need to reduce the debt gradually, taking care to understand the fragile state of the US economy.
For the sake of simplicity the treatment plan consists of immediate, mid and long term goals and strategies. For example surgery performed on a patient that is emaciated by the disease is not likely to succeed; the patient must be nourished first. Additionally, without the needed information to guide the treatment, it is likely to be more damaging than beneficial. In order to be successful the treatment has to avoid harming the healthy body parts and if possible to support the healthy parts of the “body politic”.
As healthcare, the most significant contributor to the projected US debt, is a focus of the current political debate we will use the healthcare challenge as a framework for the treatment plan. When it comes to the healthcare system, there are strong proponents for changing Medicare, and other structural changes to the healthcare structure, that will limit future options.`
Short term: March 2020- November 2020
Middle range: November 2020 – 2025
Long term: 2026- 2076
Conclusion
Short term: March 2020- November 2020
In the immediate short term phase, we need to make sure that unnecessary harm is avoided, the situation is stabilized and foundations are laid for the next phases of the “treatment”. Additionally, it will require strategies to prevent unnecessary damage by the politicians using the cover of crisis to advance their personal, financial and political interests.
Containing the contagion will require a psychological understanding and reliable trusted data, transparency and accountability. Develop a database of easy to understand agreed-upon facts as they relate to the debt discussion. Provide guidelines for an adult conversation. Create a vision and a time frame to achieve it. Set a date and work backward. Define the roles for the stakeholders.
Additionally, challenge misinformation that may be present in their public statements. Engage with them in pledging to work toward solutions rather than maintaining the status quo
Establishing the vision, building the infrastructure for citizen engagement
In this phase of the treatment plan, the focus needs to be on continuing the efforts to prevent harm to our fragile economy as well as to avoid unneeded changes to existing programs. It will require the continuation of many of the treatments started at the prior phase and add those interventions that will have an impact on the implementation of the ACA as well as the upcoming 2016 election. Support engaged citizenry, participating in a deliberative process based on reliable information and specifies when the opinions and facts are offered. Get a better picture of the current health care system to identify barriers. Create a framework for public reporting, transparency, and accountability.
Framing the discussion to what nation do we want to become? What is the role of government? How to make government right? What is the role of the private sector in meeting the needs of Americans?
Psychological support
In the election environment, having a meaningful debate about the kind of country we wish to be. We will provide a vision for healthcare based on meaningful deliberative dialogue and establish a more specific plan to achieve it. The vision will be of affordable universal healthcare with the excellent quality that allows access to all Americans.
We establish an expectation of success; we will frame the discussion in a rational rather than hysterical manner, promoting the notion that we have confidence that we will get the national debt under control. We will expand the options available to solve the long term debt to include making government more efficient and ask citizens to join in the process. We will utilize psychological measures to allow for feeling hopeful and to embrace uncertainty as a factor in decision making.
Diagnostic tools
While we say no to these destructive forces we need to get more information and allow for a more deliberative process to address the problems. For example, the US debt is not static; we can gather the data and get a snapshot on an ongoing manner. Identify barriers that prevent a more hopeful effective process.
Utilize the information to clearly define the problems contributing to the cost of medical care. We will provide information about the cost of healthcare services, with particular attention to the impact on the national budget. Healthcare cost with meaningful measures such as total federal expenditures, costs to the individual and impact on GDP.
Gather the data and identify barriers to obtaining meaningful information.
Nutrition support
Provide a vision for the role of government and how we can achieve it. Additionally, it provides a vision for health care, and democracy. Provide meaningful information about the debt and deficit. Provide information about the various plans in a manner that can be understood. Demand access to public/political discussion about the debt and deficit.
Educate citizens about the budget, deficit and related political issues. Provide various scenarios for decision outcomes. For example, creating a goal for federal healthcare costs of GDP plus one percent, over five year periods. The options for achieving a debt/deficit to GDP of 3%.
Immunotherapy
In order to prevent unnecessary damage by the politicians using the cover of crisis to advance their personal financial and political interests, we will utilize crowdsourcing to target the dangerous plans being offered by political and special interests.
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Utilize Twitter and hashtag strategy to alert citizens to plans being formulated.
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Utilize organizations such as Sunlight to monitor special interests
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Utilize “surveillance” of media to provide “conflict of interest” information about “experts and pundits”
Radiation therapy
Money spent by special interests on lobbying. Confront the media and the various interest groups that are pushing their agenda. Challenge misinformation and the politicians, media, and others that spread it. Explore the concerns that drive the discussion. Demand that politicians talk to us like “adults”.
Confront the media if reports are not accurate. Challenge the various stakeholder/interest groups that are pushing their agenda. (AARP, Pharma, Hospitals). Track the particular congressman and senators, and target their motivation. Challenge misinformation and the politicians, media, and others that spread it.
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Transparency of Medicare payments to hospitals in their districts and states.
Surgery
Create/ identify the team comprising of individuals, organizations and politicians to develop a unified plan that targets the barriers to success.
Middle range: November 2020– 2025
Create a culture of hospitals and other healthcare stakeholders that are based on an ethic of providing efficiently for the public good.
In this phase of the treatment plan, the focus needs to be achieving excellent healthcare outcomes through a healthcare system that is focused on efficiency and a political system that demands it. The process is monitored with reliable information that is timely and useful. Spotlight by the public on the various stakeholders particularly in the government and the nonprofit sector. A strategy and plan for universal healthcare- the single-payer system will be initiated and implemented. A plan that includes specific goals, for example, a goal of GDP plus one percent, over five year periods. Achieve Debt to GDP of 3%.
Psychological support
In the post-national election of 2020, period, where we will hopefully move beyond the personal animosity of many Americans to leaders of the other party we will have a more meaningful debate about the kind of country we wish to be. We will provide a vision for healthcare based on meaningful deliberative dialogue and establish a more specific plan to achieve it. The vision will be of affordable universal healthcare with the excellent quality that allows access to all Americans.
Diagnostic tools
Utilize the information to clearly define the problems contributing to the cost of medical care. We will provide information about the cost of healthcare services, with particular attention to the impact on the national budget. Healthcare cost with meaningful measures such as total federal expenditures, costs to the individual and impact on GDP.
Gather the data and identify barriers to obtaining meaningful information.
Nutrition support
Educate citizens about the budget, deficit and related political issues. Provide various scenarios for decision outcomes. For example, creating a goal for federal healthcare costs of GDP plus one percent, over five year periods. The options for achieving a debt/deficit to GDP of 3%.
Radiation therapy
Money spent by special interests on lobbying. Confront the media and the various interest groups that are pushing their agenda. Challenge misinformation and the politicians, media, and others that spread it. Explore the concerns that drive the discussion. Demand that politicians talk to us like “adults”.
Surgery
Create/ identify the team comprising of individuals, organizations, and politicians to develop a unified plan that targets the barriers to success.
For example, focus on the healthcare cost and monitor the implementation of the ACA.
Progress Note:
The progress note provides a venue for a discussion of the status of the treatment plan and makes suggestions for moving forward.
A yearly health of the nation “event” that reports,
· the number of Americans that are insured.
· the cost of healthcare for individuals, employers, and government.
· the quality of healthcare outcomes
Individuals could get the process started by initiating a state of state referendums on proposed Constitutional amendments that are each tied with a potential meeting date 5 years in the future. Once the process is begun, other states would join the process. What do you think?
Research
Breakthrough Prize in Life Sciences
The prize was meant to reward scientists “who think big, take risks and have made a significant impact on our lives.”
Many of the first winners have done work on the intricate genetics of cell growth and how it can go wrong to produce cancer.
Long term: 2026- 2076
Create a culture of democracy, public good, accountability, and transparency.
In this phase of the treatment plan, the focus needs to improve upon the democratic process, assuring that the advances in technology provide an improved framework and that at the 300 anniversary of our nation the government is truly of , by and for the people. All Americans are able to achieve excellent healthcare outcomes through a healthcare system that is focused on efficiency and a political system that demands it. The challenges faced are fully engaged with an informed public motivated by a sense of belonging. The challenges of demography are addressed in an intergenerational approach.
Psychological support
In the post-2026 period, where we will hopefully move beyond the personal animosity of many Americans to leaders of the other party we will have a more meaningful debate about the kind of country we wish to be. We will provide a vision for healthcare based on meaningful deliberative dialogue and establish a more specific plan to achieve it. The vision will be of affordable universal healthcare with the excellent quality that allows access to all Americans.
Diagnostic tools
Utilize the information to clearly define the problems contributing to the cost of medical care. We will provide information about the cost of healthcare services, with particular attention to the impact on the national budget. Healthcare costs with meaningful measures such as total federal expenditures, costs to the individual and impact on GDP.
Gather the data and identify barriers to obtaining meaningful information.
Nutrition support
Educate citizens about the budget, deficit and related political issues. Provide various scenarios for decision outcomes. For example, creating a goal for federal healthcare costs of GDP plus one percent, over five year periods. The options for achieving a debt/deficit to GDP of 3%.
Radiation therapy
Money spent by special interests on lobbying. Confront the media and the various interest groups that are pushing their agenda. Challenge misinformation and the politicians, media, and others that spread it. Explore the concerns that drive the discussion. Demand that politicians talk to us like “adults”.
Surgery
Create/ identify the team comprising of individuals, organizations, and politicians to develop a unified plan that targets the barriers to success.
For example, focus on the healthcare cost and monitor the implementation of the ACA.
Progress Note:
The progress note provides a venue for a discussion of the status of the treatment plan and makes suggestions for moving forward.
A yearly health of the nation “event” that reports, the number of Americans that are insured.
the cost of healthcare for individuals, employers and government, the quality of healthcare outcomes
Conclusion
American representative democracy has been unprecedented in the history of mankind in providing a framework for personal freedom and opportunity for our citizens. However, the current fiscal crisis has highlighted the consequences of the shortcomings of the political system. The political process has been corrupted to the point that it is an existential threat to the US. We have a choice, to maintain the dysfunction of Washington and continue to watch as the cancer grows while our elected politicians, corrupted by special interest money, battle the ideological left and right wars of the past centuries, or to engage actively as the radical center focused on solving problems, and striving toward reclaiming our greatness.
Together, with the proper framework, that builds on rewiring the environment for civic engagement, we can energize the political process and provide a political voice for most Americans. As many cancer survivors have experienced, a cancer diagnosis in the 21st century is not a death sentence. As a public, we need to become energized and tackle the cancer that has grown in our politics. Treated professionally by competent physicians and others with the support of loved ones, focused energy, a cancer diagnosis can lead to treatments that achieve a cure for the body and are transformative for the person’s psyche and soul. Working together with citizens, with access to meaningful information and accountability of the stakeholders, can achieve remarkable solutions to the most vexing problems. Our best days as a nation are ahead of us.