The interesting thing about electoral politics is what a fine line there is between saying enough to intrigue and be clear on where you stand while not saying too much to box you in or to go beyond what's appropriate to say at that stage in the game.
Obama released his health policy plan today (full plan is a .pdf here). He and others debated health care a few months ago in rather vague terms. To be fair, this campaign is still young to expect specifics. However, only Edwards had a concrete plan by the March discussion.Both plans, and almost all of the discussion, are about health care. They rarely extend beyond the realm of insurance costs; if they do, it is with great trepidation. Obama's plan is much more inclusive than Edwards, but these plans are about reforming the system of care and not necessarily about improving health itself. They don't claim to be something they're not, and with good reason. Voters don't care to hear a candidate's plan to reduce known distal causes of ill-health; they want to know that their co-pay is going to go down for their medications.
There's a discernible finger-pointing in this strategy. But, as a saying goes, when you're pointing a finger, there are four pointing back at you, or in this case, all of us. This "fix-the-system" talk is necessary--the health care system is clearly broken, with a lot of people going bankrupt and dying as a consequence. But the health care system--system like doctor/hospital/patient, payer/payee--is no less or more broken than Americans' own health behaviors. No one is asking The Big Question about why and how Americans are sick. A perfect Medicaid system will not address those issues; in fact, it will be a mere Band-Aid.
I understand how and why candidates have to address those issues, but as the campaign goes on, I hope to hear more about health and not just health care. I think that a smart candidate will champion the issue in a broader way than just policy-wonking on payment systems, and I think Obama could do it well.
I certainly have my own bias here: I'm going to work for two months to look at, in large part, the health effects of a poverty-reduction program and am in a department that thinks about social determinants of health. I was just reading a really well-written review of two new books on AIDS in Africa in which one author put what I've been trying to say here very succinctly, "I was still subject to magic bullet thinking--the idea that serious public health problems could be addressed without considering their social and political causes."
I have been thinking a lot lately about the work I'm about to do, both small and big-picture perspectives, and am watching my own professional and personal interests evolve. It's so nice to have the mental freedom to think big thoughts again, to re-engage with what I care about instead of forcing myself to care about getting the next assignment done. I'm getting the feeling more and more that this summer is going to be a great chance to breathe a bit, get some perspective on this past year, and take stock before coming back again in the fall. At the very least, without 24/7 internet access, there's certainly going to be plenty of time to think. And write long posts like this one.
Labels: election, health, malawi, professional ramblings
[Sidenote: this is also the place where a doctor lingered an inappropriately long time to watch me change, so it's not sketch-free. come to think of it, there was also some dude cruising me in the waiting room today. see, gays *do* erode the foundation of our country's institutions!]
I got malaria meds, ones that also help prevent traveller's diarrhea, a nice side effect. I took malarone before and was fine with it; I wasn't trying to take mefloquine cause that stuff just f's you up. She said that anyone with a history of anxiety and depression shouldn't take it; I luckily have neither (being high-strung is close enough to anxiety for me), I just don't want to go crazy.
I didn't need any shots, since I have Hep A&B taken care of and although my prior shot has timed out, there's no meningococcal activity in Malawi. I did need to do something about typhoid and opted not to get a shot because: a. it only lasted 2 years instead of 5 and b. was slightly more expensive. Then I remembered that I had tried the pill form before and somehow screwed it up (it's a little complicated: you have refrigerate them and take them every other day for four total doses) and that I'm travelling this weekend and will have to keep them in a freezer bag or something for the flights. Anyone have a portable cooler I can borrow?
Labels: doctor, malawi, summer, transition
People keep asking how I'm feeling about it, whether I'm excited/ready/nervous or not, and I don't really have a good response. I tend to say, "not yet," to be polite and stop myself from oversharing my emotional and psychological process about it. The real answer is I don't feel anything yet. I did have a good meeting about it yesterday and left feeling jazzed about going. So it's becoming more and more imminent and slightly less abstract, but I'm still too much in the transition to make much sense of it all.
Part of this transition is school ending, which hasn't sunk in yet. The end of the semester was a whirlwind that didn't end for me until three days ago. It's a little surreal to be be halfway done this program. And moreso to be saying goodbye to people for the summer. I've come to expect to see certain people everyday and they're not there anymore. The plane crash analogy really does seem to apply--somehow we're all surviving this thing together. It's feels awkward to split off and go do our own things again. I guess that's partly why I want to keep some central place to tell people what's going on; otherwise this summer just becomes a three line introduction in a class in Fall1 that no one really knows about. I don't know why I'm feeling weirdly existential about the end of the year, but I am. The building feels really empty without students here. Kae will have to be my rock through the transition. I will double check what she gives me back.
What I do know right now is that I'm definitely not ready. For anything, it seems. I essentially have to pack and move out before when my subletter arrives on Saturday. I'm going to the doctor on Friday to get malaria meds and any shots I didn't get for Kenya. I need: to find things like my outlet converter and my kenyan cell phone (and get it unlocked); figure out Skype, which seems to be the cheapest way to call back and forth; finish getting Medex insurance; resolve logistics for the apartment while I'm gone; buy a bunch of stuff--a few new clothes, body products; see people where possible; settle things up on the projects I'm working on at school.
It seems like a lot but it always gets done...so long as I do it. In the meantime, I'm heading to MD this weekend, which will be a good break.
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A post-script, disclaimer, and introduction:
I've never been totally clear on how I feel about or what I want from a personal blog. I've had them in various iterations over the years (one of which spawned this domain name; see below for more details); they always become something between a past-tense to-do list or ramblings on whatever came into my head, neither of which I thought were very interesting. Plus there's that weird conversation where you start to tell a story someone had already read on your blog. They're also more demanding than I think; posts, even bad ones, take a while to write. All previous attempts have thus been doomed to fail. A major benefit, however, is efficiency: I can keep in touch with people--more accurately, more people can keep up on what I'm doing--faster and easier by posting in one place. So, (previous failures => existing domain name) + (Upcoming trip with limited email access) + Efficiency = Blog.
About the name: Yeah, Hon was available, seemed like a nice homage to Maryland roots, and represented my intentions for a chatty blog. For more thoughts or verification on the "hon" phenominon, check here, here, or here. It clearly has nothing to do with Malawi. Or Boston. Just go with it.
Labels: malawi, summer, transitions
