Platform: Introduction and Health Care

The Peggy Party Platform:

Introduction
I'm writing these as though for a political party platform. Any reader is welcome to revise them, embrace them, excoriate them, share them, etc. Topics in my mind so far include health care, housing, jobs, infrastructure, climate change and minimum wage. If you are particularly keen on any one of these, please feel free to draft something; I'll post it here and give you complete credit. I'm not going to footnote and document these. I'm just going to write them, to start a conversation. All the research and details can come later. Cool? Cool.

Health Care
Overview
The concepts on which this is based are inclusion; simplification for citizens, providers and government; cost savings; comprehensive and complete care; and reduction of over-prescribing (opiods aren't the only over-prescribed drugs, just the most devastating). While it is important to allow choice, it is also important to restrict excessive use of resources. This is socially inflammatory and medically difficult territory. As a general rule, the system should lead with "yes." "No" should require rigorous, medically-based (as opposed to politically-based) defense. Now, to the specifics:

1. Universal
The health care pool must be universal. This concept is based on simple, foundational principles: we are one, for everybody. We are an egalitarian society. We have passed legislation guaranteeing equal access for everyone, and health care should be no exception.

When I say everyone, that's exactly what I mean. Veterans should be included, and have access to health care anywhere; dismantling the VA health care system will result in some savings. The Bureau of Indian Affairs (BIA) manages a health care system for the First Nations; as you may imagine, it is less than excellent. So Indigenous People must be included. Dismantling that system will also result in savings. Medicare patients select a provider for Medicare Part B, the "regular doctor" portion of Medicare, so they should also be included.

This idea should be applied to any specialized, separate health care system, including the care currently provided to members of the armed forces and to Congress.

2. Single Payer
Currently, health care in the US is a siloed system: if you are a member of Group A, you can only go to Group A doctors and must be admitted to Group A hospitals, even if Group B's hospital is just next door, and has a better reputation.

The burden of managing these requirements is shared with physician's offices, who often employ someone just to navigate the complexities of approvals, referrals and payments.

With single payer, this is removed. Hospitals may be chosen, or may be allocated based on facilities and equipment available, or where a particular specialist prefers to practice. The doctor and patient together choose a specialist; the hospital results from where that specialist practices, or equipment needed, or surgical suite available when needed.

3. Women's Health
All decisions regarding a woman's heath are between her and her doctor.

4. Inclusive, Holistic
Since dental and vision care, including dentures and glasses, cannot be separated from the health of a citizen, those items will be included. Mental and social* health care will also be covered completely, by licensed providers. This will further reduce out-of-pocket costs for patients, since these items are seldom completely covered. Prescriptions will also be covered. If requested by the primary care physician (PCP), "alternative" care such as acupuncture, massage, chiropractic, etc. will also be covered. If needed, transportation will be covered.
* Social health may be thought of in terms of questions now asked: do you feel safe in your living situation? how much exercise do you get? It may also be enlarged to include: how often do you visit friends? Do you have regular social activities such as religious meetings, clubs or hobbies? What do you need to help you enjoy these activities?

5. Payment
Nothing will be charged at any time for any services or products prescribed by the citizen's primary care provider.

6. Administration
This system is predicated on everyone having a PCP to monitor prescriptions, manage care and keep track of the citizen's overall well-being. Each citizen will visit their PCP every two years during the month of their birth; after retirement, every year. The visit will include blood work, medication review, vision check, dental check, and such tests as physical ability, EKG, Pap smear, etc., depending on the PCP's recommendation.

Medical records will be digitized and available online to doctor and patient, and for review by local, state-based medical boards, which will oversee the performance of doctors and handle any complaints. These boards should probably be elected bodies of a mandated mix of medical providers, medical administrators and general population.

In order to assure the greatest choice, higher tier services such as elective surgery, private hospitals and "rock star" doctors will of course be available, the cost to be determined by the market.

Comments?
Please comment below. Keep it respectful, please, and be aware that deriding other viewpoints is seldom helpful.

Dreaming New York

In my dreams there are several houses I may visit.* The one I visited this morning is on the banks of the Niagara River, a palatial home with park-like grounds. It has three floors, the third mostly unfinished. It is the house where my Grandfather Peck lived "with his second wife."

I arrived at this house with my sister, by a circuitous route that included a visit to some sort of medical professional (for her) and included a side-excursion to a basement room where the staff was doing some sort of installation which Cheryle insisted on helping with. Contrarily, as dreams can be, I was the nay-sayer, the cautioner, telling her of dire results if she was less than perfect, or even mildly unlucky. As in real life (sigh), she ignored me and did as she would.

The final test of the installation was conducted: a clever device that sped along on magnetic rails, ultimately crashing through to the restaurant next door, where it destroyed 20 tables' worth of china and crystal - and brought us into my grandfather's house.

We dined in the dining room (on left-over pork chops my husband actually did cook last night) and then went outside to sit on what must have been a boat launch into the Niagara River. Our heels were scraping on crusted ice, but the night was warmish (back in reality, the temperature was climbing toward the 80s). Suddenly waves washed over us, and we were drenched.

Back in the dining room, we were wrapped in blankets and clucked over. Two of the diners came toward us: Sr. Mary Sicilia, dead for years, and The Rev. Alice Scannell, still alive, if not kicking, as far as I know. They were very concerned about our getting wet; we were nonchalant. It was a lovely surprise, and we chatted, and I woke up.

For the record:

1. My grandfather never lived (as far as I know) in upstate New York. 
2. My mother, however, is buried in Brewster, NY, on the grounds of the Community of the Holy Spirit, to which The Rev Alice and Sr. Mary Sicilia also belong. Am I being haunted? 
3. While other diners were nonplussed by our bringing our own food (those chops were delicious!), the staff were okay with it, since we were at home. Sort of.
4. No, I didn't wet the bed, but the water was warm.
5. I really wish my readers could see this house. You approach through a rather nice suburb, when you are suddenly in a park, with a variety of deciduous trees, carefully spaced and impeccably groomed and cared for. There are few flowers, until you reach a turn in the path; then the park gives way to flowering shrubs - azaleas, jasmine, roses, and many more - each in its own vast bed, surrounded by graveled paths and lush lawns. Then the house: a brilliant marble facade, with sturdy pillars holding up the main floor. First is the garage/basement entrance, a cavernous space of shadows and cool concrete. Circling past it, you come to the grand staircase and the main entrance. Turning, you realize the house is built on a bluff, and below you is spread the village, the shops, and the shining river. Inside is even better.

*None of them, alas, are Manderley: https://strandmag.com/the-magazine/articles/daphne-du-mauriers-rebecca/