tougher on how we meet those ends. Itndoesn’t make sense to put a wheelchairnlift on every bus in America when wencan meet the needs of the handicappednby a much cheaper alternative. Wencan’t afford to govern by slogan.nAmerica has spent too much innsome areas and not enough in others.nHow much money has gone to buildnnew hospitals or new hospital wings?nExperts tell us that there are too manynhospital beds in America — the estimatesnrun from 200,000 to 400,000nexcess beds. Fifty percent of the hospitalnbeds in my state of Colorado arenempty. Our roads are deteriorating,nour teachers are underpaid, we havenover 500,000 medically indigent—butn50 percent of the hospital beds arenempty. The Rand Corporation foundn— albeit before DRG’s — that 25 percentnof the people in a hospital bedndidn’t need to be there. They werenthere for the convenience of theirndoctor or insurance policy.nLook at the number of health carendollars spent in the area of death andndying. We spend $50 billion a year onnpeople in the last six months of theirnlives, while we are not giving pregnantnwomen prenatal care and not vaccinatingnour children. We are simply notnrich enough as a society for each one ofnus to take $100,000 or $200,000 ofnour kids’ limited resources as we are onnour way out the door. We talk aboutnthe “right to die” as if we have a rightnto refuse. My research in this area hasndiscovered the amazing fact that worldwidenthe death rate is one per person.nWe must recognize that often the bestnthing to do in many instances is to donnothing. We must recognize that manynof the machines and procedures wenhave invented don’t cure but merelynprolong dying. Too often our legalnsystem and medical education force usnto use these machines, and “can do”nhas become “must do,” even if itnmeans using resources that could buynfar more health elsewhere in the system.nThe essence of the dilemma ofnhealth care, however, is that we haveninvented more health care than we as ansociety can afford. No matter hown”efficient” we get, no matter if wenadopt the Canadian or the Englishnnational health system, we will soonnfind that infinite medical needs havenrun into finite resources. Capital is then50/CHRONICLESnstored flexibility we have to build anbetter world for our kids. We only havenit once, and if we spend it on redundantnwheelchair lifts and empty hospitalnbeds — instead of robots and newnfactories and new teaching techniquesn— we cheat our children.nThis will require hard choices. Innsome places they are being made. Inn1986, the Oregon Legislature decidednto stop funding transplants (except kidneys)nand transfer the money, instead,nto maternal and child health. Theyndecided that basic health care for manynwould buy more health for Oregonnthan high-priced, high technologynmedicine for a few.nMisuse of our country’s energiesnand resources is rampant in many areasnof our society. Look at our legal system.nLook at the amount of moneynspent on a number of colleges andnuniversities that are simply not necessarynto meet our educational needs.nWe must painfully but inevitablynthink through the meaning and limitsnof compassion. Do we give a coronarynbypass operation to an eighty-five-yearoldnwith dementia? How many heartnvalves does the public buy for a drugnabuser? How much can we afford tonsubsidize self-abusive behavior? Twothirdsnof all the deaths before age 65nare the result of bad habits or selfabuse.nWe are going to have to findnyardsticks to compare hip replacementsnwith senior citizen centers. Do we givenchemotherapy to an eighty-five-yearoldnwith metatastic cancer and a 5npercent survival rate? I don’t know thenanswers to these questions, but I donknow that they have to be asked.nA just society can no longer bencreated by merely spending new money.nThere is some new money, but notnmuch and that is heavily mortgaged.nThe challenge of this Brave NewnWorld of public policy is to reexaminensome of our historic assumptions, tonreallocate some of our existingnresources to meet new needs, and tonfund our new inadequacies out of ournold excesses.nWhat is ultimately at stake here isnnot merely our standard of living, butnour entire economic and political system.nNo nation is great forever. Nationsnrise and nations fall. Sometimes itnis necessary to call on citizens to disciplinenthemselves, to sacrifice, to takenless, to stop thinking only of rights andnnnprivileges and to start thinking of dutiesnand responsibilities. No nation can foreverndistribute the spoils of a wealthyncontinent and past glory. At somenpoint in every nation’s history it becomesnreality time. That time is now.nTo do that, we must start to “think inndifferent terms.”nRichard Lamm, formerly governor ofnColorado, is director of the Center fornPublic Policy and ContemporarynIssues at the University of Denver.nPOP CULTUREnMother Knows Bestnby Bruce FrohnennMan may be dying out, butnpatriarchy — men’s oppressionnof women — lives on. If only we werenmore controlled by women, or at leastnby the feminine aspect of our natures,nlife would be much better: kinder, gentler,nand more “caring.” It is patriarchy,nafter all, that makes America so aggressive;nit is patriarchy that makes Americannwomen so miserable; it is patriarchynthat makes American men so disgustinglyn(dare I say it?) male.nOne of the primary battlegrounds innthe war against “patriarchy” is children’snliterature. As “Feminists on Children’snMedia” comment in the introduction tona guide to “nonsexist books about girisnfor young readers” entitled Little MissnMuffet Fights Back: “the rigid sex rolesndepicted in most children’s books —nactive and independent male characters,npassive and dependent femininen
January 1975April 21, 2022By The Archive
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