Readings and Listening To Consider - 9/20/22

Books and Articles worth a Review…

 Making Comparisons – In a recent article from American Journal of Managed Care [2022;28(12)] the   authors[1] describe how Medicare Advantage is becoming the dominant form of Medicare coverage throughout the USA but, that “meaningful and accurate comparison with traditional fee-for-service (FFS) Medicare” is often not available to both beneficiaries and policy makers. The authors call for an improvement in the “transparency of programmatic costs and benefits to promote beneficiary choice.” The need for the comparisons is clear. Medicare came about nearly 50 years ago in 1965 as an entitlement benefit for the elderly. The articles notes that at the time of Medicare’s passage by Congress the average life expectancy was 70.2 years. Now, it is 78.7 years with more than 64 million Americans receiving benefits. But, rather than a simple Medicare fee-for-service (FFS) program, there is now a more value-based care delivery option, or Medicare Advantage (MA) designed to foster and support preventive services as a focus of the program. I can personally speak to the dilemma of many elder Americans in trying to understand the variable framework, options and approach to services not only with traditional Medicare but also the various Medicare Advantage options. On the whole, the authors raise a very important point – one that should be highlighted by health care professionals across the board.

A Repeat Thought – If you haven’t yet purchased your copy of Ray Dalio’s The Changing World Order, it is a MUST READ for all of us!! If you are traveling, the Audible version is also very good although having the book allows you to review the PDFs and graphics that are part of his thesis.

 

[1] Brian J. Miller, MD, MBA, MPHStephen T. Parente, PhD, MPH, MSGail R. Wilensky, PhD

Readings to Consider - 8/1/22

Books and Articles worth a Review…

Disturbing and SadCheck out this online interview of 20 somethings on a beach from someplace warm (most likely not Maine) that was sent to me by a colleague. It’s disturbing on one level but incredibly sad on another. If we don’t know the basics of where, how and why our nation came to be – how can we expect people to understand the more complicated elements of our society like what, where and for whom? The consideration is whether or not these are simply selected outtakes from multiple other interviews – a common approach used by comedians on late night. Despite that caveat, it’s still a bit disconcerting that these interviewees actually seem to have it made through our nation’s educational system with barely adequate knowledge of the country that provides sustenance as a base of operation and culture for their lives. BTW, if any of my readers come across items that you think I need to consider for inclusion in future editions, please feel free to forward them. I do read my incoming emails. Thanks…

The Supreme Debate – There are any number of recent articles and opinion pieces on the state of the U.S. Supreme Court. There are two that deserve your attention. The first is a report from the Commission on the Supreme Court that was established in the early days of Biden Administration and whose report was released in late 2021 by The White House. We need to look at the recommendations and consider them. The second is an opinion piece by Ezra Pound in The New York Times on July 10, 2022 with a slightly different perspective…

Readings To Consider - 11/4/20

Books and Articles worth a Review… 

The Erosion of Trust in American Governing Institutions – It comes up in virtually every discussion when the conversation turns to – or actually starts with – current events. Do we trust the government? David Matthews, the former Secretary of DHHS in the Ford Administration and the current President of the Kettering Foundation recently released With The People which puts forward ideas on how we can bring back the trust factor in governing the United States of America. I encourage everyone to read it. It’s filled with good ideas and offers a perspective we need to be debating in America today! PS – it’s only 48 pages long 😊 

The American Trifecta – It occurred to me several weeks ago that while the pandemic is front and center as one of the most horrific experiences we’ve faced in the United States, there are other “pandemics” sweeping across the American and international horizon. While we need to continue our focus on the viral or medical pandemic, we should not forget that looming in the background there are a couple of other – equally important pandemics – that require our attention. You can find the article here. If you have any thoughts following your read, let me know at This email address is being protected from spambots. You need JavaScript enabled to view it.. Stay well…Be safe…

The Fickenscher Experience – It’s been a tough couple of weeks. First, Suzanne’s Dad passed away at 90 after a short illness at his extended care home. He was a brilliant theologian and leading light on the Apostle Paul. He was my “go to” guy when I was trying to figure out how put current events into context of the longer term. Then, this past week we added yet another Fickenscher to the clan weighing in at 8#, 8oz and named Aurora Rex Fickenscher (Arfie for short 😊). Congrats to my nephew, Robey, and his wife Julie on this addition to their family. Then, very sadly, my Mom passed away just a couple of days ago. She has suffered from Alzheimer’s for some time but the last several years were the worst. I’ve been around disease, trauma, and sickness ever since I started working at a nursing home at the age of 16. But the worst disease and most traumatic for the individual and the family is Alzheimer’s. I wrote a piece about what parents mean that you may want to consider reading entitled:  On Losing a Parent for the Last Time. Thoughts appreciated.

Readings To Consider vs. The Occasional Perspective - 11/5/20

Books and Articles worth a Review… 

One of the individuals I follow regularly is Father Richard Rohr, a Franciscan priest who a bunch of years ago started the Center for Action and Contemplation. He sends out a daily thought. The one from yesterday – November 3, 2020 – is especially poignant where he quoted Quaker author and activist Parker Palmer – a another very thoughtful leader with a contemplative bent. Given the tenor of the times, I thought you might be interested in what Fr. Rohr shared from Palmer’s :

For those of us who want to see democracy survive and thrive—and we are legion—the heart is where everything begins: that grounded place in each of us where we can overcome fear, rediscover that we are members of one another, and embrace the conflicts that threaten democracy as openings to new life for us and for our nation. . . . 

Of all the tensions we must hold in personal and political life, perhaps the most fundamental and most challenging is standing and acting with hope in the “tragic gap.” On one side of that gap, we see the hard realities of the world, realities that can crush our spirits and defeat our hopes. On the other side of that gap, we see real-world possibilities, life as we know it could be because we have seen it that way. . .

If we are to stand and act with hope in the tragic gap and do it for the long haul, we cannot settle for mere “effectiveness” as the ultimate measure of our failure or success. Yes, we want to be effective in pursuit of important goals. . . . [But] we must judge ourselves by a higher standard than effectiveness, the standard called faithfulness. Are we faithful to the community on which we depend, to doing what we can in response to its pressing needs? Are we faithful to the better angels of our nature and to what they call forth from us? Are we faithful to the eternal conversation of the human race, to speaking and listening in a way that takes us closer to truth? Are we faithful to the call of courage that summons us to witness to the common good, even against great odds? When faithfulness is our standard, we are more likely to sustain our engagement with tasks that will never end: doing justice, loving mercy, and calling the beloved community into being.

Source: Parker J. Palmer, Healing the Heart of Democracy: The Courage to Create a Politics Worthy of the Human Spirit (Jossey-Bass: 2011), 10, 17–18, 191, 192-193.

Readings To Consider vs. The Occasional Perspective - 10/16/20

Books and Articles worth a Review… 

A First! – The October 7, 2020 issue of the New England Journal of Medicine provided an editorial that was a first in the 208-year history of the publication going back to its origin in 1812. “Dying in a Leadership Vacuum” 34 editors weighed in on the decision in support of the decision with Eric Rubin, MD as Editor-in-Chief explaining that the events of the Covid-19 pandemic cut across all levels of leadership from the President, to Governors and other in leadership roles throughout the nation.

Enhanced Listening So We Can Learn and Act – I have recently taken on an old interest that I put on the shelf a number of decades ago (actually a whole bunch of them) and re-energized the interest. It is writing – not just blogs but on more general issues. I have been doing all these readings about how to get in touch with your other self (hmmmm) as part of an embrace for the age I’m now entering. So, check out my new article published on Medium.com – //medium.com/@drkevin1951/the-new-requirement-42bf8d96c26a">The New Requirement: First Hear and Listen with Intent to Learn and Act. The article basically is a call for moving from the passive act of hearing auditory signals, to listening where we actually absorb what is being said to learning from the exchange with others to acting responsibly on behalf of the needs of society. It emanated from the lack of dialogue, debate and discussion that has taken an overriding grip on the American spirit. Any feedback is appreciated…

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