An important column on an important matter dealing with medical priorities. It reminded me that California is providing $12 billion for stem cell research as the result of a ballot initiative that locks in the cash for those worthy pursuits without allowing the public to weigh in on what they think are the most important health care priorities in California.
I am fond of ambitious efforts to explore the unknown and develop miracle therapies. But I am also fond of attacking immediate health care issues with the possibility of at least saving lives within shorter time frames. Is it really possible to do both within the constraints of limited dollars and a limited will on the part of our political leadership to tackle them both?
You all can read more about the Golden State's research program on the California Stem Cell Report. https://david293.substack.com/
Thanks for highlighting a life and death issue Americans are comfortable ignoring. It is clear women and children are not a priority and America is not willing to invest in a society that assures the health of our women and children. The remedies are inexpensive and readily available if we cared.
This medical services industry dedicated to hyper-capitalism has deemed obstetrical and pediatric services as loss leaders and does not invest in training health practitioners, or prevention and health education required by the basic needs of society for reproductive health. MD’s have fought for the monopoly to deliver babies yet have limited the supply of trained physicians because OBGYN, Family Medicine, and Pediatrics are all low reimbursement specialties, with few high reimbursement procedures (tho’ it is worth looking at excessive US C-section rates in light of economic incentives vs medical necessity/evidence based practice).
A community based comprehensive reproductive and infant health delivery system based on midwives and doulas(with MDs only co-managing high risk pregnancies) with a focus on home or birthing center deliveries would increase access, decrease cost, and improve outcomes. A focus on prevention and health education based in communities and designed to meet a population’s health needs would include sex education, contraception, and early pregnancy detection. A humane system would empower women to make their own choices and maximize planned pregnancies. Addressing the larger social determinants of maternal and infant health would address access to childcare, nutritious food, medical and family leave, housing, and basic social supports.
These are all standard practices in countries with lower maternal and infant morbidity and mortality. These changes would gore the oxen of powerful political and economic forces with a strong attachment to maintaining the status quo. They have no political or economic advocacy. In this reality, real change is impossible. Americans choose to condemn women and children to needless suffering and death. It has become normalized and acceptable cost of doing business.
An important column on an important matter dealing with medical priorities. It reminded me that California is providing $12 billion for stem cell research as the result of a ballot initiative that locks in the cash for those worthy pursuits without allowing the public to weigh in on what they think are the most important health care priorities in California.
I am fond of ambitious efforts to explore the unknown and develop miracle therapies. But I am also fond of attacking immediate health care issues with the possibility of at least saving lives within shorter time frames. Is it really possible to do both within the constraints of limited dollars and a limited will on the part of our political leadership to tackle them both?
You all can read more about the Golden State's research program on the California Stem Cell Report. https://david293.substack.com/
Thanks for highlighting a life and death issue Americans are comfortable ignoring. It is clear women and children are not a priority and America is not willing to invest in a society that assures the health of our women and children. The remedies are inexpensive and readily available if we cared.
This medical services industry dedicated to hyper-capitalism has deemed obstetrical and pediatric services as loss leaders and does not invest in training health practitioners, or prevention and health education required by the basic needs of society for reproductive health. MD’s have fought for the monopoly to deliver babies yet have limited the supply of trained physicians because OBGYN, Family Medicine, and Pediatrics are all low reimbursement specialties, with few high reimbursement procedures (tho’ it is worth looking at excessive US C-section rates in light of economic incentives vs medical necessity/evidence based practice).
A community based comprehensive reproductive and infant health delivery system based on midwives and doulas(with MDs only co-managing high risk pregnancies) with a focus on home or birthing center deliveries would increase access, decrease cost, and improve outcomes. A focus on prevention and health education based in communities and designed to meet a population’s health needs would include sex education, contraception, and early pregnancy detection. A humane system would empower women to make their own choices and maximize planned pregnancies. Addressing the larger social determinants of maternal and infant health would address access to childcare, nutritious food, medical and family leave, housing, and basic social supports.
These are all standard practices in countries with lower maternal and infant morbidity and mortality. These changes would gore the oxen of powerful political and economic forces with a strong attachment to maintaining the status quo. They have no political or economic advocacy. In this reality, real change is impossible. Americans choose to condemn women and children to needless suffering and death. It has become normalized and acceptable cost of doing business.