Category Archives: accountability

Is Hospital Management Listening to Security Directors?

Just finished a webinar yesterday to over 60 hospital security directors and managers and they later wrote in to say that their management listened politely to their suggestions, their budget needs, their warnings about the new violence levels — and then they said, “Thank you very much”, and went back to their paperwork.

We all know how tough it is to run a hospital, but when will the administration realize that violence in hospitals, whether it’s a distraught son, shooting his mother’s doctor in Baltimore, or a grief-stricken Chinese man running through a Shanghai hospital killing innocent bystanders with a knife — that we have a BIG PROBLEM with the increasing violence in hospitals.

The nurses know about the violence.  In a recent survey of 1000 nurses who worked in emergency departments, nurses reported that 97% experienced verbal abuse, 94% had physical threats, and 66% HAD BEEN ASSAULTED.  The saddest part of this was that 25% of the nurses said they expected abuse and violent attacks.

We need to devote some resources to this problem and not wait until 100% of nurses report assaults.  It starts with awareness that there is a problem. Tomorrow we’ll discuss the next steps.

Maine Hospital Fined by OSHA for Not Providing a Safe Workplace

The Acadia Hospital in Bangor, Maine was fined $11,700 by OSHA (Federal Occupational Safety and Health Administration) on January 26th, 2011 for failing to provide a safe working environment for employees and improperly documenting workplace injuries.

They were referring to the fact that staff at the hospital had been subject to 115 attacks by patients between 2008 and 2010.  The report went on to say, “”The serious citation points to the clear and pressing need for the hospital to develop a comprehensive, continuous and effective program that will proactively evaluate, identify and prevent conditions that place workers in harm’s way,” said Marthe Kent, OSHA’s New England regional administrator.

OSHA’s report on The Acadia Hospital was at least partially the result of hospital officials making a policy decision to not use restraints on violent patients.   In fact,  Acadia Hospital’s CEO, David Proffitt, Ph.D., was very proud of this policy, saying in a published article in 2010,  “I want to share something I think is very exciting. The last mechanical restraint recorded at The Acadia Hospital was on June 21st, 2009.  This is a big deal.  We set a goal to end mechanical restraints and you have done so. It reflects a commitment to be the best at what we do.  And it gets better…… Our adult rate of restraint has been well below the national mean since May of 2009. . That means we are now in the top 3% of best performing hospitals!  I hope that fact inspires great pride in your self, your co-workers, and this hospital.  I know it does me!”.

Obviously, the no restraints policy wasn’t so great for the nursing staff!

Additionally, the OSHA report ordered the hospital to implement procedures to better protect staff, including screening patients for violent tendencies and offering more staff training on how to use physical restraints, though it did not specifically order the hospital to use them.

In the last eighteen months, OSHA has fined only a handful of hospitals for workplace violence-related incident, including Danbury Hospital, which had a homicide, and Oregon State Hospital in Oregon, which was fined in November 2010 for failing to give staff members self-defense training for dealing with violent patients.

According to The Statesman Journal,  OSHA fined the hospital $3,750 for violating three major safety violations:

  • Failing to provide timely training for staffers to use shields as “a tool to protect employees from projectiles, riots, and to approach patients in order to secure them.”
  • Not reporting to OSHA that a worker was hospitalized in late January after being assaulted by a patient.
  • Lack of written verification showing that a “hazard assessment” had been performed to ensure employees were provided with adequate personal protective equipment.

Looks like OSHA is gearing up to take workplace violence incidents more seriously in the future.   One of the backstories is that hospital employees talk to their unions, and the union leadership contacts OSHA on behalf of the employees.

The increasing problem with workplace violence in hospitals makes it absolutely imperative to start with a comprehensive program to combat and prevent workplace violence.

After Arizona, Does Congress Need Gun Legislation, or Just More Effective Security Risk Assessments?

The terrible shooting in Tucson this week was widely seen as a wake-up call for members of Congress who probably spent at least part of the weekend wondering if their security was enough.

 I can answer their question – it is probably NOT enough.  The morphing of politicians into celebrities (call them Pol-ebrities??) is great as long as you get lots of TV time and the cameras are flashing and the contributions are rolling in.   The downside is the same one that led to John Lennon’s death – Celebrities draw the crazies.  Now that elected officials are becoming Pol-ebrities – they are becoming targets.

With proposals rolling in from all quarters, including putting a giant Plexiglas shield around the House floor, limiting the distance a constituent can stand in relation to a congressperson or senator, and many other ideas, it is clear me that what is missing is the use of standardized Threat/Risk Assessments.

 Security is always a trade-off.  How much money to spend to protect a public servant and legislator?  Is it worth an extra $25,000 per year per person, or should it be $100,000 per person per year – or should it be a million dollars?

Ask the potential target and I guarantee they are voting for the $100,000 solution.  Ask a beleagured taxpayer and they would think maybe $5000.00.  The problem is that it is impossible for an individual to do a true cost benefit analysis and decide how much money is enough?

Enough to provide ‘adequate” and ‘reasonable’ protection. 

Enough for a ‘normal event’?  What about a high-profile event?

Can you analyze it based on the numbers of people who attend a certain event?

All these questions are about 1/15th of a security risk assessment. 

Like the Department of Homeland Security – the executive protection should move to a more quantitative, risk-based model.  Traditional executive protection checklists are no longer enough.

There are so many elements that go into a threat risk assessment of an public, or private event.  We can look at the Tucson shooting and see that if the usual checklists were used, someone might have:

Checked the crime rate around the location (which turned out not to be at all relevant.)

Checked to see if any other congressperson had ever been attacked
at a town hall meeting in the last twelve months (perhaps more relevant).

These are just a few of the many checks that would have been performed prior to the event, but whether these were done partially, completely, or not at all, they are not risk-based, instead, the classic protection model is more threat-based than risk-based, when what you need is a combination of the two.

If we can create a standardized risk-based scenario for protection of these high profile Pol-ebrities, it would include all the basic information, plus data on the number of phone threats received by that individual legislator; and also, an aggregate of threats received by all legislators.  It would include blog and web searches to see how many times a particular name was mentioned or cited in a negative way.  (And yes, finding a web site that includes a rifle target signal over your district counts).

In addition, it’s interesting to get a historical perspective to see how many government representatives have been threatened, shot, stabbed or murdered in the last five years, and to see whether that trend is increasing or decreasing.

The shooting in Tucson was a workplace violence incident by a totally deranged person who had total access to his victims.   There was no advance screening, no physical barriers, no bodyguards waiting in the wings in case something went wrong.

Many of these missing elements, along with others, can be used to create useful threat risk assessments that can be standardized,   and automatically generated for all our high profile public servants to provide much more effective security for the people who need it most.  

Instead of treating each of these violent incidents as a completely isolated event, society needs to recognize these patterns that are emerging as legislators become celebrities, and that there is an increasing acceptance of violent solutions to individual problems.  These patterns need to be watched, tracked, and applied to each individual’s protection profile to improve personal security and prevent future violent attacks.

JOHNS HOPKINS HOSPITAL MURDER/SUICIDE IS TOO CLOSE TO HOME!

My summer vacation is over so I jumped right back into work by doing four webinars on workplace violence in the last four days.   I have been very concerned about the trend toward violence toward healthcare and hospital workers.

Having just researched and presented on this subject two days ago, I was greatly saddened to see it AGAIN, 30 miles from my home, at the prestigious Johns Hopkins Hospital.   Local media and CNN covered it extensively because the man shot his mother’s doctor in the stomach, apparently after his mother was paralyzed as a result of spinal surgery.  He then barricaded himself into his mother’s hospital room and eventually shot and killed her and then shot himself.

With a staff of over 30,000,  this was a major incident.  I would love to calculate how much the hospital might have lost from having the staff vacate the building for at least two hours.

This incident once again opens the debate about how to ‘secure’ hospitals, or at least to have a better way to ensure the safety and security of both the staff and the patients.  Hospital administrators continue to maintain an ‘open environment’, and don’t seem to understand that this problem will continue to increase, if there is not way to better manage access in hospitals.

On the radio today, I heard that Baltimore City Council President Bernard C. “Jack” Young said that John Hopkins security is adequate and that using metal detectors would create a hazardous situation for patients entering the building.   “Why would they want metal detectors going into the hospital?” Young said. “People go to the hospital because they got shot. People wouldn’t go to the hospital because of the metal detectors. They would stay away and die rather go through metal detectors.”  He also mentioned during the same interview that the hospital has over 80 entrances.

This exact problem is raging at hospitals all over the country, because violence is dramatically increasing in healthcare.  The NIOSH study from 2004 reported that  violence in hospitals was over four times the national average for non-healthcare workplaces.  Of course, it is now 2010 and that is a long way from 2004 – AND – we have had a terrible recession raging since 2008….

The results of an Emergency Nurses Association survey released in 2009 found that more than 50% of ER nurses had experienced violence by patients on the job and more than 25% had experienced 20 or more violent incidents in the past three years. Research showed long wait times, a shortage of nurses, drug and alcohol use by patients, and treatment of psychiatric patients all contributed to violence in the ER. 

There has been only sporadic interest in this phenomenon and no standard has emerged.  For example, a NIOSH (National Institute for Occupational Safety and Health) Publication in 2004 is called Guidelines for Preventing Workplace Violence for Health Care and Social Services . OSHA Publication 3148-01R (2004). This guide describes the special considerations surrounding workplace violence in the environments of health care and social services.

After my last column on Workplace Violence issues in healthcare, I got a few angry letters from associations and organizations saying they had been working on creating standards for this – FOR THE LAST FOUR YEARS… but amazing, they have not been published.  

There is NO standard or requirement for preventing workplace violence, only the vague requirement for employers to maintain a safe workplace.   Twenty-seven states have come up with their own ‘guidelines’.  Remember – standards are Required, guidelines are only recommended.  That means if the incident happens, the management has no liability because they did not disregard a requirement.

My regular readers will remember that I recently visited a hospital that had a murder about two years ago and even two years later, it was still having a traumatic impact on the staff who witnessed the incident. 

I am a big believer in risk assessments and I think having a workplace violence assessment REQUIRED of every hospital, and having that information aggregated nationwide and studied, would be a big step that improve our knowledge of why this continues to increase, and would also point to more effective solutions to safeguarding our hospitals.

Maybe people will start to press hospitals on this issue – after all – they may end up in a hospital some day, and probably would like to be safe and secure during their visit.

Maybe the aging baby boomers will finally demand more security in their hospitals.  I hope so.

Workplace Terror in Manchester, Connecticut

Yesterday a tragic story unfolded in Manchester,  Connecticut.   You probably already know that nine people were killed when an employee who was being fired, came back in with his hand gun,  started shooting and, after calling his mother, killed himself. 

This incident is part of a bigger and growing trend to more workplace violence incidents – not only in companies in general, but in hospitals to an even greater degree.  The Manchester incident also illustrates again some of the basic tenets of preventing workplace violence incidents. 

Patrick Fiel, Public Safety Advisor for ADT Security, commented, “The industry standard is to not  terminate employees in open areas where other individuals may be working.   Firings are always touchy situations and should be conducted in an isolated areas, even off-site, away from the work areas.”  

“Many companies have crisis plans in place, and also conduct security risk assessments annually  to prevent this kind of incident.   A comprehensive security assessment  might have saved nine lives by setting up procedures for the termination; and additionally, by making sure employees knew what to do when he did draw his gun.” 

I have been reviewing workplace violence incidents in healthcare and find that they have skyrocketed since the recession started.   Violence against supervisors, managers and also nurses and other healthcare workers has spiked significantly.

 It is surprising to read the following statement on the osha.gov web site:

There are currently no specific standards for workplace violence. However, this page highlights Federal Registers (rules, proposed rules, and notices) and standard interpretations (official letters of interpretation of the standards) related to workplace violence.

Section 5(a)(1) of the OSHA Act, often referred to as the General Duty Clause, requires employers to “furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees”. Section 5(a)(2) requires employers to “comply with occupational safety and health standards promulgated under this Act”.”

It might be time for OSHA to develop some workplace violence prevention standards.  Many of the ones we use in our risk assessments are related to standard security safeguards – such as having a written termination policy; making sure that if  worker at one location is fired, that all other locations are notified so he can’t just go to another office and cause an incident. 

Much of the statistical data we found on the OSHA website were at least six years out of date, which makes it harder to track current trends in workplace incidents, unless you catalog the media-reported events and run an analysis on them.  The U.S. Bureau of Labor Statistics reported  “Mass shootings receive a great deal of coverage in the media, as we saw with the Orlando, Fla. office shootings in November 2009 and in the shootings at the manufacturing plant in Albuquerque, N.M. in July 2010.  Out of 421 workplace shootings recorded in 2008 (8 percent of total fatal injuries),  99 (24 percent) occurred in retail trade.  Workplace shootings in manufacturing were less common, with 17 shootings reported in 2008.  Workplace shooting events account for only a small portion of nonfatal workplace injuries.” from http://www.bls.gov/iif/.

It makes me wonder if the workplace violence statistics from 2008 until now may be such a large increase, that has been either underreported or even held from publication!

According to a report by the National Institute for Occupational Safety and Health — “State of the Sector/Healthcare and Social Assistance” — published in 2009, health care workers are more than three times as likely as workers in other industries to be injured by acts of violence.

“Health care workers are at risk for verbal, psychological and physical violence,” the report says. “Violent acts occur during interactions with patients, family, visitors, coworkers and supervisors. “Working with volatile people or people under heightened stress, long wait times for service, understaffing, patients or visitors under the influence of drugs or alcohol, access to weapons, inadequate security, and poor environmen­tal design, are among the risk factors for violence,” the report continues.

In the current economic environment, the physical security (facility) risk assessment can be used as an important tool in making sure that basic industry standards for preventing workplace violence incidents; or limiting the damage they can do – especially for making sure the staff are protected from violent incidents by their co-workers.

The security assessment can be followed by the creation of specific, detailed crisis plans that make sure people know what to do when the unthinkable happens at work.  One of the reasons that workplace violence incidents are so upsetting to all of us is because the person KNEW the people he was killing.  He probably knew their spouses and met their children at a company picnic.  It makes the violence more personal and scary, a whole different thing than falling off a ladder.   And it reminds us all that it COULD happen here!

Return of the Sea Monster as a Force of Nature

Last week I wrote about the oil spill in the Gulf and today I was looking at my Loch Ness model of a sea monster with a cute little red beret.  I thought about the concept of a SEA MONSTER. Any terrible  sea monster worth its salt would:

     1.  Kill things indiscriminately

     2.  Hide under the water until it is unleashed on an unsuspecting world.

     3.  Be very hard to kill or subdue.

Sound familiar?  Because the gulf oil spill IS a Sea Monster – probably worse because the Spill Monster doesn’t just kill virgins and itinerant fishermen – it kills everything.  Kills grass and insects and crustaceans (like shrimp) and also sucks the oxygen right out of the water so it doesn’t just kill everything now and then go about its business, but it makes recovery impossible.

If I was a senator or congressman I would be drafting up a bill requiring drilling AND mining companies to not only do a complete and comprehensive risk assessment PRIOR to exploration or drilling activity, but also to publish their contingency plans, disaster recovery plans and emergency plans.

Somewhere along the way – the phrase “disaster recovery” planning got pinned to the information technology recovery but it really applies to everything and certainly to risky endeavors like mining and drilling.

It would be tempting to say that the risk assessment and disaster recovery planning (in the broad sense) should be required on everything that has the potential to adversely affect the planet.   Who would administer it?   This is where the U.S. is again trapped into a corner by the responsibilities of each federal agency.  

In a perfect world, you’d like to think that the EPA (Environmental Protection Agency) would be in charge, but that, under the present structure, would exclude deep sea drilling and agribusiness concerns.   Because the EPA is regulating toxic substances like chemicals, and air quality, but not everything that affects the ‘natural environment’.

We need an ENVIRONMENTAL OMBUDSMAN to protect the citizens of the United States, and maybe of the whole world.   This position would cut across the current agency lines to include oil drilling/extraction; mining as in strip mining;  use of pesticides in agribusiness; industrial pollution of rivers, lakes and oceans; and deforestation.

Over-fishing belongs in the same category.  I have heard that Blue Fin Tuna is now endangered and the United Nations is going to vote this year on protective measures. 

Basically all these kind of industries, mining, drilling, fishing are all scooping raw material up out of the earth and selling it.  The companies involved seem intent on drilling, fishing or scooping up as much as they can get of FREE STUFF from the planet, and then selling it for enormous amounts of money.  Again, you would think that old self-preservation gene would kick in, but instead, it may be that when one of these industries hears that whatever they are taking could be limited, or managed, or made less easy to get, they rush to get every more before the limit or ban goes into effect. 

This behavior accelerates the underlying diminishing supply problem, drives up prices, making industries want to get even more of their oil, minerals, diamonds, fish, whales, or whatever and so the cycle becomes maximally destructive to the environment on even a shorter time line.

One of the biggest aggravating factors of the current SPILL MONSTER is that we, the taxpayers, basically financed it and now we are going to get to pay to clean it up, and the paying includes providing services for all the damaged parties.  Do you really think that BP is going to cover the entire costs by the end of the day?  I am highly skeptical.

We keep hoping that man’s (and woman’s) survival instinct is going to kick in at some point and people will think, “If we don’t keep the earth clean, it is going to negatively affect MY health, or MY business, or MY customers”, but we, as a country, are not quite a that tipping point yet.   I hope we get there sooner instead of later.

The Oil Rig Disaster and Risk Assessment — And Accountability Issues with Politicians

“Drill, baby, drill.”   We have heard that before – being from California and being a tree-hugger, I didn’t think that was a great idea, especially since I know our oceans are already struggling, but I did not expect something this bad to happen.

The politicians who were so busy expanding oil leases and the profit-rich oil companies who are raking in billions,  don’t spend much time on assessing the potential risks AND the potential losses for a catastrophic oil spill.

Maybe we should require them to do REAL risk assessments on the total possible impact of an oil disaster.    It would not be an environmental impact statement, which downplays the risk by putting in lots of scientific jargon and ASSUMES that proper safety controls and contingency plans are in place.  But obviously that either was not done;  or it was not accurate, or it was done and burned so no newsperson would ever see the smoking document (or should I say, the oily document).

If we go back to the classic risk model – we are by listing the assets at risk:

  1. The Cost of the Original Rig and Drill Equipment – $500,000,000
  2. The Value of the Lives of the 11 workers who died –    25,000,000
  3. The Value of the Oil itself, with replacement value
    (5 million gallons at  $2.00 per gallon = $10 million dollars)
  4. BP’s Reputation as a good company – $2 million
  5. Gulf Fishing and Shrimp Industries Value – $2.5 billion dollars for

Just Louisiana – add in Alabama, Mississippi and Florida and quickly     the bill runs up to $10 billion dollars.

  1. Value of Summer Beach Tourist Business in the Gulf – $20 billion
  2. Value of lives of 20,000 – 50,000 shorebirds; 10,000 turtles; 0ther assorted marine mammals, birds, and fish   – $25 million.

So we have a resource worth about $33.5 billion dollars – that is potential loss estimate.

What we will lose if a threat materializes?    Keep in mind, for comparison purposes, that BP had recently doubled it’s profits from $3 billion to $6 Billion a quarter,  which calculated out to about  $24  Billion Dollars a Year.

Next we factor in the likelihood of a threat occurring.  Reviewing the frequencies of and problems problems with oil rigs, and oil spills, we find:

There are an average of about 2000 oil spills a year of various degrees.

There are an average of 1 million gallons spilled each year (going back 7 years).

(Already you can start to get a idea of how terrible this spill is.)

Next we list all the problems (vulnerabilities) that could or would have made it more likely to have a disaster occur,  you will recognize many of these from the latest news conference

  1. New,  untried technology
  2. No recovery plan if secondary shut offs fail
  3. Difficulty of working on deep ocean
  4. No reliable oil containment systems have ever been developed

SO – if British Petroleum is making $24 BILLION A YEAR and because of this spill, BP loses about $1 billion dollars. That’s not a bad Return.

The problem comes in with the $30 Billion dollars that is borne and felt, not by BP, who goes on to drill somewhere else, but by the citizens of the affected states and the whole United States due to the incalculable environmental damage.

The last thing we look at in a risk assessment model is the potential controls that could have been put in place to reduce the likelihood of the threat materializing, and the cost of those controls that could either reduce the threat, or, and even more important in this case, minimize the damage if the threat occurs anyway.

What controls could have been improved in this model?

Development of effective oil capping techniques BEFORE a disaster

Better training of oil rig workers

Better fire controls which might have saved the rig from sinking.

Accountability Increased for the Materials Management Service (MMS)

Tougher Regulations for Oil Companies

Better oil containment tools

Better oil absorption tools

Regular drills so that workers are better prepared in an emergency like this.

I’m still here watching the news coverage but I have learned why this happened – because BP was making so much money, it just didn’t have that much to lose from a disaster.  So it avoided improving its technology and spending money on controls that might have helped.

And the former and current U.S. administrations are to blame for not requiring accountability from the MMS.  And the rest of us, including the bluefin tuna, the birds, the jellyfish, the crabs, the shrimp, bottlenose dolphin, sperm whale, dozens of varieties of sharks, manatees, oysters, warblers, terns, swallows, egrets, plovers, sandpipers, pelicans,  loggerhead turtles, Ridley’s turtle, diamondback terrapins, and alligators.

According to the Louisiana Department of Wildlife and Fisheries,   here are the numbers of species that will be affected:

445 species of fish,

45 species of mammals

32 species of amphibians and reptiles

134 species of birds,
and the ocean itself, and all of us.

Avatar, the Field and the BP Oil Spill

As the old drill-baby-drill cry loses its appeal, the coastal communities in the Gulf of Mexico are beginning to understand that they will feel the devastating consequences of the BP oil spill. 

The U.S. is a bicoastal country – 50% of the entire population of the United States lives within 50 miles of a coast.  And pays extra in housing prices to live there.  Ignore for a moment all the businesses that will be impacted – and think about buying a $4 million dollar house on the water – and have the water turn into an oil slick. 

I watched Avatar last night and noticed how the movie depicted the planet, Pandora, as an interconnection of elements that you could SEE how they supported  and depended on each other. 

That illustrates our relationship with our own Earth and how if one thing changes, it effects everything along the food chain (literally, in this case).  So the oil gets the birds and the blue crab larvae and the shrimp and now they are saying it may wipe out a generation of sea life.

As a species, we generally do not recognize that our connection with the earth is every bit as interconnected and tangible as the network on Pandora.  We need the earth to give us water, provide us with food (whether you are a vegetarian or not), provide water and shelter, medicine – everything – even manufacturing of plastic comes from the earth through our use of petroleum.

 That is also why ideas about animals are often so ‘un-evolved’, meaning they are thought of a things, not spiritual beings.  Time magazine ran an article on animal intelligence several years ago and said, at the conclusion of the article, “if we recognized and were aware of how sensitive and intelligent animals actually were, we would have to change everything we do as humans.”

News flash — we ARE going to have to change everything we do – we have to find our connection to the earth and the animals and plants who share it, or we will continue to have these devastating environmental disasters and wake up one day to a wasteland that can no longer support us. 

If you’ve watched “What The Bleep”, which is a movie that explains new developments in quantum physics – and I highly recommend that you watch it…  you will reach the same conclusion – that the electric Field exists on our planet and connects you and me to every dog, every blue crab, every tree, every blade of grass.  There is no artificial separation.  We are them and they are us and we are the same thing – just a different sector of the same energy field. We are Pandora. 

Oil spills and other disasters make this living network more apparent by watching, hour by hour on CNN, how one event affects everything, first in the Gulf, then in the entire coastal area touching the Gulf, then probably the Caribbean – who knows how wide the damage will be from this one oil platform. 

Do you feel the connection?  A few years ago, I got a great book about ‘curing the incurable’ and it was a collection of Russian folk remedies – from a former doctor to the Russian Olympics.  One of the remedies was how to use trees for healing – complete with details about which trees were most responsive – how to tap into the energy of the trees and use them by standing eighteen inches from the tree and putting your hands on the trunk…

This oil spill may dissolve political differences and even national differences and show us, one more time, how interconnected we are with the earth – and I’m hoping that we will find a positive way to use that information.

DO WE NEED HEALTH INSURANCE?

HEALTHIER WITHOUT HEALTH INSURANCE

Last week I showed you my medical records – now I’m going to give you my take on the Healthcare Bill & Accountability! 

I never had health insurance — shocking, isn’t it!!  I grew up and raised two wonderful sons without any health insurance.  Part of it was my natural disinclination for paperwork, part of with my years of being self-employed but the main reason was I never understood why I should pay someone – that is – bet against myself — on my health.

Because I wasn’t saddled with medical paperwork, I could negotiate with the doctors for treatments I needed and usually got the price down 40% BECAUSE they didn’t want to use insurance anyway – it meant they got paid in six months instead of right now. 

My family believed in Adelle Davis – for those younger readers – she wrote “Let’s Eat Right to Keep Fit” and “Let’s Cook It Right”, “Let’s Get Well”, and “Let’s Have Healthy Children”. These books came out in the 50s and my mom was an immediately convert.  In fact, if you find these tattered old paperbacks in a used book store – you’ll see they were ahead of their time, in worrying about aluminum pans contributing to Alzheimer’s, endorsing fresh fruit and veggies for Vitamin C., and taking on the food industry which mightily contributes to disease in this country. 

I was never sick.  One bout of Scarlet fever that left my sister, Linda, deaf in one ear, but other than having two children – I was never sick.  The one year I did have health insurance was a total loss – paid about $3000 for N*O*T*H*I*N*G.  

Mind you, I’m in favor of national healthcare, delivered simply and effectively.  I am NOT in favor of fifteen xrays for a sprained ankle, seventeen mammograms that find nothing and basically – what I call the over-zealous use of medical technology.

Hey – news flash – healthcare is a BUSINESS!! Healthcare providers want to MAKE MONEY. The more procedures they perform – the more money they make.  It’s a very simple system.

So if it’s true that you have to incentivize people to stay healthy – maybe that’s the way to teach personal accountability for your own health!   I am amazed at how many of my friends, who are smart, and well-educated – turn their healthcare over to any doctor and do not question anything the doc says.  They don’t ask about the procedures or the tests, and they always assume that the doc knows best.

Nothing wrong with doctors – I love them.  But it’s YOUR BODY – learn how to take care of it!  Watching all the news about obese children, increase in diabetes, and declining health of the baby boomers (me included – I’m a baby boomer, but still healthy), it’s clear to me that what is missing is the connection between how someone lives every day – and how healthy they are.   So how do you encourage a healthy lifestyle?  That’s the $64,000 question.

My ingredients are simple:

Being outdoors
Taking extra vitamins and herbs
Getting moderate exercise
Eating less animal products
Low fat dairy
Don’t eat refined foods
Having pets
Doing work you love
Stress relieving activities – yoga and meditation work for me.

And… the big secret – being happy every day. 

So I am all for encouraging accountability and changing the insurance picture in this country.    This could mean – sliding scale of insurance costs based on how healthy you are.. like a Good Driver Discount for Staying Healthy! 

Having employer-sponsored plans also weighed and have unhealthy workers penalized.(I know that’s tough love – but they will thank you years later).

And adjusting pricing of health services so that preventive things  — like getting your blood pressure checked, become less expensive than expensive procedures like MRIs and CAT scans. 

Getting back to my original point – if you are totally RESPONSIBLE for your own healthcare – you make the extra effort to stay healthy. It’s a personal choice we all make every day.