The Plight of the “Poor (as in underrepresented in politics, power and money) Boys”

The Plight of the “Poor (as in underrepresented in politics, power and money) Boys”

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Recently, something magnificent happened to me!  A gifted writer with a great deal of following, upon whose article I commented earlier on, actually replied to me! You heard right. He not only replied, but also managed to, even if (slightly) patronizing me in his response, still connect with me on LinkedIn! Oh, the omnipresent and positive power of social media… What happened you ask? Well, before you’ll see my brilliant if I say so myself response, let me catch you up first:

This writer wrote a fabulous & empowering piece “Letter to My Fellow Men” where he questioned the ingrained gender-specific, ok let’s call them sexist, stereotypes, behaviors and views. It started with him noticing the treatment/ behavior his wife was getting from the men in Silicon Valley. So needless to say, from the get-go, I was a fan! It cut right into politics and democracy, into the make up of the 2015 U.S. Congress, it went right through to the issue of true representation of women in city/county/state or federal governments or to the dismally low number of nurses, for example, being elected to hospital boards. His Letter took a strong stance on gender, politics, sociological conditioning and the distribution of political power therefore on the learned, ingrained and enforced stereotypes we all face in everyday society. Right up my alley, yes?

The follow-up to the Letter, was a long article discussing a variety of issues among which was a paragraph commenting on the current heightened trend – if I may call it that – of supporting girls or ‘looking after girls’ and their empowerment, and how as a society we are now more cognizant of gender issues with #HeSheHero campaign. Still good, right? After the girls empowerment, he went on to list the shortcomings of the boys; how boys are medicated with Ridillin (no kids, no idea about the spelling) at much higher rate, how boys read at much lower grade level, and how boys don’t do well at school. At the end of this part he asked: so who is “looking after” the boys?

With that one sentence, my teeth started to grind especially since our ‘gender-barring friendship’ was going so well.

That one question stopped me in my tracks and while realizing we were perhaps on our way back to “Gender-Stereotype Central“, it all started to (not) make sense. One thing, however, was clear: if an educated man who publicly stands up, questions, critiques and calls upon his fellow men to end their gender stereotypes and sexist behavior, if he thinks that the current support for girls or the attention to girls empowerment (hurray for #GirlsLead) threatens the boys status or existence -> we have a very long way out of the frequently-jammed and traffic-impacted Gender-Stereotype Central. Perhaps I am not doing him justice, perhaps it was not meant like that. Perhaps. But on the other hand, why would you pose such a question?

Hmmmm…..

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So I gathered my courage to face fears of being publicly criticized and/or not liked, and I wrote: “…yes, and even with such dismal statistic, the “poor boys” still manage to make it to the top and control the power, money and influence.” And this is where the marvelous thing happened – he replied! Then however came the next round of courage in reading his response…

What I read was a slightly patronizing reply about how making comments like mine lead to no other purpose than to gender discourse and/or to the perpetuation of sexism, or something to that sense. He went on to say that he found my use of the phrase “poor boysoffensive or smarmy and was quite frankly surprised to hear it there, or from me, I can’t remember the exact wording. HUH?

As a good ol’ feminist broad with a keen feminist mind for analysis, I immediately started to count the ways in which he just patronized / offended me based on nothing but my gender… Yes, my Women’s Studies professor was thinking about me and didn’t know why… 🙂

…so here you have it, folks, all she wrote (well, not quite). You have been caught up.

=>> So Before you scroll down and read my brilliant and utterly awesome response, please do let me know if I am wrong (or how much wrong), if you encountered perhaps a similar situation, or felt like talking back or speaking up somewhere on a gender issue? What would you have said? Do you agree OR disagree with ascertaining that comments like mine, or similar in nature, serve no other purpose than to incite gender discourse or bias or sexist behavior?

I always enjoy your comments, I appreciate other people’s point of view, I learn from it. It is only through communication we truly learn <<=

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So, HERE WE GO(due to word limited replies on LinkedIn, I had to edit my piece down and posted the second half only)

“Thank you Louis for your response.

I do appreciate it, and I’d like to welcome you to my professional network. Happy to have you as a part of mine.

I’ll take a wild stab here when I say I am not alone here; a woman, an immigrant, with an accent, without influential friends in Ivy colleges (or Towers but I would want some), fighting her way in men’s business every step of the way. Trust me when I tell you there was no offense or smarminess (is that a correct word?) intended in my comment because I know how it feels since I have been on the receiving end. As a discussion leader in Women’s Studies classes at a university, I brought the men in to talk about issues, I asked their opinion, I shielded them from emotional and un-constructive attacks and I always included them. So you are way off the mark here.

You take an offense at me using phrase ‘poor (as in underrepresented in politics, money, power and government) boys‘ but rest assured, I do not take offense at your shall-we-say smarmy or even-slightly patronizing response. I like your article, I enjoy reading your stuff, I love your Letter to Men and I think there should be more men, thought-proving leaders and husbands like you. Having said that….

My use of the ‘poor boys‘ phrase was meant not as an offensive derogatory terminology, but as an incredulous response to your question of who is looking after the boys. That quite frankly, I could not believe I was reading!

Men control if not all, than almost all, of U.S. power and money, in 2015 we’ll have still-a-laughable-number of mere 100 women in U.S. Congress, women make up 51% of population yet less than 24% of elected officials in city and/or county governments, and while nurses (majority of women) make the largest pool of healthcare professionals, they still make only 6% – 9% of elected hospital board members.

Taking it one step further, before the Mid-Term 2014 Election, even “Liberal” California has elected only I believe around 180 women in total during its entire political history to the CA State Legislature, furthermore, speaking of California, women candidates / possible legislators even lost several seats here. And I could go on….

So when your article asks who is looking after the boys, yes, the poor (as in underrepresented in politics, power and money) boys since we are now finally looking after the girls, I must ask if we are talking about the same playing field, because I do see little disparity here, don’t you? And that was THE intended point of my comment. I thought THAT could be something a great writer such as yourself with an impressive following could look into and write about. People would listen and attitudes would change! What happens that even if having such dismal initial statistics, as you write, boys (i.e. men) still end up at the top, controlling the power, wealth and the seat of influence? What happens?

That was the point I was trying to make, and clearly badly.

PS: Boy do I like this! Thank you for such a great topic and for this discussion.”

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Velvet Revolution… the American Style!

Velvet Revolution… the American Style!

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Unless you have been under a rock (or sedated) for the last week, you must have heard that on Nov 10th, 2014 it was 25 years since the fall of the Berlin Wall. What you may not know, however, is the fact there is another 25 years anniversary coming up! Yes, it is the anniversary of the Velvet Revolution in then-Czechoslovak Socialistic Republic (CSSR) on Nov 17th, 2014.

What is most fascinating, and also troubling to me, is the fact that there are celebrations and commemoration events scheduled and planned all throughout the week of Nov 17 through Nov 22, 2014 in Washington D.C. These events include a future of democracy panel discussion, Czech Philharmonic Orchestra performance, Gala at the Czech Embassy in Washington D.C. (no, sadly don’t have an invite), to a Panel Discussion on Vaclav Havel’s Legacy Today (yes, I scored an invitation by simply begging the organizers. Thank you very much!) to the Dedication & Unveiling of the Vaclav Havel’s Bust in U.S. Congress (I will be begging the organizers once I arrive in D.C.) all the way to something most extraordinary!

On November 17th, students, faculty and Alumni of the world-class respected and coveted Georgetown University will be re-enacting – yes, you read right – re-enacting the events of Nov 17th, 1989 in Prague where the brave university students took to streets of Prague and demanded more freedom! Czech students were peaceful, did not make any troubles, except of course for gathering and speaking publicly which was unlawful and criminal in then-Czechoslovakia. To punish the students and make them dispersed, the Communist regime, under the tutelage of president Gustav Husak and Prime Minister Milos Jakes (none were ever held accountable), sent units of Police (Verejna Bezpecnost) in heavy riot gear, with sticks (“pendrek” in Czech), tear gas and water cannons to “take them down”.

The rest is, as they say, history…

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So let’s recap: Georgetown’s students, faculty and Alumni, while celebrating International Students Day, will be re-enacting events of Nov 17, 1989 and of coming days, including reading passages of speeches and proclamations made by then-student government and their leader Simon Panek (current Director of Czech global humanitarian organization ‘People in Need‘ and in Washington D.C. for the events) and by the leader of Obcanske Forum [Civic Forum] Vaclav Havel, the last president of Czechoslovakia and the first democratic president of Czech Republic. Why is this so extraordinary and remarkable?

Because there are NO such commemoration events planned in Czech Republic! That’s why.

Plain and simple. Sad, isn’t it…? I contacted a number of friends in Czech Republic asking them about celebrations. Nothing…

This one fact should tell you everything you need to know about the status of Czech politics and the standings/respect of Czech politicians. I no longer say I am in politics, or that I studied politics, or that I do politics, or that politics is my passion – I do not say that when I come home. I do not speak of politics, about a strategy for democratization of institutions, about my passion for state/nation-building or about my expertise in political systems… Why? Nobody is interested in hearing it.

Sadly, this only further ensues my original worry that while D.C. will have Velvet Revolution the American Style, there are no such celebrations or massive commemorating events in Czech Republic.  But there should be!

How easily we forget that Velvet Revolution brought down 40 years of communism, and after 21 looooong years marched the Soviet tanks back to Mother Russia, tanks that invaded & occupied our sovereignty since the Prague Spring in 1968. Velvet Revolution brought us freedom, liberty, opportunity, multi-party political system, free democratic elections, and it also opened our doors to Western culture. It brought us choices and responsibility, and maybe that is the problem?

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The only questions comes to mind: What happened in 25 years to Czech society that we do not celebrate, ney, that we don’t even turn around in our beds to commemorate such a historic and historical occasion?

What happened to Czech people, politics and culture that we no longer appreciate the freedom to study abroad, for example, or the freedom to travel to Egypt or Italy, decide an election, shop whatever and wherever we want, learn foreign languages, etc…  What happened is certainly THE question.

Well, what happen is LIFE, life happened. And with life came the loss of fluffy future based on political slogans seen through rose glasses.

Now, devoid of the proverbial ‘rose glasses’, we must face the ‘horrors’ of having to be responsible for ourselves, having to be responsible for our choices, for our society AND for the status of our political system & political culture. Scary stuff I tell you!

There is no longer “them” (as in the communist) to be blamed for the status of our lives, politics or the status of our culture. Now, it is “us” and that is starring at us in the mirror every day. What will we do with “us” ? Will we turn “us” back into “them” -> as in allow the Communist who inflicted so much devastation and pain onto my country back into full slay of power and openly into government? It is all up to “us“!

Yes, people are disillusioned, tired, fed up, hurt. They are learning the hard way that democracy is hard and “freedom ain’t for free” as they say. People feel betrayed and used, as if there is no justice. And perhaps there isn’t, not right now anyway.

So what are we going to do about it? Do we have it in ourselves to stand up again, demand changes, demand accountability, demand AND accept responsibility and finally demand some respect? Can we do it?

Will it be “us” or will it be “them”? …Tis the question. 

                                                                                                                   Czech 2

So for now, I will be in Washington, D.C. commemorating my Velvet Revolution, revolution “I did” and where I was active. I will be commemorating my home country that I love so much, but for now, I will be celebrating Velvet Revolution the American Style!

PS:

We better remember that during the 1948’s national election, it was the Communists who were elected during the last democratic elections for next 42 years, because they promised pink fluffy future of political slogans seen though rose glasses.

http://www.speaker.gov/press-release/vaclav-havel-bust-will-be-dedicated-november-19

http://www.25yearsofdemocracy.org

Ukraine Bloodshed: Political Advisor, Manager but Humanitarian and Nurse First n’ Foremost

Feb 20, 2014

Ukraine in flames

February 20th, 2014 in Sacramento, CA. USA

I was a young Czech nurse when the atrocities were happening in the Balkans, and NOBODY from the EU moved a finger, nobody helped them! I often asked myself what would have I done…?

While I had no influence over it, as after the Velvet Revolution in Czechoslovakia, after 40 years of oppression, and 20 years of Soviet occupation, I finally was allowed to travel abroad and I left home.

I looked after children, cleaned houses and pubs, learned English by myself at nights, held 2-3 jobs in order to follow my dreams of studying and obtaining my Nursing licenses in Canada & USA, only to go further towards my biggest dreams of earning multiple university degrees in global politics, global health & regional development & administration at prestigious U.S. universities (CSUSM and UM). CSU grad kept her ‘eye on the goal’ – San Diego Union-Tribune  San Diego Union-Tribune regional newspaper did an interview with me about my road towards BA in Political Science  Magna Cum Laude coming from post-Communist country.

To this day, I am ashamed to be European for our utter failure in the Balkans! Seeing the almost unrepairable damage that conflict left until today, over 18 years later, is utterly heartbreaking. We all bear responsibility.

For better or worse, the ONLY leader who proved to LEAD was U.S. President Clinton, who due to the long-standing ‘Monroe Doctrine’  did not and could not put “boots on the ground” as Americans love to say, but instigated aerial raids. President Clinton’s role in this conflict is being discussed even today, however, speaking as someone who has deep historical roots to the Peoples abandoned and left behind Ukraine needs the change to come from withind by the Western powers in their time of need, without any help… (The Munich Agreement of 1938, The Prague Spring of 1968 -> followed by foreign invasion of my beloved homeland by 5 foreign armies, led by, you guessed it, the Soviets and their criminal leader Leonid Brezhnev). Trust me when I tell you, you want help, any help!

It is only here, in this country, where we have the incredible luxury to discuss and criticize actions of which we quite often know very little. BUT, let me finish, it is a part of our political system, it is a part of democracy and as a democracy “groupie” myself, I fully respect and admire this system very much. In fact, I have been actively involved in the post-communist transition to democracy and democratization of institution in Czech Republic on the local political level for past 20 years, and it is Job’s job. It is only when you are on the ground, demonstrating against the power that is usurping you and denigrating you, waving your flags, being beaten and shot that you are looking towards the skies hoping to see some allies and The Allies!

For my beloved Czechoslovakia in 1968, the year my amazing parents got married and sadly also the year their HOPE and DREAMS were squashed by the Soviet invasion, there were, for very obvious Cold War reasons, no sky allies or any Allies…  And we (as in my fellow countrymen, since I was not even ‘an idea’) were looking up and waiting, every day! In the years afterwards, during the deep Normalization process (just a different word for Communistic indoctrination enforced by Soviets), we were secretly listening to the Radio Free Europe and Voice of America (both I believed financed by the US) in our basements, faced with hard jail time if caught, waiting for hours to hear our country even being mentioned! And this is how people of Ukraine feel today.

We are amalgamate of our previous experiences, and I really do “FEEL” the past plight, hurts and betrayals of my people and my country. Well, visiting every concentration camp around during yearly school ‘day trips’ since 2nd grade left DEEP scars and nightmares in my soul. At the same time, it also cemented such un-moveable human resolve, built foundation for my ‘Fight-or-Flight‘ (political not systemic) response, and cemented my strong sense of protection, responsibility for others, and especially for the weaker and for those who at that time were /are unable to look after themselves => any more questions why I am a nurse, political operator and a humanitarian?   No, did not think so 🙂

We have a collective responsibility and we have obligations.

Now as a proud (dual Czech and) U.S. citizen and highly degreed and educated RN, at this point my love & passion for politics, strategy and campaign goes away and my nursing  and humanitarian responsibility takes over. That is exactly WHY I DO politics, to PREVENT this! However, once you cross over a certain threshold, it is no longer about my ability “to do” politics but about my ability to “take care of people”. People need help no matter who is shooting at them and my nursing training and practice precludes me from judging my patients, and that I had some I did not like in my 15+years! Period.

EU lagging behind, always

I wrote an article last May 2013 year asking Should the EU Care about Syria? The Balkans, anybody..?!?

Now, as if I had a premonition, similar problem is on the border with our Czech brothers, Slovakia! (and Poland, Romania & Moldova on my EU side) and the EU is STILL discussing and issuing statements about ‘freezing assets’ of the bad guys – on both sides. OK… and how is that gonna work from a logistical point of view, and MOST importantly, HOW is this gonna help the dying people of Kiev? This piece is NOT debating blame or who started what, this piece is strictly concerned with the PEOPLE and their medical and human needs. Period.

Knowing how Russian tyrant Putin feels about Ukraine since he considers it to be a part of his Mother Russia, holding them hostage at will over access to natural gas and other resource… and hearing as a freedom loving and globe trotting Czech the same tyrant Putin saying that he ALSO consider my Czech Republic to be still under their sphere of influence, my heart stopped! We’ve already been there, it was hell, and nobody wants to go back…

It is my unequivocal belief we all have global roles to play, we all can help and serve wherever we can. Thus I am able to feel the plight, fear, resolve but also the uncertainty of people of Ukraine. I promised myself, I will never sit on the sidelines, and I never do, should anything like that started to happen again especially in or around my original homeland and Europe.

I believe, this is my calling and my responsibility.

I can never let the Balkans repeat. Ever!

Awareness, Responsibility

http://www.usnews.com/opinion/articles/2014/02/20/ukraine-doesnt-need-sanctions-from-the-united-states-or-the-european-union?src=usn_tw

Tagged:

Stability: International Journal of Security & Development
University of Miami, Master of Arts in International Administration (The MAIA Program)
USAID – US Agency for International Development
International Rescue Committee
FEMA Federal Emergency Management Agency
CDC Emergency Preparedness and Response
People in Need – Official
The Relief Foundation, Inc.
USF Global Disaster Management & Humanitarian Relief
ReliefWeb
Humanitarian Assistance Program
European Commission – Humanitarian Aid & Civil Protection
Human Rights Watch
U.S. Department of Health and Human ServicesSee More

A Mid-Career Czech-up: how do you stack up in 100 words?

A Mid-Career Czech-up: how do you stack up in 100 words?

Wondering how your career looks like in 100 words?

Ever wondered how would your career look like all nicely and neatly summarized (since nothing in life is that simple) all the while looking visually appealing ?

I copied & pasted my professional positions, projects & endeavors in public health, healthcare and politics from my LinkedIn profile and used the amazing wordle.net to see what have I been really up to for the past 13 years in my let’s say all-encompassing career and how does it stack up to what I feel are my professional passions & interests with what I think I’ve done and accomplished in my career so far.

I must say I am (one-could-almost-say) pleased to see my career in a shape for which I worked, studied and sacrificed so much, AND most importantly as we continue to evolve, for one that is leading toward a better defined shape that keeps on toning and strengthening those already ‘shapely’ areas, keeps on finding new ways of doing, seeing, understanding things… all the while never seizing an opportunity to learn from wise, humble, accomplished and interesting people along the way… AND yet staying true to my ongoing professional calling, my passion and my dedication.

Yes, ALL this in 100 words, no kidding!

Yes, wordle.net can summarize it way better than me, that’s for sure…

How would your mid-career check-up look like?

Should the EU Care about Syria? The Balkans, anybody..?!?

MDG : world map with numberof IDP by conflict

This is the disturbing world map of internally displaced people [refugees] in 2012 (link to map below)

Want to know what I see when I look at it? …The shame of BALKANS! Why you ask?

Perhaps because I am a proud Czech American and thus have closer to European affairs.

No wonder!

I was a part of the Velvet Revolution in than-Czechoslovakia, I spent 3,5-hrs every day on a bus to and from Prague so I could demonstrate on Venceslav Square demanding the departure of the Communist party from power, I spoke up fiercely and alone at meetings when discussing course of actions in removing still-to-power-clenching communist leadership at my brand new place of work and town, I was a party to democratic political changes, city institutional reforms and democratization process of a medium-size town in Czech Republic.

I have always been involved in Czech political affairs, and because in the future I want to serve my people who so deserve learned leadership, I dutifully researched democratization process and studied politics, women’s studies, global health, regional development and administration at american universities – yes, at the seat of democracy.

Also, I was lucky enough to have a couple of internships at the European Parliament (EP), I know wonderful hardworking people there, but I’ve also seen the massive bureaucracy and the European Union (EU) machine led by Eurocrats, NOT by democratically elected leaders responsible and accountable to their people. So my interest seeing this map rests with Syria, as I worry about a possible slide to the 1990’s disaster and utter European disgrace in the Balkans.

 

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While I understand the region maps and I know that Syria is farther away than the Balkans, since the region is clearly not under the American influence and due to the Monroe Doctrine the U.S. does not even put ‘boots on the ground’ in the vicinity, it stands to reason it falls under the European influence – since the region in question had been under the French influence in modern history.  In 1920, a League of Nations gave France a mandate to administer the region of Syria & Lebanon. France divided Syria into administrative regions under the disguises of “decentralizing” government only to keep its power and influence over a strategically important piece of real estate. At last, France proclaimed Syria’s independence in 1941.

 

Fast forward 70 years and you are the beginning of this bloody and catastrophic civil war conflict where more than 2.4 million people were displaced in Syria by 2012, with another almost million people expected to flee this year (up to half a million by June  2013) and all be absorbed by Lebanon, Turkey & Jordan. This is tragic. 

Another alarming issue, next to the fact that no Western power(s) will help, is the fact that very soon Jordan and Lebanon will stop accepting refugees as they are already sending signals of distress because they have no resources or space to deal with such an influx of people in dire needs. Clare Spurrell, an IDMC spokeswoman said “Humanitarians can’t save Syria, it has to be the politicians … what you are seeing are people who are utterly exhausted…” (link to article below)
The only power that possibly could (as in do something) is France as this region used to be under French influence, but with their new socialist president sending pretty clear signs he will not lead any efforts, unlike Sarkozy in Libya, we are left to the “will” or the lack there of, Russia (and China, of course).
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Only if and when Russia will get some brain power, and only after Putin will stop computing how it will best serve him and only him, only then the UN Security Council (UN SC) can agree on a Resolution and a course of action by invoking Article 42 of its Charter stating that “if peaceful means have not succeeded in obtaining adherence to Security Council decisions, it may take such action by air, sea or land forces as may be necessary to maintain or restore international peace and security” (link to the UN Charter below)
Only then, and without the UN SC Permanent Members Russia and China Vetos, can the Security Council authorize the use of force allowing intervention and ‘boots on the ground’. 
Now, whose boots and how it will be financed is another question…

 

What always disturbed me, ever since the massacres in the 1990’s at the Balkans, is the absolute inability, ineptness, and the total lack of any (real!) interest of the EU in these events. 

As an European, it is simply unthinkable for me to comprehend they are still unable to get their committees moving fast enough – or at all, not sure – in order to put their efforts together and lead or spearhead this (or any) effort! The absurdity of this situation is that they do have time to pass stupid and useless EU legislations, such as banning calling Czech rum Rum (just using a simple example)!

What a waste of institutions, waste of time, and waste of so much money! 

 

This is how it looks when the U.S. is not leading the world’s police action anymore.  And for the world, get used to this! This is how it will look in the future when the U.S. is no longer the world police dog. Sorry, you can’t have it both ways. 

People are dying and being massacred by their own government, 3 million refugees are exhausting the human, financial and material resources of neighboring countries, and we are sitting at home on our couches and are even bored to watch it on the nightly news. 

I am NOT saying the U.S. should invade Syria, god no! I am simply calling for a real and constructive political effort to mobilize the international community, or in the instance of EU + EP [as this region falls in their influence because it is certainly not under American influence] – at least, mobilize your own community, the very community that pays your salaries and benefits(!) and help some people in need! People that, in fact, do not live that far away from the EU borders! (…yes, it is little far, but I am making a point here. The U.S. is way farther away….)

 

My Conclusion and the Balkans connection:

The catastrophic vision of history repeating itself not that far away from European borders, while “she” continues in her complete obsession with its rivalry between Germany and France, by Great Britain’s refusal to conform to almost any EU rule, all the way to Germany and France’s almost totalitarian rule over the new EU Member States, Czech Republic included, may indeed preclude the EU powers that be in recognizing an opportunity to strike and deliver an actual humanitarian help, action or initiative; an initiative that in the long run could prove to bring a great political capital and economic benefit for the EU.

Why is it that nobody sees or recognizes this… ?!?

Maybe they do – but that brings us back to the Eurocrats who are ruling their committees and all EU’s actions.

So Syrian refugees, tough luck!  

See how Europe got to that deep black hole of shame when (not)dealing with the Balkan conflict? 

It took, yes you guessed it, an American President, who mindful of the Monroe Doctrine, did not meddle into European affairs, used NATO, and did not put any boots on the ground. He sent air strikes. 

P.S.

…Oh, and by the way, who was it that for past 2 years was working hard behind the scenes as not to look like the leader of this effort and sent millions in aid just few weeks ago? Yeah, Hillary and the U.S. 

So, the score so far is Clinton and Clinton 1  :  EU 0

1) World map showing displaced people:
2) Analysis of 2012 internally displaced people: Syria & DRC
3) United Nations Chapter

Is ‘population diversity & behaviors’ to blame for lower U.S. life expectancy…?

Government Spending

Government Spending (Photo credit: Tax Credits)

Last week I posted article asking a pertinent question “If U.S. Spending is so Outrageous, Are We Getting the BEST?”

https://marketahouskova.wordpress.com/2013/04/22/if-u-s-health-care-spending-is-so-outrageous-are-we-getting-the-best-2/

The answer is “kind of”.

We do have the best technological and medical advancements in the world, and our acute care and treatments can deliver miracles.  We don’t have to wait 4-6 month for a surgery, we mostly get timely care, good care, and we do have great outcomes. However, as wonderful as that is, it does not impact the overall measurements of ‘life expectancy’ as it falls under the category of ‘acute care’ and we do really well here.

It is injuries or conditions lasting more than 6 months that are considered ‘chronic’ and require ongoing management, ongoing medication, follow-up doctors visits, repeated test, etc… and that’s where the U.S. is seriously lacking. So yes, while we are very good at acute care, we lack in chronic care management – and that does impact the overall ‘life expectancy’ and quality of life.

Which brings me to the fact that even after spending over $8,000 per capita in overall healthcare expenditure in 2010 (the highest in the world) , the U.S. has a lower life expectancy compared to other OECD nations. Why is that? Is “healthcare”  to blame? Is “public health” to blame? Or is it due to our “population diversity and behaviors“?  I have heard many  blaming it on the “diversity & behaviors” part, but in that case a question remains –  isn’t it the health and life expectancy of the whole population, no matter what diversity groups it includes, that makes for ‘life expectancy’ studies, surveys and measurements?

I agree with you that our diverse population is an integral part of our society, however, it is 21st Century and everybody knows that if you want to live longer and have a good quality of life, when you are not feeling well or have certain episodes – you should go see a doctor. And this is where the crux of “it is population diversity & behaviors fault” argument weakens, as 50 million of low-income working Americans (yes, majority about 80% are working and 82% are legal citizens) DO NOT have options or access to a non-acute or preventive care, so they go without seeing a doctor, without taking medications, and without ongoing management of preventable conditions – NOT because of their population diversity or behaviors – but because under the current system they have no viable option for obtaining health plans!

This clearly and directly impacts the overall life expectancy and thus the overall quality of healthcare we as ‘all Americans’ get.
If 1 in 5 Americans don’t have access to health care – it seriously impacts all of us in terms of loss of economic potential, loss of productivity, and in the end, in an increase in overall health care spending.

I ask again, does $8,000 per capita (twice as much as others developed nations) deliver the best health care to our society? Does it…?

Now, since we established that “population diversity & behaviors” are not to blame for lower U.S. life expectancy, is it a fault of healthcare, or public health? The answer is “yes” as the status of U.S. health care and it’s overall total health care spending and expenditures is a direct result and implication of U.S. health policies implementations. States are responsible for health care but federal government plays its role in Medicare, Medicaid, CHIP & other programs.

Medicaid, for example, by covering health care needs of pregnant women and prenatal care is not only delivering health care, but also implementing a U.S. public health policy. Smoking cessation programs – public health issue, or health care issue? Both, as continued smoking leads to lung cancer, COPD, emphysema etc… and that is very costly in terms of health care spending. Public health programs are offering smoking cessation in order to prevent future health care spending, a clear integration of health care and public health policies.

Without proper public health policies we will not be able to deliver proper health care to our diverse population. Clear and simple.

P.S.

Yes, while certain “diverse” behaviors cause increase in health care spending (i.e. smoking, bad diet etc..), if we look at it closer – these behaviors span all socio-economic levels, not only diverse population often mentioned. So we are back at the beginning, why the U.S. has lower life expectancy that other OECD nations? The one clear answer is that it is not due to “population diversity and behaviors”.

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If U.S. health care spending is so outrageous, are we getting the BEST?

In today’s heated political and economic debates, healthcare reform and healthcare spending remain a hot topic of conversation – and rightfully so!

Why is it that while the U.S. spent over $8,000 per capita on health care in 2010 (almost 50% more than Norway and Switzerland in 2nd and 3rd place), per OECD ratings, we deliver only average level of care based on U.S. lower life expectancy, lower than Switzerland or Norway. Life expectancy graph puts the U.S. roughly in the middle of the developed countries in life expectancy at birth (the longest gevity is in Japan). How Does the United States Compare page 1.

The problem with that is that other developed countries who show even higher life expectancy than the U.S. are able to bring their population to such age for a fraction (or at least for 50% less) of total health care cost than here in the U.S. It shows that the huge per capital spending does NOT necessarily assure or ensure longer gevity delivered through better care or more advanced technological treatments.

So WHY does health care cost so much in the U.S.?

The answer comes under the cloak of science, as the most significant contributor to U.S. health care cost growth is technology innovation & medical advancement. Clear and simple. We have the best diagnostics, imaging, new-surgery-techniques, technological possibilities and acute care treatments & capabilities in the world – bar none. The fact that we are also a wealthy country contributes to our income growth meaning that the wealthier the country – the more of healthcare consumer spending and insurance-induced demand there is.

It stands to reason that while new medical technology may be expensive, when used in time and appropriately, it does extend patients lives, improves their quality of life which in turn makes them live longer and makes them more productive. So technology – it’s a go! But the need for increased healthcare efficiency with curbed spending will bring a major strain on the U.S. health system in the coming years.

While the U.S. has the best diagnostic and acute health services in the world, we are lacking in preventive care and in management of chronic diseases and conditions affecting a large segment of U.S. (aging) population. Additionally, the wealthiest country in the world and we have around 50 million un-insured people from working families! Yes, you heard right, a vast majority are from working families – as in low-income workers unable to afford private or employer-based health plans premiums. Kaiser Family Foundation Primer (2010) states that 50% of ALL health care spending is used to treat 5% of the population and they are the people with 3+ chronic diseases needing ongoing medical & nursing care, list of medications, follow-up doctor’s visits and other services. http://www.kff.org/insurance/upload/7670-03.pdf

Needless to say that the un-insured have overall much worse health conditions as, due to financial constrains, they do not go see doctors with first symptoms, do not get medications to correct or manage conditions, do not go for tests or follow ups to see how such condition(s) can be treated or fixed or improved. So such condition(s) grow in silence and when finally there is a life-threatening event – they will go to emergency rooms where they will get the care including all those technology innovation & medical advancement tests, images, diagnostic procedures and latest treatments, but they will also get a bill for all that technology innovation & medical advancement. And anybody who went through ER and spent a couple of days in a hospital knows the amount I am taking about here! And without insurance plan to help cover the large amount, they are left with a stark total! http://www.kff.org/uninsured/upload/7451-06.pdf

Let’s not forget, these un-insured are not insured not because they don’t want to or feel like getting a health insurance, but because their low-income jobs leave them unable to pay for private or employer-sponsored health plans and not eligible for Medicaid and too young for Medicare (over 65 y.o.)  Yes, it is true, hospitals can write something off, but on average, it still leaves the low-income un-insured with a bill of about 1/3 of the hospital cost. And good luck with that!