Let us continue from the last post, “Health Care – Using the ‘Schematic for Sustainability'”
Again, the first elemental question needs to be asked again, “Do you have a vision for a sustainable society, nation(s), and civilization?” Without asking this question, what you are reading is simply an academic exercise for pleasure or information. But if you are reading this to learn how to design sustainable social institutions (family, community, health care, educational services, criminal justice, religion, etc), whether in your own family, community, neighborhood, or the world, you have taken a step toward becoming co-responsible for your and their survival and sustainability. // Now let us pick up where we left off, with writing the Global Statement of the Project.
Column 4, CRITERIA FOR FULFILLMENT (Global Statement of Project): “A national health care system that provides health care services from pre-conception to death.” Again, this statement is very general, but more defined than the STATEMENT OF INTENTION. Beneath this statement, we will list the various criteria that will define this project. // The process of generating a design does not argue points of the design from positions. Rather the work is to develop a complete continuum — in this case, health care services from pre-conception to death. Our primary interest and focus is to build a design that fulfills the Intention and Global Statement. Position-taking can be done later in different venues.
In this example I will not attempt to design a fully developed continuum of services. The example is being developed to give you enough information to help you work this process on your own. I will mark each new criterion with a “+”. Again, this is not a fully developed continuum, but only a cursory example of its parts.
CRITERIA OF FULFILLMENT: + Birth control education; + Pre-natal care (diet, nutrition, abstinence from drug use, education for post-natal care) including food support and supplements; + Natal care for mother and child; + family social education; + preventive care; + emergency services; + health care education (continuing through life); …. + elder care involving diet/nutrition, self-care and self-observation, emergency contact procedures, elder health education, elder networking, etc; + end of life choices; + hospice; ….
As you write each criterion in the fourth column do so considering columns 1-3, asking “the question” that each column asks of each criterion. e.g., Does this criterion support the value of Life? This question is further qualified by “the quality of life.” When considering public debate about health care as a social issue, know that this qualifier has its origins in the phrase from the Declaration of Independence, “…that they are endowed by the Creator with certain unalienable Rights, that among them are Life, Liberty, and the pursuit of happiness.” These last four words are directly related to the quality of life. King George VIII granted life, but it was the quality of life that was contested by our nation’s Revolutionary and Constitutional founders. This single factor, and the right of political self-determination, have been the political turning points for generations of Americans and other democracies around the world.
Let’s now turn to “the question” for Beliefs, and then next to Expectations. For Beliefs, the question becomes, “What are our beliefs for sustainability of the quality of Life, Equality, and Growth, regarding public health care?” Here are only a few examples of beliefs that emanate from the value of Life and contribute to the sustainability of our societies: “We believe that,*a sustainable public health care continuum is intrinsic to the general health of our nation and the quality of life of each citizen; * that this quality of life begins with the health of future citizens before they are born in the healthy environment of their mother, father, and family; * and when pregnancies are wanted; * that good nutrition is essential to enable the greatest endowment of genetic potential both before birth, after, and continuing into adolescence; ….” And more.
EXPECTATIONS: “We expect that: * a continuum of health care options is available for all citizens; (We expect that) * health care information, training, and education is available for all citizens; (We…) * health care information, training, and education is more than adequately developed to help citizens of child bearing age to make informed and responsible decisions to beget children, or not; …; (continuing); * health care services are provided for the various care needs of all age groups of citizens until death.
Finally, back to column four, CRITERIA FOR FULFILLMENT: Fund, design, build, and operate local health care educational services, clinics, preventive services, emergency facilities, hospitals, aftercare, (continuing)… and hospice services. As you might guess, the Criteria would become line items in budgets. The criteria are written in a manner that are measurable, definable and fulfill the VALUE(S), BELIEF(S), and EXPECTATIONS given for each criterion.
Yet there is one more Criterion that is essential — the quality of service that is so directly related to the quality of life of citizens. Considering the sustainability of a healthy nation, not only that measurable criteria of fulfillment include, for example, the number of citizens per clinic, but also the quality of those services. Those measures must be written into the CRITERIA FOR FULFILLMENT. For example: number of teen pregnancies, number of infections incurred during hospitalization, number of deaths while in hospital … per 1,000 patients, and so on.
The Schematic for Sustainability is holistic in its application(s), for public health care and all other designs for social sustainability. The functioning of sustainable social institutions requires a much different mindset for the relationship of governmental agencies and citizens — a move from overt paternalistic policies to co-responsible policies. This movement produces a much more responsible citizenry, with the educational processes behind, that support a population that thinks in terms of social sustainability. //Daniel Raphael