Thursday, March 27, 2008

Fear of Foreigners

I'm a member of a national organization that has about 1,000 members. I sent an email to a staffer and asked how many members were from outside of the US. She wrote back that there were 7 non-US members, 5 in Canada, 1 in the Bahamas, and 1 in Puerto Rico.

I went to the organization's blog site and asked a question: Should the organization actively recruit members from outside the US? Although there isn't much activity on this blog, it took several weeks for the blog moderator to read my blog. But when she did, she called me on the phone and said that I must remove my question. She said that it was up to the Board and the executive director to make such decisions and that the members should not discuss the issue. I complied and removed the offending question.

I haven't been back to contribute to the blog site since. And when my membership comes up for renewal, I'll decline to renew. There are other such organizations that I can join that have open minds and actively seek members from the US and abroad.

Curiously, the parent organization to the one that didn't like my question had learned of my interest in global issues from other sources and asked me to send them more information and references to be a part of a speaker's bureau they operated. They said they didn't have any speakers on global issues.

So here is an organization with one its offspring fearing international relationships and the parent willing to promote international relationships.

The fear of foreigners, of course, is evident in some of our political leaders who really feel that foreigners like the ones who flew into the World Trade Center are trying to get into the US to kill more Americans. That may be true, but all foreigners are treated by the immigration people in the US, on Congress' direction, as if they have bad intentions toward US buildings and people living in the US. On a recent trip from Australia to Hawaii, a video was shown by Qantas Airlines alerting non-US citizens that they would be photographed and fingerprinted upon arrival and that certain nationalities would need a valid visa or they would be denied entry.

I talked with one Australian immigration officer who said he never intended to visit the US as long as all non-US citizens were presumed to be criminals.

For many in the US, there is a problem with foreigners as members of an organization, just as some organizations in our history had a fear of having blacks in the organization. The biggest issue is that the communication between those in the US and those in other countries is effectively blocked and we do not have an opportunity to learn from one another things that would benefit both Americans and foreigners.

There is one organization, called Rotary International that advocates world friendships to achieve world peace. This organization was started in Chicago at the turn of the 20th Century by a lawyer, Paul Harris, and has millions of members and thousands of meetings all over the world every day of the work week.

I can go to Sofia, Paris, Auckland, Tokyo, Quito, Warsaw, Moscow, or virtually any city of any size and find a welcoming group of fellow Rotarians willing to have breakfast, lunch or dinner with me. Members can talk about any topic without fear of reprimand from the head office. It is an open forum. We take "banners", like little flags, with us from our home club and exchange it at another club for their banner. Then when we return to our home club, we present the other club's banner to our members.

Rotarians give millions of dollars to help people in developing countries drill water wells for washing or for irrigating their crops. One Rotary group in Cornwall, England has "shelter boxes" that contain a tent, water containers, cooking implements and other items that can be used in these temporary shelters for people who have lost their homes due to wind, fire, landslides, or flooding.

Rotary has existed and thrives after over 100 years of promoting international exchange and world peace. Rotary will still be around long after the organization I mentioned in the beginning of this blog.

Saturday, March 08, 2008

International Health Care

American healthcare is sophisticated in that we have the latest technology, a variety of new drugs, and medical professionals that are dedicated, highly trained, and respected all over the world. However, our total healthcare system, in terms of outcomes, is not ranked as the world's best. In fact, some say it is rated as about the 25th best in the world.

We have the technology and the people that could make us the best in the world, but the system, when all the pieces of the puzzle are put together to show the big picture, doesn't produce the best outcomes for the people who seek care from the American health care system.

We have nearly 50 million people who, for one reason or another, can't afford, can't get, or just don't have health insurance. Having some kind of insurance, whether it is commercial, Medicare, Medicaid, military, veterans, or something else, is the golden key that opens the door to preventive care, procedures on demand, being able to see a primary care or specialty physician on demand, and getting needed medications and durable medical equipment.

Anyone, whether a citizen, resident or visitor in the USA, can get seen for care to stabilize health problems at any hospital emergency department, regardless of whether the person has insurance or cash to pay for the service. That doesn't mean they won't be billed for the service. It does mean that they will get the immediate care they need to stop the bleeding, mend the bones, or otherwise intervene when a health problem arises.

If you ask people in the US which country has the best health care, most are likely to say that country is the USA. However, when we look at infant mortality rates and other indicators of health care quality, the USA is not the best in the world. And, the USA is one of the highest cost systems. We spend more than other countries on health care, but don't get the best outcomes.

That's why many are looking at other national health care programs, such as those of France, Sweden, the United Kingdom, and our neighbor to the north, Canada, where we see higher levels of preventive care, lower expenditure on health care per capita, and more access for everyone to the total healthcare system. What we also see are best practices that we can import to the USA.

That's why I am starting a wiki on international healthcare, based on the Joint Commission web called WikiHealthCare. The address of the international healthcare wiki is at The wiki is in its infancy, basically many pages that are awaiting contributors to fill in the blanks. I'm inviting contributors to report on any country in the world to provide information on what the country's healthcare system is like and what best practices and quality indicators there are in that system. Best practices can be in clinical services as well as in support services, such as marketing, public relations, planning and administration.

Anyone can read the wiki web site and anyone who registers can contribute information to the site. You can contribute.