Figuring it out is all that matters.

We have to stop asking who is to blame, because it just doesn’t matter.

Over the last few days I watched as a young lady went into diabetic ketoacidosis – aka got sick as shit from uncontrolled diabetes – and then spent a few days in the medical ICU recovering.  Yes, I am a doctor, but I am more about cancer diagnostics and lab medicine than actual boots-on-the-ground care like this, so it wasn’t particularly fun to see.

The amazing part was how commonplace this was to everyone else, especially the providers.  Because it is commonplace.  She doesn’t have insurance, and getting glucose monitoring stuff and medicines and keeping it all together as a pretty twenty-something is a bit of a hassle, so when push comes to shove or a co-pay goes up or a meter breaks, one thing commonly leads to another.

And let’s face it, this is not my responsibility.  I have a wife and two daughters of my own, impeding holidays, college tuition to deal with, and car parts to buy.  This girl’s care is not on my balance sheet, and why should it be?

I hate to ball up your accounting report, because it sure as hell is on my balance sheet.  And yours too.  And the details don’t matter.  It doesn’t matter if she is lazy and worthless (she is not), uneducated and unmotivated (she is not), or even a drug addict or criminal (again, no and no).  It just doesn’t matter, because this year alone, you and I are looking at about a hundred thousand in medical bills that we are going to pay.

You might pay it buddy, but not me! you growl through gritted teeth, with an eye-roll for effect.

Like it or not, you sure as hell are.

BS: SHE has to pay! Not me!

Really?  Where is it going to come from?  And should we stick it to her?  Think about it for a minute.  Who out there is prepared to absorb 100k in medical bills?  And if we forced that burden on her, how well do you think her future care is going to go?  Because I think she will be right back in the ICU, and again, and again, until her kidneys fail and she is on dialysis and disability and then you and I are going to pay for EVERYTHING.

How about we just take care of her – help her take better care of herself – and get her back to life and work and play where she can be an active part of our community, instead of being a liability?  Even if you have your own mound of problems and you don’t really give a happy crap about others, it’s going to be a helluva lot cheaper.  So let’s try it this other way, and save some money, shall we?  Wouldn’t you rather invest a little time and money and have her making a paycheck and paying taxes and buying stuff instead of pouring Medicaid money into a giant hole?

We are all responsible for each other.  It doesn’t matter whether you like it or not, it’s the way it is.  So we have to build systems that enable us to help each other out, that connect us, that make life easier.  This all seems so completely unrelated to some transportation app, but these things have everything to do with one another.  If we don’t figure out how to manage the little bills like test strips and insulin for people with diabetes or transportation for people without cars, we are going to be on the hook for much larger bills like ICU visits or lifetimes without employment.

On Tuesday (provided some snow melts) I will be discussing MoveUP with City Council.  This is more than a transportation app, it is our city coming together to learn how to live cooperatively.  This is not about free stuff for some group of people or continuing to fund a service that isn’t working, it’s about building something that works for all of us.  December 11, 4:00 pm, Council Chambers.  Please come and add to the momentum.

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