Sublime

As a result of so many changes, compassionate care is all too often being replaced by institutional care characterized by electronic medical records (EMRs), coding, and algorithms.

We feel paralyzed because we fear that our institutions and leaders are no longer able to operate and the solutions require many to act against their own immediate interests. We strive to make more people and communities capital-efficient and market-friendly even as the water level rises. The logic of the market has overtaken most of our waking liv

We at the Veterans’ Administration historically offered [medical] treatment but the veterans don’t [typically] get housing, you don’t get jobs, you don’t get family support. We had the model totally backward. Without a safe, affordable place to live and without something meaningful to do with our day, the carousel is going to keep going round and r

Keeping Americans at or above a certain baseline of good health requires collective action to assure the availability of such necessities as food, housing, and transportation.

On average, in Boult’s study, the geriatric services cost the hospital $1,350 more per person than the savings they produced, and Medicare, the insurer for the elderly, does not cover that cost.

The requirements to adapt to unexpected circumstances tests both organization and system, revealing weaknesses that are partly structural and partly functional, whose full potential for disaster may not previously have been noticed.

In the end, the United States, with a more limited view of the social contract, leaves its people to rely on the purchase of medical care as the main lever for attaining or improving health.

Nuland was a renowned surgeon-philosopher whose seminal book about mortality, How We Die, had come out when I was in high school but made it into my hands only in medical school. Few books I had read so directly and wholly