Sunday, April 15, 2012

Titanic As Metaphor: Ten Lessons for Medicare

Even on the 100th anniversary of RMS Titanic's sinking, the Disease Management Care Blog can't make it through a single sitting of either A Night to Remember or James Cameron's Titanic.  It only cares to watch the films' last half hour.

That doesn't mean that the DMCB can't use the tragedy as a Medicare metaphor. 

To wit:

1.  We still believe the guarantee that Medicare is unsinkably going to meet its obligations.

2.  The threat is a huge fiscal iceberg that we know exists. It will not be seen until it is too late.

3.  Medicare's design experts were likewise stunningly wrong.

4  The regulations, made years if not decades ago, remain hopelessly obsolete.

5. The twin unpredictable Black Swan mirages and tides of a) "savings" and b) technology can only be recognized in retrospect.  And there are other "unknowns" out there.

6.  Those presently in charge can be wrong about remaining calm: if the ship is listing, it's time to panic and run for the lifeboats.

7. Once disaster strikes, ill-conceived actions can make things worse.

8.  Whether it's news or movie media, much of what we think we know is a littered with historical inaccuracies.

9.  If the ship goes down, the lowest socioeconomic classes will suffer the most.

10. When we deal honestly with the lessons of a disaster, we can eventually build a better and safer system.

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