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>>Donald Zimmerman: And before I came to Towson, I spent the majority of my
career in public policy and in politics.
And the first slide reflective of kind of what I've graduated into.
I'm not a Marxist in this sense.
I told that joke in Canada and had a conversation about Das Kapital, but
that was not the conversation I wanted to have.
But I'm going to talk about the working definition of
globalization, and ask some questions about the U.S.
health care system.
And then raise some fundamental research questions for the future.
When we take a look at the literature about what globalization is, this is
a fairly standardized definition that focuses on eliminating barriers in
trade, in communication and culture.
And just quickly going around here.
The IMF certainly is something that I know that I don't read every day,
but when I do - always is reminding us that what happens here, what happens
in Europe, effects everybody else in the world, and that effects us.
Well, this is going really fast.
My point here is that that model of globalization creates a sense of
everybody being the same.
And I'm going to call that model Global Gagaization (ph).
And I'm going to contrast that with a very different perspective that's going
to ask us not to look at what's the same, but what is different about it.
And I'm going to focus on U.S.
health care policy.
So here are some things that we can see when we go global - 35 million people
living with ***/AIDs, 43.7 million refugees worldwide, which, by the
way, is about 31 times the number of people that live in the Baltimore area -
2 million babies die, etc. The question is, can additional resources be
brought to bear to address these kinds of problems?
And if that's a reasonable question, then we have to ask, where do we find the money?
This is where the looking in comes in.
The U.S. spends over 2.7 trillion dollars on health care.
Counting one dollar per second continuously, it would take us 82,000 years
to count all the dollars we've spent.
The question then becomes, are we using that money in the most efficient
possible way?
And if not, can we take some of that money to try to address some of these
deeper global issues?
So let's start with whether or not our system is effective and
efficient.
The first thing that you notice is that we have no goals.
What is the purpose of this 2.7 trillion dollars?
Is it written down some place?
I've never found it.
Not only that, but we've spent a lot of money and we don't accomplish very much.
And here's just one example with infant mortality.
In 1960, we ranked 12th in the world.
We're now 40th in the world in terms of our ability to deliver a well baby.
We also have a lot of underlying problems facing our society.
We all know about the obesity issue.
I found this particular issue of great interest - that we're afraid to talk
about it.
This slide shows that we know what the root causes are for a lot of reasons
why people die.
And it's tobacco, it's the lack of exercise, it's a bad diet.
It's all the things that contribute to a poor underlying health status.
Twenty-seven trillion dollars spent, 77 million spent to try to address
those underlying causes.
That's 3.1 percent that we're spending on trying to fix these underlying issues.
There's a deeper problem.
Institute of Medicine estimates that 30 to 40 percent of all the money
we spent is either wasted in some ways, is paying - used fraudulently, etc.
This is obviously way too much stuff to try to cover in 5 minutes, isn't it?
(LAUGHTER)
>>This is really important data.
(LAUGHTER)
What that shows is an enormous variation in what happens to people in the
last six months of their lives, with enormous financial consequences.
And here's my take on Obamacare.
An expansion of health insurance is obviously a good thing.
But given the way the system currently works, it's my metaphor there is
- it's like giving a drunk an open tab at the open tab at the most expensive
bar in town while people outside are left to be thirsty.
So here's my two questions - can we expand and redirect some of these
funds from a U.S.
perspective to a global perspective?
And the the second question is, how in the world do we do that?
So that's my Marxist presentation.
So thank you very much.
I apologize.
(APPLAUSE)