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The Lone Star State Battling Cry – “Divest in Texas.”

Posted on | October 6, 2021 | No Comments

Mike Magee

re·vanch·ism

/rəˈvän(t)SHˌizəm/

noun

  1. a policy of seeking to retaliate, especially to recover lost territory.

“a recipe for deep future resentment, revanchism and renewed conflict”

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Texas Governor Greg Abbott has been on a tear lately, and his central theme appears to be “revanchism.” Faced with declining demographics, he is retaliating against enemies and newcomers alike, aligning himself with slippery politicians and vigilantes. As they say in Texas, “He’s on a first name basis with the bottom of the deck”, and the game he’s playing appears to be “South Africa – 1950.”

The formal establishment of apartheid in South Africa occurred in 1948, though racial injustice had been baked in centuries earlier. Violence and intimidation, embedded in legislation supported by a 15% white minority, led to the creation of the African National Congress (ANC) which launched what they called their “Defiance Campaign.” By 1962, their party had been outlawed, and their dynamic leader, Nelson Mandela, imprisoned.

And yet resistance continued to grow, inside and outside the country. Religious leaders, like Archbishop Desmond Tutu, took to the street, organizing huge, peaceful rallies. In 1976, images of Black children being attacked and killed in Soweto township during a protest spread like wild fire around the world. 176 died and thousands were injured. In response, the United Nations called on its member states to divest and impose economic sanctions. Only 2 leaders did not. (More on that in a moment.)

Minority rule, oppression, vigilantism, and disenfranchisement are eventually loosing propositions as Greg Abbott is learning. A majority of 52% now say his state is moving in the wrong direction. The list of grievances is long and continues to grow. Catholic bishops decried his inhumane handling of immigrant families this year. Baptist minister Rev. Frederick Haynes III spotlighted the Republican legislature’s voter suppression law recently suggesting they were “dressing up Jim and Jane Crow in a tuxedo.” Only 39% approve of his handling of the pandemic, and many Texans find the renewed endorsement of “vigilante justice” for unfortunate women and girls seeking abortions to be a disturbing and dystopian new reality. By the way, 1 in 5 Texans lack health insurance, and Texas is one of twelve Republican led states that continue to refuse federal offers to expand Medicaid coverage of their citizens.

Modern day demographics in the Lone Star State suggest that the territory is no longer dominantly white, rural, or conservative. Texas population has grown by 40% (over 8 million new residents) in the past 20 years. Since 2010, over 95% of these new entrants are people of color. For every 1 white entrant in the past ten years, Texas accepted 3 Blacks, 3 Asians, 3 multiracial citizens, and 11 Hispanics. The cities and suburbs that have grown nearly 20% in the past 10 years, now include 70% of the statewide population. Rural areas have grown only 1%.

New entrants are finding jobs in firms attracted by liberal zoning, low taxes, and cash incentives. Firms like HP, Tesla, Oracle and Amazon say they are big fans of 3P management (People/Planet/Profit). But how will this new “creative class” of techies and scientists like living in a state that wants to embrace a 4th P – Prejudice?

The current Republican crowd may be gutsy, but let’s face it, Abbott is no Reagan. And even “The Great Communicator” himself, has been somewhat sullied by brush up’s with history.

For example, by 1983, all but two UN member national leaders had supported divestment of South Africa – Ronald Reagan and Margaret Thatcher. Reagan in fact doubled down in 1986, placing Mandela on the terrorist watch list (where he remained until 2008), and said, “The South African government is under no obligation to negotiate the future of the country with any organization that proclaims a goal of creating a communist state…”

This was five years after tipping his real hand to Walter Cronkite in an interview, describing South Africa as “a country that has stood by us in every war we’ve ever fought, a country that, strategically, is essential to the free world in its production of minerals.”

Professor Steven Pedigo director of the LBJ Urban Lab at the University of Texas, is an expert in urban economic development, regional cooperation and placemaking. Pedigo has developed strategies for more than 50 cities and regions in the United States and believes the Republicans reliance on “gerrymandering, voter suppression, and relentless cultural warfare” is a “fatal miscalculation.”

With Abbott riding “abortion” the way Reagan once rode “communism”, and with Rev. Frederick Haynes III channeling Desmond Tutu, how long will it be before “Divest in Texas” becomes the new Lone Star State battling cry?

The Legality of Vaccine Mandates – A 7 Minute Summary.

Posted on | September 30, 2021 | 5 Comments

Mike Magee

Later this Fall, I am teaching a 4-part course titled “The Right to Health Care and the U.S. Constitution.” In preparing for it, I’ve struggled to remain one step ahead of my future students – some of whom are lawyers.

The course itself crosses the boundaries of law, medicine, political science and history. Facts and figures and dates all matter of course, but not nearly as much as the clarion voices from past and present.

For example, there is Alexander Hamilton,  on October 27, 1787 in Federalist #1 who wrote: “It has been frequently remarked that it seems to have been reserved to the people of this country, by their conduct and example, to decide the important question, whether societies of men are really capable or not of establishing good government from reflection and choice, or whether they are forever destined to depend for their political constitutions on accident and force.”

Most would agree that our society has yet to “decide” on this “important question.”

By Federalist #45, James Madison had taken a more conciliatory tone, an early Joe Biden if you will, as he reassures reluctant states here:

“The powers delegated by the proposed Constitution to the federal government are few and defined. Those which are to remain in the State governments are numerous and indefinite. The former will be exercised principally on external objects, as war, peace, negotiation, and foreign commerce; with which last the power of taxation will, for the most part, be connected. The powers reserved to the several States will extend to all the objects which, in the ordinary course of affairs, concern the lives, liberties, and properties of the people, and the internal order, improvement, and prosperity of the State.”

As the current battle over vaccine mandates well illustrates, the tussle between federalists and states over respective “rights” has never been fully resolved.  Consider for example the politicization of life-saving vaccines. The power to mandate vaccines was litigated and resolved over a century ago. Justice John Marshall Harlin, a favorite of current Chief Justice Roberts, penned the 7 to 2 majority opinion in 1905’s Jacobson v. Massachusetts. It’s impact was epic.

In 1905, Massachusetts was one of 11 states that required compulsory vaccinations. The Rev. Henning Jacobson, a Lutheran minister, challenged the city of Cambridge, MA, which had passed a local law requiring citizens to undergo smallpox vaccination or pay a $5 fine. Jacobson and his son claimed they had previously had bad reactions to the vaccine and refused to pay the fine believing the government was denying them their due process XIV Amendment rights.

In deciding against them, Harlan wrote, “in every well ordered society charged with the duty of conserving the safety of its members the rights of the individual in respect of his liberty may at times, under the pressure of great dangers, be subjected to such restraint, to be enforced by reasonable regulations, as the safety of the general public may demand … liberty for all could not exist under the operation of a principle which recognizes the right of each individual person to use his own [liberty], whether in respect of his person or his property, regardless of the injury that may be done to others.”

Slam dunk, except for two things:

1.In 1927, the Jacobson decision provided judicial cover for Buck v. Bell. That case centered around a young Virginia girl who supporters of the Eugenics movement accused of being a product of a long line of “mental deficients.” They asked the courts to impose involuntary sterilization. In his decision, Justice Oliver Wendall Holmes wrote, ““The principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian tubes (Jacobson v Massachusetts, 197 US 11). Three generations of imbeciles are enough.” Based on that decision, 24 states moved forward and sterilized 60,000 women in the next three years.

2. A state’s right to legislate compulsory public health measures does not require them to do so. In fact, as we have seen in Texas and Florida among others, they may decide to do just the opposite – declare life saving mandates (for masks or vaccines) to be unlawful. At least 14 states have passed laws barring employer and school vaccine mandates and imposing penalties in Republican controlled states already. 

So state powers are clearly a double-edged sword when it comes to health care.

Questions anyone?

Does the Federal government have the power to come to the rescue?

NO. Judgments thus far refer specifically to states rights. These include the 1922 decision, Zucht v. King, where the decision supported a local public school district’s right to require vaccination for admission to school. In this decision, Judge Louis Brandeis wrote, “a state may, consistently with the federal Constitution, delegate to a municipality authority to determine under what conditions health regulations shall become operative.”

Can the federal government forcibly require or compel you to get vaccinated in the U.S.(with exceptions for religion and disability)? 

NO.

Isn’t that what they are doing with a mandate?

NO. A vaccine mandate means the government is “setting a condition on you returning to society or participating in a particular activity.”

If a state doesn’t mandate masks, distancing, or vaccines, and a business decides to, is that legal?

With appropriate exceptions for religion and disability, when the intent is to protect employees and customers, legal scholar, Professor James Hodge,  director of the Center for Public Health Law and Policy at Arizona State University, believes YES, although this remains to be adjudicated.

If a business asks me if I’m vaccinated on entry, is that a HIPAA violation?

NO. HIPAA regulations restrict hospital and health care workers, not store clerks.

Doesn’t the First Amendment give me the right to reject vaccines?

NO. According to legal scholars: “Freedom to believe in a religion is absolute under the First Amendment. However, freedom to act in accordance with one’s religious beliefs ‘remains subject to regulation for the protection of society.’”

Didn’t the FDA “Emergency Use Authorization” require vaccine mandates?

NO. This authorized sale and distribution of the vaccine, but did not require anyone’s use of it.

Is President Biden doing all he can, within the powers of the Executive Branch, to protect Americans from the pandemic?

Legal expert, Georgetown Law professor Lawrence Gostin, says YES. “While states have near plenary power to protect the public’s health, the federal government’s powers are limited…(Biden) is acting fully lawfully pursuant to those powers.

1. The president “is using his executive power to order vaccinations for the federal workforce. (this includes members of the Military.)

2. He is using his spending power through Medicaid and Medicare to ensure vaccine mandates in health care settings.

3. And he is using the Occupational Health and Safety Act to mandate vaccinations in all businesses of 100 or more employees. All of these are comfortably within the president’s power.”

Biden could go farther and attempt, by providing financial rewards to states that mandate vaccines, or through the Commerce Claus to limit non-mandated states interstate travel, to extend compliance, but these would most certainly generate extended legal challenges. Federal Law under Title VII of the Civil Rights Act of 1964 and Title I of the Americans with Disability Act also require vaccine exemptions for religious and medical reasons be in place. (Nationally, less than 1% have claimed these exemptions.)

As for the states, it’s a messy affair. While Texas Governor Abbott grandstands, the federal District Court in Texas in Bridges et al v. Houston Methodist Hospital refused relief for any of the 117 employees suspended and threatened with termination if they refused to get vaccinated. The decision read: plaintiffs “can freely choose to accept or refuse a COVID-19 vaccine; however, if [they] refuse, [they] will simply need to work somewhere else…Every employment includes limits on the worker’s behavior in exchange for his remuneration. This is all part of the bargain.”

In another recent case, US Court of Appeals for the Seventh Circuit in Indiana, and the Supreme Court in an appeal, denied relief to eight Indiana University students barred from attendance because they refused to comply with mandated vaccination. Students had chosen not to apply to the university for medical and religious exemption, which if granted would permit attendance if they wore masks.

States nationwide generally require entering students to have proof of up to date vaccines to prevent 11 childhood diseases.

Over a century ago, the fight over vaccines was no less heated than it is today. A New York Times editorial at the time of the Jacobson 1904 decision, tagged the dispute as  “a conflict between intelligence and ignorance, civilization and barbarism”

On the “intelligence” side, Nearly 60 top medical organizations released a joint statement on July 22nd in support of mandated vaccines for all health care and long-term care workers as a “logical fulfillment of the ethical commitment” to patients.

A Special Event.

Posted on | September 22, 2021 | 3 Comments

A Unique Offering for Students, Professors, and Lifelong Learners.

(Register For Virtual Zoom Access Here.)

Join me, in person or virtual, on 4 consecutive Thursdays this Fall.

Together we’ll examine 250 years of history and case law, to expose what our U.S. Constitution says (and leaves unsaid) about Americans “right” to health care. From the Bill of Rights to the Federalist Papers, from McCulloch v. Maryland to Griswold v. Connecticut, from “Comstockery” to Sanger, and FDR’s  “Court Packing,” we’ll cover it all.

You’ll learn about “penumbras” from William O. Douglas, and Due Process within the XIV Amendment; how the AMA chose Reagan as their spokesperson against “socialized medicine”, and how LBJ forced integration of hospital wards on Bible Belt states.

 We’ll do a deep dive into Roe v. Wade and learn how Justice Blackmun arrived at his compromise solution for “Jane Doe” and others, and examine why Texas Governor Abbott is trying to torpedo it a half century later.

We’ll revisit the politicization of the Terri Schiavo “Right to Die” case, and uncover “conflicts of interest” and deficiencies in “informed consent” at the University of Pennsylvania that contributed to the research death of Jesse Gelsinger.

We’ll hear the voices and opinions of students and professors, analyze Justice Roberts’ National Federation of Independent Business v. Sebelius split decision that preserved the Affordable Care Act…address mandated vaccines and much, much more.

In just four 90-minute packed sessions, you’ll gain a perspective on the current struggle for health care in America.  Most of all, you’ll learn and participate in the process. That’s a promise!

Register Today HERE.

 _____________________________________________________

The Right to Health Care and the U.S. Constitution: Legal, Philosophical, Ethical, Practical 

Wilde Auditorium, University of Hartford and via Zoom

1:30 PM to 3:00 PM

Course fee: $80

Thursdays: Oct. 28, Nov. 4, Nov. 11, and Nov. 18

Get informed with “Dr. Mike,” back by popular demand, on the recent political history and legal controversy surrounding attempts to establish universal health coverage in America.

Full course details

The Politics of Self-Destruction: Racial Animus Continues to Fuel Medicaid Opposition.

Posted on | September 16, 2021 | 1 Comment

Mike Magee

If you like to see a political party self-destruct, you need only accompany the likes of Governors De Santis and Abbott, and failed California candidate Larry Elder who went down 2 to 1 in his states recall election this week. And If you would like to visit the meeting place of America’s two great contemporary pandemics –COVID-19 and structural racism – you need only walk down the historic Medicaid path and enter the dangling doors of its most vulnerable populations. 

The current pandemic is disproportionately killing and maiming Black and Brown Americans. This should come as no surprise to Medical Historians familiar with our Medicaid program. Prejudice and bias were baked in well before the signing of Medicaid and Medicare on July 30, 1965.

President Kennedy’s efforting on behalf of health coverage expansion met stiff resistance from the American Medical Association and Southern states in 1960. Part of their strategic pushback was the endorsement of a state-run and voluntary offering for the poor and disadvantaged called Kerr-Mills. Predictably, Southern states feigned support, and enrollment was largely non-existent. Only 3.3% of participants nationwide came from the 10-state Deep South “Black Belt.”

Based on this experience, when President Johnson resurrected health care as a “martyr’s cause” after the Kennedy assassination, he carefully built into Medicaid “comprehensive care and services to substantially all individuals who meet the plan’s eligibility standards” by 1977. But by 1972, after seven years of skirmishes, the provision disappeared.

Medicaid has always disproportionately served as a backstop for Black Americans. They are more likely to be financially eligible, and more likely to spend their final years in Nursing Homes funded by Medicaid dollars. They are also likely to die younger than white counterparts, have twice the rate of heart disease, high blood pressure and stroke. For younger Black women, lack of access to maternity care and mental health services places them at high risk. Their children are 500% more likely to die of asthma than white children.

Southern states, led by Republican governors, have also led the way in a decade long battle to collapse the Affordable Care Act, and most notably the 90% federally funded expansion of Medicaid services and eligibility which the Supreme Court deemed voluntary in a landmark 2012 decision. Until 2017, eighteen states stubbornly held ranks. But in the past three years six states (Idaho, Utah, Oklahoma, Nebraska, Maine and Missouri) have fallen in line after voter propositions passed in their states.

That leaves some 2 million vulnerable citizens without coverage that is readily available. Polls in those states show that 2/3rds of their citizens favor Medicaid expansion in opposition to their own governors – and that was before the pandemic. Even in red counties of red states, 1/3 of Republicans are polling in favor of Medicaid expansion.

When COVID-19 hit, Nursing Homes were at the epicenter. Thanks to the action of Republican governors and their opposition to vaccines, children are now also in the cross-hairs. The major Southern states resisting enrollment in Kerr-Mills in 1965 were Texas, Arkansas, Louisiana, Tennessee, Mississippi, Alabama, Florida, Georgia, South Carolina, and North Carolina. Today, eight of the twelve states resisting Medicaid are the same, and their hospitals have been overwhelmed for a second time by Covid. These 12 states account for 92% of adults eligible for but not covered by expanded coverage. As such, they are last in line for COVID-19 testing, PPE, and vaccines. 

As a recent Health Affairs article concluded: “Addressing these ills through policy is not the only step needed to end racism in our country, but it is a necessary—and long overdue—step.”

Remember Yesterday – The Day The “Full Biden” Emerged From Behind the Screen.

Posted on | September 10, 2021 | 8 Comments

Mike Magee

Yesterday, President Biden made clear he had had enough of McCarthy and Abbott and DeSantis.  “We’ve been patient, but our patience is wearing thin”, were his words. The politics of the moment – muscular, clear, and calculated – were reminiscent of another veteran politician and President, Lyndon B. Johnson.

Johnson brought to the task an encyclopedic knowledge of the federal legislative system, an energy that knew no bounds, and a skill set and style of negotiation that colleagues referred to as the “Full Lyndon.” As Hubert Humphrey said, “He’d come on just like a tidal wave. He went through the walls. He takes a whole room over just like that.”

The Full Lyndon involved using the full scope of his six-foot-four, 250-pound frame to tower over people in such close quarters that they felt both physically overwhelmed and verbally intimidated. Various victims subjected to this unpleasant treatment over the years described clutches, patting, pushing, and bumping intermixed with threats, promises, and flattery.

By May 1964, six months after Kennedy’s death, Johnson had captured the moral high ground for his “Great Society,” which would now include the commitments that had been made within the dead president’s New Frontier. It was about the “quality of our American civilization.” A few weeks later, on July 2, 1964, President Johnson signed the Civil Rights Act. A month later, he launched the War on Poverty. The third leg to the “martyr’s cause” was Medicare.

The presidential contest of 1964 between Johnson and Barry Goldwater was a landslide for the Democrats. Johnson received 61 percent of the roughly 70 million votes cast, and 486 electoral votes to Goldwater’s 52.57 The AMA, which had very publicly run a “Doctors for Goldwater” PR campaign, had egg on its face.

On July 30, 1965, Johnson flew to Independence, Missouri, to celebrate the passage of Medicare with Harry and Bess Truman at his side. In his remarks, he said, “It was really Harry Truman of Missouri who planted the seeds of compassion and duty which have today flowered into care for the sick and serenity for the fearful. . . . Many men can make many proposals. Many men can draft many laws. But few . . . have the courage to stake reputation, and position, and the effort of a lifetime upon a cause when there are so few that share it.”

However, as Johnson flew back to Washington, he knew that the success of Medicare was by no means assured. He had given President Truman the first Medicare card, but now, 19 million other potential recipients needed to be enrolled. The administration had only 11 months before the program would go live, and the scope of the communications and public education challenge was unprecedented, with doctors threatening to boycott the program, and Southern states threatening to resist it.

In the 1960s, hospitals throughout the South still maintained segregated restrooms and segregated floors and wards designed to separate black and white populations. The passage of the Civil Rights Act in July 1964 had sent a clear warning: Title VI of the bill stated, “No person in the United States shall, on the grounds of race, color, or national origin, be excluded from participation in, denied benefits of, or be subject to discrimination under any program receiving federal assistance.”

As a result, all hospitals, in order to qualify for federal Medicare certification, would have to prove that they were no longer segregating patients. Johnson’s first steps were by the book, deploying 1,000 federal inspectors across the country to ensure that the letter of the law was being implemented. Even with this, 10 months after Medicare had been signed into law, and a month or two before the launch date, half the hospitals inspected in 12 Southern states thumbed their noses in defiance with the support of their Southern governors.

Johnson called a special cabinet meeting and leaned heavily on his work horse vice president, Hubert Humphrey, to head south and communicate directly with every mayor in the noncompliant Southern cities that he was no longer screwing around. (Years later President Obama would entrust his own Vice President, Joe Biden, to go onsite and face off similar blowhards when needed.)

By May 23, 1966, all hospitals were compliant except in Alabama, Louisiana, Mississippi, and South Carolina. By July, they were clearly heading in the right direction, though 320 hospitals had not yet completed the conversions. Though some would still lag behind on the day Medicare went live on July 1, 1966, all would soon comply.

At the same time, the President himself focused on herding in recalcitrant physicians. Johnson saw this challenge as one only he could address. As the Senate was closing in on final approval of Medicare, in early June 1965, AMA president James Appel called the White House to request a meeting. It was scheduled on June 29, the day the Senate would vote its final approval of the bill.

When the delegation arrived with Dr. Appel in the lead, Johnson began by reading them verbatim from the proposed bill: “Nothing in this title shall be construed to authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or the manner in which medical services are provided.” He spent the next half of the meeting “hugging” the doctors, thanking them for their service, day and night, to patients “like his daddy.” He expressed his respect and gratitude for their devoted and selfless service, then asked whether they would be able to help him round up some doctors to address the pressing needs of the war-ravaged Vietnamese people.

The response was unconditional from the doctors—they were at the president’s and the nation’s service. Johnson then immediately pivoted, calling for “a couple of reporters,” who arrived quickly on cue. Johnson praised the doctors and their leaders by name, and the reporters not surprisingly wanted to know whether the AMA intended to support Medicare. Johnson interrupted, visibly shocked by the question. “These men are going to get doctors to go to Vietnam where they might get killed. . . . Medicare is the law of the land. Of course they’ll support the law of the land. Tell him, you tell him,” he said, pointing directly at the AMA leader. Appel had no choice but to confirm their support, stating modestly, “We are, after all, law abiding citizens.”

What the country witnessed yesterday was a journey man politician at work. Addressing members of the same crowd LBJ faced off fifty-five years ago, he said, “Instead of encouraging people to get vaccinated and mask up, they are ordering mobile morgues for the unvaccinated dying from Covid in our communities. This is totally unacceptable.”

Remember yesterday – the day you saw the “Full Biden” emerge from behind the screen.

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See CODE BLUE: Inside the Medical Industrial Complex (chapter7) for references and more.

The MIC in Schematic Design with QR2 Interactive Reference Codes.

Posted on | September 2, 2021 | No Comments

Laurence M. Raine DrPH is a Senior Science Analyst with the Department of Homeland Security with extensive research and governmental experiences in the life sciences. He holds a Doctorate in Public Health, a  Masters in Botany, and a Certificate in Scientific and Technical Illustration. What Larry enjoys is creating detailed integrated system schematics to describe complex subjects like the Medical Industrial Complex. Here is the MIC through Dr. Raine’s eyes complete with interactive QR2 reference codes. (lmraine@gmail.com)

Source: Academia. Access to Download.

“Metaverse” – What’s In The Word?

Posted on | September 2, 2021 | 4 Comments

Mike Magee

Keying in on words is a habit that dates back to Medical School. From 1969 to 1973, in Syracuse, NY, (experts estimate) I absorbed 15,000 new vocabulary words as part of my training.

dystopian

[disˈtōpēən]

ADJECTIVE

  1. relating to or denoting an imagined state or society where there is great suffering or injustice.

NOUN

  1. a person who imagines or foresees a state or society where there is great suffering or injustice.

There are certain words that keep popping up in 2021 whose meanings are uncertain and which deserve both recognition and definition. And so, the offering above – the word “dystopian.” Dystopian as in the sentence “The term was coined by writer Neal Stephenson in the 1992 dystopian novel Snow Crash. “

One word leads to another. For example, the above mentioned, dystopian term, referenced by science fiction writer Stephenson three decades ago, was “Metaverse”. He attached this invented word (the prefix “meta” meaning beyond and “universe”) to a vision of how “a virtual reality-based internet might evolve in the near future.”

“Metaverse” is all the rage today, referenced by the leaders of Facebook, Microsoft, and Apple, but also by many other inhabitors of virtual worlds and augmented reality. The land of imaginary 3D spaces has grown at breakneck speed, and that was before the self-imposed isolation of a worldwide pandemic.

But most agree that the metaverse remains a future-facing concept that has not yet approached its full potential. As noted, it was born out of science fiction in 1992, then adopted by gamers and academics, simultaneous focusing on studying, applying and profiting from the creation of alternate realities. But it is gaining ground fast, and igniting a cultural tug of war.

Today multinational corporations are all in. Jason Warnke of giant consulting firm Accenture sees it as a power enhancer and multiplier. He says “…we believe we now have the opportunity to bring our people together in ways never before possible in the physical world.”

Not so fast, says Esther O’Callahan, the Gen-X founder of the online recruitment firm Hundo. She says the term is“… owned by young people who care more about community than profit and use it for the good of the real and virtual world. And if that sounds ludicrously naive and optimistic about it – I am and I’m not sorry!”

Karinna Nobbs, CEO of The Dematerialized, envisions the coming metaverse as a societal builder referring to it as “the next significant third space.” In doing so, she is appropriating a term made famous by sociologist Ray Oldenburg in his 1989 book, “The Great Good Place”. In it, the author advocates for investment in public spaces, outside of home and work that encourage congregation, civic engagement and relationship building. Karinna sees her virtual company as a “third space” to converge and nurture the emerging digital fashion ecosystem.”

Not surprisingly, health entrepreneurs are all over the metaverse as well. Or at least they think they are. Many of the new ventures are led by current or former health executives, attracted by investor demand, selling marginal moves in telemedicine, robotics, behavioral health, consumer wearables and the like.

Deloitte & Touche LLP report that digital health investment has quadrupled in the past four years, including $21.6 billion in 2020. They see health tech invasion of the metaverse as “a prescription for disruption by a growing base of health technology investors armed with funding from special-purpose acquisition companies (SPACs).” Investors are literally betting on an idea since SPACS go public without any existing business operations. They play to profit, not to disrupt.

Journalist turned tech analyst, AMP Creative’s Elena Piech sees the metaverse as “enabling us to be surrounded by information…this is the next iteration of life.” Could that work for health care, and if so, what might be the deliverables. Here are three:

Heal – When humans fall ill, they entrust doctors and nurses to respond in real time with knowledge, touch, and accessible resources. Could a health metaverse allow for a more ethical, equitable, efficient, inclusive and safer system of interventional care?

Health – Prevention and wellness benefit from patient-health professional relationships marked by compassion, understanding, and partnership. Could the metaverse reinforce trust and confidence, reliable information exchange, personalized health planning, and management of fear and worry?

Whole – Health is a function of a wide range of social determinants like housing, nutrition, clean air and water, education, and economic security. These resources are the products of good governance and healthy communities built around individuals, families, and societies. Could the metaverse, as a virtual “3rd space” contribute to community harmony, stability, security and happiness in a manner that kept us whole?

When it comes to a healthy metaverse, what then is the takeaway? Our health is not a game. It is our life. And as Esther O’Callahan said, “…if that sounds ludicrously naive and optimistic about it – I am and I’m not sorry!”

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