Healthcare--A Community Experience

Dimension: Class

While I was in graduate school I created an exercise called "A Community Experience" to be used for a workshop on cultural competence that I was facilitating along with my advisor, Dr. Sandy Shulman. It is a basic have/have not exercise where participants are divided into 3 groups--the Sun, the Moon and the Stars--and given resources that must be traded, exchanged, bartered in order to achieve enough goods for everyone in their family group. There is also a competing goal of trying to garner more resources than any other group in order to win the prize (generally a bunch of money). Since 1984 when I first conducted the exercise, I have faciliated it literally hundreds of time with almost the same results every time. Despite the fact that during the directions I reinforce the terms that "there is more than enough for everyone collectively" the haves end up having more and the have nots either keep the status quo or get worse in an attempt to get better.

As I listen to the healthcare debate I am reminded of this exercise. I am not naive to the multiple issues or the political and cultural war that these issues present but I want to scream "there is more than enough for everyone collectively." People who already have the "public option" of medicare are afraid that they will lose what they have. People who are covered by their employers are afraid that they will be forced by that employer to a cheaper (and by its logic, a lesser) plan. Private insurers are afraid they will be put out of the business of making a profit on people who are sick. People with private insurers want it all--the best care, choice about providers, reduced or little out-of-pocket costs and no one interfering on how they spend on end-of-life care, sick care, wellness or elective surgery.

Just like in the Community Experience experience, while the haves take inventory of their resources, the have nots are still wondering how they get resources. In the simultated exercise we use paper plates, cups, chips and pretzels as resources. In real life, we are talking about medical care--literally life and death issues. We need to end the madness of the political and cultural wars and remember "there is more than enough for everyone collectively."