Saturday, June 25, 2016

Sovereignty: Globalists and Nationalists, Patients and Physicians
My dictionary defines “sovereignty” as independent or self-governing power.
Synonyms for Sovereignty
You can call sovereignty  other things as well -  autonomy, self-governance, self-rule, self-determination,  freedom,  desire for privacy, rise of  populism,  revolt against powerful elites and remote bureaucracies,  resurgent nationalism,  and power to control one’s destiny on one’s  own terms.
The Brexit Example
Whatever name you wish to use,  sovereignty  is  significantly politically , as evidenced by Britain’s  vote to exit from the European Union, a revolt against being told what to do by faceless  European bureaucrats in Brussels.  Fraser Nelson , editor of the Spectator and columnist for the Daily Telegraph,  said Brexit was similar to other battles being fought in Western democracies,  “It is the jet-set graduates versus the working class, the metropolitans versus the bumpkins – and, above all, the winners of the globalization against the losers."  It is a cry for liberty by workers suffering from economic stagnation and a rebuke of the political elite establishment.
The American Counterpart
Sovereignty is important in America as well. It is the will of the people, as  they  revolt against the establishment in Washington, D.C.,  and against being “globalized” as a forgotten  subsidiary  of the world’s global economy.    Global climate warming agreements,   international trading pacts, secretive foreign treaties with adversaries, and withdrawal of American power from the world scene, may be the ways to go, but the opposition do  not agree.  As in Britain,  middle class and worker anger is growing as is reaction against immigration,  globalization,  free trade,   unemployment,  capital flight, and the technology elite, rich people, and the well-educated.
Sovereignty in Health Care
In American health care,  sovereignty manifests itself  as a reaction against  ObamaCare.  The basic thrust of the health law is having Washington “govern” the patient-doctor relationship. This is done in the names of enhanced efficiency, quality, and outcome, as seen through the eyes of governing elites.
Gains and Losses
Among patients and physicians,   this  gain in government power is perceived  as loss of personal sovereignty. It  comes at a price – higher taxes,  more regulations,   loss of privacy, and increased  intervention into the lives of patients and  disruption of physician work patterns.
Patients and doctors resent having their life styles and practices measured,  monitored,  and transformed and being told what to do.
That is why as many of one-third to one-half of patients  withhold  or distort information or even lie  when they see doctors using electronic health record systems to record their personal information.  
That is why physicians complain about government-induced hassles, leading to losses of productivity,  overhead expenses, and time spent away from patients – all to please the whims and misconceptions  of government  bureaucrats and policy elites.
It may be, of course, that each mindset – that of the government  elite and that  the governed -  are partly right and partly wrong.    
Culture-Changing Events
Whatever point of view prevails , keep in mind that cultural changing events -  interconnected information-globalization produced by computerization,   universal access to this information by IPhone and other devices,    mass migration facilitated by open-border mentalities,   declines  in the  personal and physician sovereignties ,   and noble bureaucratic intentions to improve population-health  through use of data -  come at a high price,  will generate controversies about loss of  personal “liberties and freedoms, “ and  will  take time to implement and cultural attitudes to overcome.

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