1. In 2017, health care providers across the US wrote more than 191 million prescriptions for opioid pain medication—a rate of 58.7 prescriptions per 100 people.
2. Despite guidelines to limit opioids as a first approach to managing most chronic pain, a study found primary care clinicians write 45% of all opioid prescriptions in the United States.
3. More than 11 million people misused prescription opioids in 2017.
4. Every day, more than 1,000 people are treated in emergency departments for misusing prescription opioids.
5. In 2017, prescription opioids were involved in more than 35% of all opioid overdose deaths: nearly 17,000.
6. From 1999 to 2017, almost 218,000 people in the United States died from overdoses related to prescription opioids.
7. The CDC estimates the total economic burden of prescription opioid misuse in the US is $78.5 billion a year, including the costs of health care, lost productivity, addiction treatment, and criminal justice involvement.
Whenever my life begins to feel too “cushy” – which is often since I’m a spoiled American Baby Booming corpulent white male with a loving/doting wife, a squared-away son, a reasonably functional family, early retirement, and a supportive church family – I sign up for a mission trip, foreign or domestic.
Which cures the spoiled-brat syndrome pronto.
If you embark on such an adventure, expect: crushed legs on long flights, strange food clogging the septic system, strange water unplugging the septic system, flat-hard hotel beds, endless oversize bags full to maximum 49.9 pounds of cement-grade calcium carried up and down steps via human chain, sleepless nights filled with the cacophony of poultry crowing contests and spontaneous dog fights, mission beds made of burlap and two-by-fours, water-less showers until Angel Plumbers work their magic, twelve-hour days spent mostly on the feet, the ringing sound of eighty voices banging around the cement walls of the clinic, three languages bouncing in a Babel of towering intensity.
So, why do we subject ourselves to that?
Probably for the same reason soldiers return to Afghanistan seven-or-eight times. Why firefighters rush into burning buildings. Why doctors continue to practice medicine into their eighties, serving a network of friends they’ve made over a lifetime.
They do it for the tribe.
Opinion: we are designed by the Creator to function in small groups, say twenty-to-sixty people – all carrying different abilities (spiritual gifts) – a tribe where everyone has a job, everyone is respected for their contribution, and everyone is connected to a purpose outside their own agenda.
“In 1753, Benjamin Franklin wrote to a friend about a curious phenomenon in the American west. White prisoners rescued from Native American tribes were seizing the first chance they could to flee into the wilderness and rejoin their captors. There were no reports of native warriors migrating in the opposite direction. Perplexed, Franklin concluded that the errant whites must have become ‘disgusted with our manner of life’ despite being shown ‘all imaginable tenderness’ on their return.” (Source).
Sebastian Junger, author of Restrepo and The Perfect Storm, recently penned a book titled Tribe: On Homecoming and Belonging, which focuses on the War in Afghanistan and veterans’ mental health. Junger writes: “Today’s veterans often come home to find that, although they’re willing to die for their country, they’re not sure how to live for it.”
Instead of focusing on job training and social re-conditioning, we treat vets like pariahs and load them up on drugs while ignoring the root cause of their distress and side-stepping psychiatric care, which is expensive and time consuming. We treat veterans as if they aren’t worth our time and effort after they return with lost limbs and shattered psyches. The suicide rates for white males over sixty-five, many of whom are Vietnam vets, bears witness to these unresolved issues.
“In 2008 active duty and veteran military personnel abused prescription drugs at a rate that was more than twice the rate for the civilian population. In 2009, the VA estimated that around 13,000 vets from Iraq and Afghanistan suffer from alcohol dependence syndrome and require veteran mental health treatment for this problem.” (Source)
After listening to Junger’s podcast, it occurred to me that we are indeed better beings when connected to a well-functioning small group, which is why churches, synagogues, mosques, Boy Scouts, Rotary, Lions Clubs, Crips, Bloods, and Hell Angels exist.
The last three will probably lead to harm, but the call of the tribe is embedded into our nature, and that is why making a conscious decision to serve on a positive team is a healthy choice.
The March 2018 medical mission I joined to Ixtepec, Tatoxcac, and Xochiapulco, Mexico offered unending examples of a high-functioning tribe than I can list (starting with the angel who swapped her airline aisle seat twicefor my leg-killing window view); furthermore, this team comes together bi-annually to bring medical care to under-served residents in the rugged mountains northeast of Puebla, Mexico. Nearly half of the folks treated were indigenous, speaking Totonaca, a native language “not closely related to other native languages in Mexico.”
Which required three levels of translation: English – Spanish – Totonaca — and back again.
This year I was the “optometrist” which meant that I helped 320 folks find workable reading glasses over four days using two Bibles (the KJV, and a Totonaca New Testament), a spool of thread, a needle, a flashlight, and a pocket knife to cut plastic. The spectacles were donated by the generous Lion’s Club Tribe.
My Spanish interpreter – Fany (pronounced Fanny), from the Methodist College in Puebla – was coming off a semester of concentrated French, so the combination of suddenly switching to English while simultaneously deciphering an unknown indigenous tongue wore on her along with all the physical challenges, yet she hung on to gain a second wind and finish the week admirably.
Local teens connected to the Ixtepec Methodist Church also saved the week by giving fully of themselves, obviously loving and cherishing their elderly by listening carefully to their needs, then translating them into Spanish, where Fany would pass it to me, and then back again. Three hundred twenty times in four days.
Multiply that by the entire cohort of volunteers (approximately 120), and you begin to perceive the amount of coordination it takes to make this mission work.
Plus eleven months of planning and preparation up front.
Sebastian Junger claims that we need three essentials to live healthily and harmoniously: 1) we need to feel competent at what we do; 2) we need to feel authentic in our lives; and, 3) we need to feel connected to others.
Looking back at the suicide statistics, it must be noted that the Hispanic males take their own lives in much fewer numbers than Caucasian males.
“White men over the age of 65 commit suicide at almost triple that overall rate. These men are also eight times more likely to kill themselves than are women of the same age group, and have almost twice the rate of all other groups of male contemporaries.
Disparities along ethnic lines for elderly males are also substantial. Compared with white males ages 65 and older, African American males (9.2 suicides per 100,000), Hispanic or Latino males (15.6), and Asian or Pacific Islander males (17.5) in the same age range had significantly lower suicide rates.” (Source)
Research on the “why” is thin, but after spending a week in Ixtepec, casual observation of the culture exposed a deep connection to family, community, nature, and God: all characteristics of a healthy tribe.
In contrast, the phenomenon of disconnected angry white American males sitting in dark rooms drinking alcohol and absorbing CNN or FOX is ending badly.
Our Mexican patients exhibited a wide range of physical needs – missing teeth, scabies, parasites, allergies, an entire gamut of untreated ailments testing the knowledge and experience of the mission doctors, nurses, and pharmacists – but the local populations’ connectedness to the spirit, energy, patience, and genuine good nature lifted the hearts of all servants, Mexicans and Americans alike.
Pablo, a minister from another province, traveled to Ixtepec with his teenage son, both patiently washing, drying, and treating foot ailments. Ricardo and LuLu traveled from Nicaragua to lead the translating team, and three other college students traveled with Fany from Puebla to sacrifice their free time and comfort to serve their country.
The exact ratio of Mexican-to-American servants on this mission is unknown, but it seemed like 3:1 as local teens, the church pastor’s family, and other Mexican missionaries – plus half the congregation – pitched in to make it work. Villagers lined the street to tote heavy bags down to the church the minute we arrived, and waited patiently for hours on end — often in the rain and wind – to receive their annual medical care.
The Ixtepec-Tatoxcac-Xochiapulco clinics succeeds because everyone has a job – or three – everyone is valued for their contribution, and all are connected through Jesus Christ.
No matter where our travels take us – Johnson City, Ixtepec, Tasmania, wherever– if two-or-more are gathered in His name, we are connected. We are also connected by our willingness to serve, to share that last full measure of devotion that propels The Tribe.
“Therefore I urge you, brethren, by the mercies of God, to present your bodies a living and holy sacrifice, acceptable to God, which is your spiritual service of worship.” Romans 12:1 NASB
My two previous mission trips to this beautiful mountainscape northeast of Puebla occurred in the late Nineties, and I must say there is a noticeable improvement in infrastructure – the highway from Puebla to the mountains is new and modern – plus the thirty-two years of medical mission work is revealed in the faces of the people, who look much healthier. Even the dogs show fewer ribs.
The visiting team stood in awe of these patient, hard-working, community-loving, God-present, spiritually connected folk – The Tribe – functioning as it’s meant to be.
Meanwhile, reality-show Americans continue to back-stab each other on social media, ignore common values, highlight differences, suck down opioids and alcohol in record volumes, endlessly eyeball the latest fear-mongering headlines slanted to feed personal preferences, and commit suicide in record numbers.
"How do you become an adult in a society that doesn't ask for sacrifice? How do you become a man in a world that doesn't require courage?" -- Sebastian Junger, Tribe: On Homecoming and Belonging
Those who serve rely on the tribe: church family, Sunday school classes, spouses, and relatives, all connected through Christ – who finance our way, who donate medicine, eyeglasses and crutches, who pray for and bless our service with their love.
We certainly relied on the tribe in Mexico who fed, housed, worked diligently beside us, and have served faithfully for over thirty years.
From desert wanderers seeking the Promised Land … to disciples sharing the Good News … to medical missions serving the needy in foreign lands … The Tribe functions with efficiency through its unselfish connection to The One.
I don’t know about you, but I’m sticking with The Tribe.
Benjamin Franklin had his faults — ask most conspiracy theorists — and it was a known fact that he admired young women.
But when it comes to having a clear vision on accruing wealth, Poor Richard nailed it:
There are two ways of being happy: We may either diminish our wants or augment our means -- either will do -- the result in the same; and it is for each man to decide for himself, and do that which happens to be the easiest.
If you are idle or sick or poor, however hard it may be to diminish your wants, it will be harder to augment your means.
If you are active and prosperous or young and in good health, it may be easier for you to augment your means than to diminish your wants.
But if you are wise, you will do both at the same time, young or old, rich or poor, sick or well; and if you are very wise you will do both in such a way as to augment the general happiness of society.
-- Benjamin Franklin, statesman, author, and inventor (1706-1790)
First, Franklin starts the “American myth” that happiness is tied to the pursuit of property. We have more stuff therefore we win begins here. But it is true that we decide our own financial fates, and Americans differ widely on their pursuit of savings.
The advertising industry raises its ugly head in paragraph three, making stuff a “need” in the hearts of North Americans and fanning the fire of want. Ironically, one of Franklin’s many nicknames was The Patron Saint of Advertising, which he mastered early on.
Apply the last paragraph to your life and its ongoing change of circumstances and good things will happen. The Millionaire Next Door hit home with many who’ve since reaped the benefits of Franklin’s (and Stanley’s) advice. There are now more than twice as many millionaire households than there were in 1996, and 10.1 million US households now report a million dollars worth of assets.
Here’s how to apply Franklin’s commonsense rules to runaway government spending.
We have to ask ourselves, do we need to police the globe? Has doing so improved world peace? Or has it fired up the military-industrial complex to thrive in a Brave New World of Endless War?
It’s obvious that our military wants exceed our taxpaying grasp, especially with new cuts about to favor billionaires and corporations. But does the average American really want to police the globe?
Since endless wars come at such a high cost, shouldn’t we fall back, assess the hot spots, employ better technology — in terms of rooting out evil, not nuking the earth into oblivion — and emasculate the bad guys with focused strikes?
I’m all for rooting out the bad guys, both foreign and domestic. But instead of spending on R&D for pinpoint technology, we’re filling our docks with billion dollar warships and our airfields with million dollar airplanes to fight conventional wars that no longer exist.
On the Other Hand
Here’s how we relate to a few other countries when it comes to saving cash:
What’s made America uniquely bad at saving? Perhaps America’s mix of wealth and diversity, the very staple of the American identity, is the culprit of its spending habits. In 2008, several researchers studied the stereotype that minorities spend more than whites on “visible goods”—like clothes, shoes, jewelry, watches, salons, health clubs, and car parts. They discovered that, even after controlling for income, minorities save less than whites and spend more on such conspicuous consumption goods. But the story wasn’t just about race. White people in poor U.S. states spent more of their income on visible goods than whites in higher income states.
The Atlantic, 2016
Let’s look at that again: ” White people in poor U.S. states spent more of their income on visible goods than whites in higher income states.”
The sitting president, however, is all about lifting up the elite at the expense of the rabble.
The Orange Tweeter, exhibiting bouts of sociopathy mixed with narcissism, seems incapable of focusing on any issue longer than a nano-second, and his sinking popularity now represents roughly 31% of the electorate.
Draw your own conclusions on what percent of this group falls into the “rabble” category (those still smarting from the deplorable slap), and what percent of Trump supporters are billionaires wanting to rake in more loot in the short term.
My personal guess is that moderate Republicans hoping to work across the aisle to solve the many pressing issues of the day would be a minority within that 31%.
Just a guess.
Yet the nation continues to treat world and domestic affairs like a football game — we win, you lose — without considering the simple fact that we’re actually all on the same team.
Yes, we can nuke any nation on earth into oblivion. Then the fallout blows over on us.
Yes, we have conventionally bombed nations into near-oblivion, but then they thrive after we go home, though most of the cash ends up in the hands of the upper-class.
You can’t enjoy small government and big military simultaneously.
But Trump voters aren’t interested in logic. The rabble still believes they’ll grow fat on the scraps tossed down from the elite’s tall table of big tax cuts and military-industrial-complex stock-and-bond windfalls.
They’re throwing commonsense to the wind, these lower-middle-class lovers of commonsense.
Our current health care mess is more a political debacle than a substantial challenge to the intellect when it comes to solvency.
We can do better by providing excellent health care to allAmericans while lowering the overall cost, though it may slightly burden the wealthy and middle-class folks in order to reach the prize of truly affordable health care for all.
In the 90’s I taught at a local community college and one of my students – who was abused as a child and neither fully-supported nor fully-educated – struggled her entire life with health issues, racking up hundreds of thousands of tax-payer-swallowed medical bills over the course of her too-short life.
Multiply this situation by millions – many citizens are now hooked on opiates – and one can see how this particular demographic could force a single-payer Medicare expansion into near-future reality.
While I was researching this article, it was obvious that
the “facts” coming from sites linked – in one way or another – to private insurance companies were quite different from those emanating from neutral sources.
The insurance-linked information sites apprised the cost at $32 trillion while the neutral sites announced it would actually lower costs. The truth often lies at the midpoint, a hefty sum indeed. But our current direction, and the soon-to-be-announced Obamacare Lite are simply untenable.
Limiting Congressional health-care benefits to their own
plan for the rest of us would be a start. But don’t expect a sitting Congressman to write that bill. And now Republicans are replicating the major mistake Obama committed in his first term, which was to push a secret backroom inviable bill into law while briefly holding the majority and babbling they’d better pass it first so “you can see what’s in it” later.
Fast forward to today and it turns out that the ACA is actually a step above what the current Trumpcare plan offers the truly needy, a plan that boils down to “the rich get richer”.
An alternate path – leading away from the debacle of Obamacare/ Trumpcare – is fairly simple and workable: expand Medicare using a single payer plan while dropping Medicaid altogether.
“So what is single-payer health care? Essentially it involves expanding the present Medicare system to cover everyone and eliminating private insurance (with the claimed accompanying savings of hundreds of billions of dollars).
"Additional features would include the absence of means testing, no concern for pre-existing conditions, the restoration of independent doctors and hospitals who negotiate with Medicare and would be chosen freely by consumers and one public agency processing and paying bills.
“Because it would be unneeded with this system in place, the present Medicaid program for the indigent and its associated administrative costs would be eliminated. Proponents suggest that costs could be contained and quality maintained through more efficient review by the single insurer. Costs would be financed through a progressive income tax.”
Sounds good, aye? Well, unless you’re a millionaire and break in to a cold sweat at the clause “costs would be financed through a progressive income tax”.
Like me, you’re probably reading between the lines here.When “eliminating private insurance” pops out, one’s mind – if the slightest bit of pragmatism is embedded there – questions the odds of cash actually drying up in the UnitedHealth, Kaiser, Humana, Aetna, and Cigna Rivers.
“In the 2012 election cycle, the insurance industry contributed a record $58.7 million to federal parties and candidates as well as outside spending groups. Of the nearly $55 million that went to parties and candidates, 68 percent went to Republicans, who have long been the recipients of most of this category's giving.”
Admittedly, private insurance companies may suffer at first with a single-payer plan, but people with cash would buy supplemental insurance beyond Medicare basics and sustain the industry; jobs would shift to government positions aimed at administrating the new system and would therefore mitigate unemployment.
With the GOP in power, we’ll likely get Obamacare Light if they can scrape up the Senate votes, which fattens the coffers of the already-wealthy while neglecting the truly needy.
However, the worm may turn in 2018, and if a new Congress actually functions, we’ll be able to bring down costs and increase quality with a single-payer Medicare expansion while simultaneously closing the income gap.