HomeMy WebLinkAboutRebuilding Your City Towards Healthiness_ Establish a City Office of Epidemiological Accountability
Christian, Kevin
From:Jon Li <jonli@dcn.org>
Sent:Monday, June 1, 2020 2:20 PM
To:citycouncil@cityofsantacruz.com
Cc:ladykpetersen@gmail.com; brooksforcitycouncil@gmail.com;
jbertrand@ci.capitola.ca.us; ebottorff167@yahoo.com; samforcapitola@yahoo.com;
rlj12@comcast.net; dtimm@scottsvalley.org; jdilles@scottsvalley.org;
dlindslind@earthlink.net; jimreedSV@gmail.com;
felipe.hernandez@cityofwatsonville.org; cityclerk@cityofwatsonville.org;
aurelio.gonzalez@cityofwatsonville.org; lowell.hurst@cityofwatsonville.org;
francisco.estrada@cityofwatsonville.org; rebecca.garcia@cityofwatsonville.org;
trina.coffman@cityofwatsonville.org; ari.parker@cityofwatsonville.org;
apatino@cityofsantamaria.org; gsoto@cityofsantamaria.org;
ewaterfield@cityofsantamaria.org; mmoats@cityofsantamaria.org;
mcordero@cityofsantamaria.org; j_osborne@ci.lompoc.ca.us;
g_cordova@ci.lompoc.ca.us; v_vega@ci.lompoc.ca.us; d_starbuck@ci.lompoc.ca.us;
j_mosby@ci.lompoc.ca.us; WadeNomura@ci.carpinteria.ca.us;
AlClark@ci.carpinteria.ca.us; GreggCarty@ci.carpinteria.ca.us;
RoyLee@ci.carpinteria.ca.us; Ariston.julian@me.com; grubyguadccm@gmail.com;
lcardenas@ci.guadalupe.ca.us; councilmemberramirez@ci.guadalupe.ca.us;
ecosta@ci.guadalupe.ca.us; amichaud@ci.guadalupe.ca.us;
toussaint.ryan@cityofsolvang.com; robert.clarke@cityofsolvang.com;
chris.djernaes@cityofsolvang.com; karenw@cityofsolvang.com;
daniel.johnson@cityofsolvang.com; hollys@cityofbuellton.com;
artm@cityofbuellton.com; eda@cityofbuellton.com; davek@cityofbuellton.com;
ajs@cityofbuellton.com; jtorres@ci.lathrop.ca.us; msalcedo@ci.lathrop.ca.us;
pakinjo@ci.lathrop.ca.us; dlazard@ci.lathrop.ca.us; bcantu@ci.manteca.ca.us;
jnuno@ci.manteca.ca.us; gsingh@ci.manteca.ca.us; dbreitenbucher@ci.manteca.ca.us;
dmoorhead@ci.manteca.ca.us; rswift@cityofescalon.org; ealves@cityofescalon.org;
jlaugero@cityofescalon.org; wmurken@cityofescalon.org;
pkrumeich@cityofescalon.org; jparks@cityofripon.org; ddegraaf@cityofripon.org;
uecker105@yahoo.com; mrestuccia@cityofripon.org; leo.zuber@yahoo.com;
mayor@stocktonca.gov; dist1@stocktonca.gov; dist2@stocktonca.gov; dist3
@stocktonca.gov; dist4@stocktonca.gov; dist5@stocktonca.gov; dist6
@stocktonca.gov; Florence.Low@stocktonca.gov; Robert.Rickman@cityoftracy.org;
nancy.young@cityoftracy.org; dan.arriola@cityoftracy.org;
Rhodesia.Ransom@cityoftracy.org; veronica.vargas@cityoftracy.org;
hmoreno@atascadero.org; cbourbeau@atascadero.org; rfonzi@atascadero.org;
sfunk@atascadero.org; hnewsom@atascadero.org; crayrussom@arroyogrande.org;
kbarneich@arroyogrande.org; jpaulding@arroyogrande.org;
kstorton@arroyogrande.org; lgeorge@arroyogrande.org; E-mail Council Website;
council@prcity.com; medinadistrict1@gmail.com; supervisors@cosb.us
Subject:Rebuilding Your City Towards Healthiness: Establish a City Office of Epidemiological
Accountability
Attachments:Rebuilding US Cities Epidemiologically.doc; Brazil Health VSM 12 Layers.docx; VSM
Layers \[Bolsonaro implodes benchmark\].pptx
Rebuilding Your City Towards Healthiness: Establish a City Office of Epidemiological Accountability
1
Dear City Council Member
The US social economy is tragically ill, exploding with violence in reaction to racism and murder by police. Authority is
falling apart.
What does your city’s revenue stream look like? It is probably in the toilet. Except for the federal bailout. A lot of good
that is going to do you: it is one time money, a pittance compared to the growing gap between your expectations and what
is happening.
Your budget for Fiscal Year 2020-21 that is scheduled to start July 1 is a fraud. It doesn’t work as an idea. You are going
to be in so much uncertainty that you are going to need shocking daily updates. Disappointing, disastrous, acceleratingly
bad daily updates.
You can try to ignore the escalating problems, but if you had been reading the left wing press since Marx, you would have
seen this coming ever since the environmental movement. The “novel”, unusual, human-loving Covid-19 virus is just
another symptom of the industrial and social problems that the corporate economy has forced on the world.
The next time you check, every day from now until the November election is going to be more bad news for the US
economy, and the US power image. The US dollar is so over-extended that it is going to crash, along with the banking
system – making the 1929 crash and the Depression look like a picnic. When that happens, probably sometime in
October, your State is going to have to authorize your City to issue script unique to your city, because the electronic
banking system is full of misinformation. The German Mark will stabilize the global economy beginning January 1,
2021, but the time from now until then will be traumatic in just about every way possible.
Due to a legacy of greed, the US period of power is coming to an end. Some of that is due to the irresponsible egos of
Trump nationally, and some local incumbents like Lucas Frerichs of the Davis city council who feel that they should
continue to be in charge of the gravy train. The days of government giveaways are over.
thth
On March 11, when the World Health Organization declared a global pandemic, it signaled the end of the 20 century,
dominated by using electricity to run machines to make money. The Society, the Ecology, and finally, the Economy have
paid a tremendous price and been badly abused; the Coronavirus has forced the world to stop it.
The health care delivery system is getting worse. The fee-for-service insurance system cannot respond to the needs of the
pandemic, so it is like throwing away food when people are hungry, there are health professionals idled or laid off, while
their hospital is going bankrupt.
2
How are we going to survive? Well, most of us will live through this. What do we do from now on?
A hundred years ago, at the end of World War I, there was a two year long pandemic that killed an estimated 20 to 100
million people, in waves over two years, in Europe, in Asia, and in the Western Hemisphere. It resulted in the most
significant breakthrough in public health history: building sewers to carry away human waste instead of letting it sit there
and attract disease. The obsession with consumption has driven a bloated economy of disease.
We need to build a new economy, from the grassroots up, based on HEALTH instead of money. This is a toolkit for you
to lead your City or Town in a serious conversation for where do we go from here.
1. Shift all government to the Community within a City level. Counties were designed to run rural areas, and
property. Counties don’t do health and human services well. The social support people need is at the community
level. This is a shift in governance to the Community of 10,000 people level, with all the other levels just looking at what
the numbers mean, within the context of the real world:
Village-Neighborhood-Community-District-Region-Area-State-Federal-International
2. Consequences:
Current Federal H&HS Full Time Equivalent: 80,000 people
2022-23 Federal H&HS Full Time Equivalent: less than 1,000 people
st
3. Health & Human Services in the 21 Century: every community of up to 10,000 people receives an annual allocation of
$25 million to provide care coordinated by a clinic and an elected 7-member locally-elected board, with daily
accountability to national standards. Hospitals and Medical Schools are run from a separate pot of federal money
allocated to each clinic for their decisions. Hospitals should only be providing the 15% of the services that they are best
designed to serve. Current medical practice is primary care about 30%; this is a shift to much more emphasis on healing
(where fee for service insurance rewards surgery). Most health care should be provided in clinics, in the community and in
the home.
4. Establish an Office of Epidemiological Accountability at each level, to monitor areas of concern, daily. At each level
(clinic/community, city, Health Service Area, state, and federal station): there is a station with an Administrative Team of
“Reporters” for Health & Human Services with seven, and only seven, positions: 2 Health, 2 Behavioral Health, 2 Social
Services, 1 Team Leader-Servant.
5. New Social Science Technology to Monitor the Uncertainty of the Future: this toolkit of governance technology is
based on the work of Stafford Beer, especially the analytical metaphor called “the Viable System Model” and its
application, the Social Economy Quantitative Flow Chart. This is called “Disseminated Regulation in Real
3
Time”. Decide what matters, monitor statistics that measure the important, fast changing things daily, and argue about
what the numbers mean.
6. Applying the Model to the Real World: The Beer-Li Model:
WikiEconomy: a computer information idea for creating a global grassroots economy. Basically it is a dynamic
information catalogue for all the parts of a woman's life: income, food, housing, health care, transportation, clothing,
education, media, entertainment, taxes, managing the economy, public services, infrastructure, utilities. That information
matrix has components that scale up physically/geographically: family, 10; neighborhood, 100; village, 1,000;
community, 10,000; district, 100,000; and region, 1,000,000. Unlike counties, these can be compared.
This computer model does not exist yet. It still needs to be built. Needed features include: a model for today’s city, real
time and up to date, called “CityData,” to be interactive and user friendly, with numbers easily converging for analysis;
plus “CityFuture” which focuses on the future, identifying options and even assessing the probability of their outcome.
WikiLife/WikiEconomy: decentralized economic information system: built up from the individual
Most of the global economy is hidden, and in a lot of trouble. This is a mechanism to turn the global economy inside out,
so that most of it is transparent, and manageable. Anatomically, a fig fruit has all of its fruit inside the skin; turn it inside
out, and it looks like a strawberry. WikiLife is like the strawberry: you can see everything you want to look for. It is an
information structure that allows many people to fill in the beginning of cells of a decentralized economy at the
neighborhood, village & community levels locally, while other people will discover what is actually happening in the
larger economy at the regional, state, national, continental and global levels.
This is a few orders of magnitude more complex than Linux or Wikipedia, but it is organized to evolve in a similar
fashion. Each cell of the economy will be governed by people who participate in it. Cells at each level will have similar
information challenges, and common approaches will emerge when they succeed. The idea is to build a grass roots global
economy.
If it is as complex as possible now, what would be the simplest?
7. Matrilineal?
Let’s face it: 3000+ years of patriarchy has failed. Socially, ecologically and evolutionarily. The pursuit of material
wealth and power has led us to a downward spiral of decay, social and environmental damage. How can we break out of
it?
A Real World Example
4
From what I understand, the Danes have an excellent prototype in use as their national information system now. To the
extent this is not true of the Danes, this is what I envision:
One computer information network unifies the entire country. Each person in the society has an ongoing account, and it
includes all of their personal, business, social and commercial activities.
A primary job of people who work in the government is to assist people in accessing their individual computer
information; if there is some kind of bureaucratic complication preventing someone from doing what they want, to assist
them in clearing up the problem. Since this account includes all of the individual’s banking data, when a person is making
a business or commercial proposal, there is no question as to the source of the information, and the quality can be
determined.
How it would feel physically:
You custom design your own web page. It includes a portal to your business accounts, which are firewalled. Complete
audit trail of anyone who goes in and what they do. You buy a bicycle; it is documented. Included is the annual public
fee, which will continue to be charged as long as you own the bike. When you get rid of the bike, you make a data change
as documentation, the fee stops, and changes are reflected in other parts of your web sites, and the relevant community
statistics about number of bikes owned.
If something is improper, you go to a community official, who you have spoken with before and built some trust,
and the official helps you through your difficulty. Public officials who do inappropriate things will be identified and
handled, and prevented. Most people will see the information system for what it is, a valuable public service that allows
them to get on with their lives, get their needs met, and have control of their personal economy.
Public Policy Analysis/Academic/Scientific Research
The aggregate data becomes the fuel to drive the public policy debate. Social scientists can focus more on population
behavior instead of needing to worry about methodological nightmares. Part of the debate always remains about
protecting individuals from data diving for manipulative commercial purposes. Within the ground rules for data use, it
becomes an ongoing census and the basis for public policy debate, decision taking, and ongoing societal evaluation.
You have many new and growing challenges. You need to get on with the practical work of moving forward. Here is the
toolkit and analysis:
Rebuilding Your City Towards Healthiness: Establish a City Office of Epidemiological Accountability, and Clinics
in Every Community of 10,000 People
st
I. Rebuilding the 21 Century City
1. Managing Uncertainty
5
2. New Federalism: Useful Community-City Governance for the XXIst Century
3. Sustainable City as Regulator and Mediator of Community Health
4. The Computerized Community (1970, 2011, 2019)
II. US Health & Human Services Challenges
5. Planning for the Future: Evolving a U.S. Universal Health System
6. Reducing Unnecessary Complications: Nature’s Efficient Complexity vs 20th Century Complicated
Bureaucratic Institutions from too much Variety
7. The Human Cost of U.S. Health Insurance: Physician Time: 48% computer, 26% patient care:
Primitive US Health Insurance vs Sophisticated European Non-Profit Universal Coverage
st
III. US Health & Human Services for the 21 Century
8. U.S. Universal Health Care with 40,000 Community Clinics that is better than Private Insurance:
The Community Health Clinic: The Central Resource for Community Centered Health & Wellness Clinical Care,
Michelle S. Famula, M.D.
9. Human Support Services: How to Make the Welfare System Work
10. Embracing Long Term Service and Support from a Next Friend’s Perspective
11. Create an Office of Epidemiological Accountability at Your Level
IV. Making It Work Administratively
12. U.S. Universal Health Care: Brazilian Design, Dutch Administration, Daily Accountability: Optimize Primary Care
systemwide in every State in the U.S.: 75 FQHC Community Clinics with $25 million annual budget in each
Congressional District
13. Warm Data
14.Present-Future: Stafford Beer’s Viable System Model & disseminated regulation in real time: How to Run a Country
or a City
15. U.S. Universal Health Care: Budget 2021-2 through 2024-5, The Political Strategy and Implementation Timeline
The Global Economic Problems
6
16. German Mark Stabilizes the World January 1, 2021: G-Curve: Trump Monthly Hockey Sticks; Biden Election; CCP
Dissolves into history 11/15/22; Green New Deal save the World
Appendices: Presented to the Berkeley meeting of the Physicians for a National Health Program 1/24/2020, and the
Healthy California for All Commission 1/27/2020:
#1: Lessons From the Dutch: Health Care that works for Everyone
The Standard We Are Using
How This Works
Brazilian Health VSM Twelve Layer Analysis 1.0
#2: Harvard’s Getting Health Reform Right: A Guide to Improving Performance & Equity
#3: Systems Science Spectacles: London Clinic: Stafford Beer’s Health & Quiet Breathing (1970);
Economist January 25, page 16: Letters: Stafford Beer’s Viable System Model
#4: Systemic Trauma: The Troubled Prospects for Managed Care in California & the United States (1996)
Attached: Stella’s Brazilian Health VSM Twelve Layer Analysis 1.0 & Bolsonaro 2.0
st
This is the new US Revolution: rebuilding our society and creating a new social contract for the 21 century. Please start
a US Universal Health Care “Committee of Correspondence network among the cities in your state. This requires a grass
roots effort of mutual support.
David Brooks, in Friday’s New York Times: “America is a diverse country joined more by a common future than by
common pasts. In times of hardships real leaders re-articulate the purpose of America, why we endure these hardships
and what good we will make out of them. Right now, science and the humanities should be in lock step: science
producing vaccines, with the humanities stocking leaders and citizens with the capacities of resilience, care and
collaboration until they come. One of the lessons of this crisis is that help isn’t coming from some centralized place at the
top of society. If you want real leadership, look around you.”
st
Today is the first day of a sustainable human 21 Century.
Let me know if you want some help figuring this stuff out.
Jon Li, social systems scientist.
7
Institute for Public Science & Art
A physician, or anyone else, should be able to explain an idea so it becomes useful.
8