Quote of the moment

"I have to tell it again and again: I have no doctrine. I only point out something. I point out reality, I point out something in reality which has not or too little been seen. I take him who listens to me at his hand and lead him to the window. I push open the window and point outside. I have no doctrine, I carry on a dialogue." Martin Buber

Wednesday, March 28, 2012

The value of truth, trust AND community - The story of Andy's pizza

When Andy was young  Jorge would always read as a bedtime story cover to cover until even the cover fell apart:

It seems that the reading and lessons have paid off recently.  It was to be a late evening for us so we agreed upon ordering a pizza.  Jorge was still working and I still needed to walk the dog. I thought that if I ordered and prepaid for the delivery of our pizza from the neighborhood corner pizza restaurant I could time it all perfectly to return home with pizza waiting.  I stopped by Da Dino's pizzeria that Andy frequents independently and as a result is well known but them as they are by us.

 Usually the concierge must call up and announce the arrival of anyone. Since Andy never answers the phone, if my timing failed I figured that the pizza would be awaiting me at the concierge's desk upon my return. However, upon my return to our apartment the concierge informed me that the pizza not only arrived, but also said he had sent it and the delivery man on up to our apartment.

I also discovered from the concierge, that once the delivery man arrived with the pizza, Andy, aware there's no such thing as free pizza, tried to pay the delivery man again. The delivery man explained the best he could to Andy in Spanish that  the pizza was paid for- but Andy wouldn't accept without paying so he tried again. The delivery man was insistent and left without taking Andy's money. He then  made certain that the concierge would inform us that he was a truthful and trustful delivery man.

Upon my arrival at our apartment, I was amazed again and very pleased to find Andy in the kitchen eating a nice large salad that he had prepared himself and his slice of pizza awaiting its completion. How wonderful to learn that all our coaxing to pace himself while eating his favorite food had paid off!

I strongly believe that there was one more value beyond those of truth and trust on the part of the delivery man and that also of Andy wanting to pay for his dinner. The greater value displayed here was that of community and the relationships that develop from it that enhance a confidence of truth and trust.   As John McKnight notes though:
Whether we are safe and secure in our neighborhood is largely within our domain. Many studies show that there are two major determinants of our local safety. One is how many neighbors we know by name. The second is how often we are present and associated in public, outside our houses. Police activity is a minor protection compared to these two community actions. This is why most informed police leaders advocate for block watch and community policing. They know their limits and call to our movement.
No matter how hard they try, our very best institutions cannot do many things that only we can do. And what only we can do is vital to a decent, good, democratic life. People in the new movement know what only we have the power to do as local neighbors and citizens. Read the full article: John McKnight on Community Capacities and Community Necessities
Without all three- community,  truth and trust- I most certainly realize this story could have had a much different, even scary ending.

Friday, March 23, 2012

Health care in Chile: Resources and research

When moving to a new country health care is a critical concern for many. Questions asked include, "Where do I go for health care that is good and that I can afford."  Chile's health program has also entered the USA political arean in this presidential and political season. Candidates have been comparing Chile's health programs to that in the USA.

 I have had personal experience with the private side of health care. In fact friends tease me as coming to Chile to sample the various health care options. I have also seen a friend of mine with an intellectual disability receive minimal care only after great advocacy of his friends. See my post: Health Care- A Tale of Two Patients, A Tale of Two Crazy Pigs

After seeing what was available for my friend with an intellectual disability and the efforts of another friend to make changes in the Chilean AUGE health system so that dystonia would be covered, I realized I needed to learn more about the issues. This post is a collection of the references and information with abstracts that I have discovered along the way. I have ordered the information by publication date. If you know of other references to add to this list please include it in a comment or contact me directly. 

Health Care in Chile

This site was created for GE's healthymagination by the Economist Intelligence Unit. It presents the results of a wide-ranging investigation into the critical healthcare issues facing countries around the world. The analysis, data and commentary can be viewed in multiple formats. Information for Chile includes 

Health Care and Insurance: All Chile.Net
Chile Wiki For Expats, Gringos, Foreigners, and the curious covering information and resources for working living, relocating, and visiting, ALL of CHILE, South America. This page covers information regarding health care.

Chile's government is debating reforms to the country's healthcare system, but is unlikely to dismantle the private funds. (November 23, 2011) Economist Intelligence Unit. 
Chile's Parliament looks set to debate a package of healthcare reforms that are among the priorities of the right-wing government of president Sebastián Piñera. The goal, according to officials, will be to improve the quality of health services provided to poorer Chileans....The most common complaint among Chileans, however, is that the country's healthcare system is highly unequal – a complaint many link to its mixed public-private system. Chile is one of only three OECD countries where private healthcare spending outweighs public - the others being Mexico and the US. Public spending as a percentage of GDP is low, with only Mexico ranking lower, and the same goes for health spending on a per capita basis. Families can opt between health services provided by the public system run by the Fondo Nacional de Salud (Fonasa) or those offered by private firms known as Instituciones de Salud Previsionales (Isapres). Even though the two systems charge workers 7% of their monthly income for their services, it is widely agreed that the Isapres provide much better and more comprehensive healthcare service. 

In 2005 the government of Chile passed comprehensive health reform. The law mandated coverage by public and private health insurers for selected medical interventions related to fifty-six priority diseases and conditions. This paper presents previously unpublished evidence on various consequences of the reform. It also presents a first, partial evaluation of the reform’s impact on access to care, treatment outcomes, hospitalization rates, and medical leave rates for six chronic diseases. For some of those diseases, such as hypertension, types 1 and 2 diabetes, and depression, we find that the reform was linked to growing access to services and increased coverage. For those diseases and for childhood epilepsy and HIV/AIDS, the hospital case-fatality rate dropped.

This paper examines the introduction of a prioritized list of fifty-six health conditions in Chile, for which access to treatment is guaranteed. This is an important health reform issue, and the discussion of Chile’s rich and complex approach may benefit other countries. Conditions on the list were selected using multiple criteria: burden of disease, inequality, high costs, social preferences, rule of rescue, and cost-effectiveness. The dominant criteria were high burden of disease and social preferences. Cost-effectiveness was introduced after the fact to identify effective treatments at a cost that the country could afford.

The current health system in Chile began to take shape in 1952, with the creation of the National Health Service (SNS), which united different public health service providers and centralized nearly 90% of public health resources under one entity. See also:  National Health Fund (FONASA)

Rex A. Hudson, ed. Chile: A Country Study. Washington: GPO for the Library of Congress, 1994.
An on-line version of a book previously published in hard copy by the Federal Research Division of the Library of Congress as part of the Country Studies/Area Handbook Series sponsored by the U.S. Department of the Army between 1986 and 1998. Each study offers a comprehensive description and analysis of the country or region's historical setting, geography, society, economy, political system, and foreign policy.

Health Compared - Chile and USA

John Boehner is sure the U.S. has “the best health-care system in the world.” But to lots of other people, the question of where we rank is a real head-scratcher. Countries vary enormously in demographic, economic and cultural terms (and treatment can be judged in multiple ways) complicating what might seem a straightforward issue.  Researchers have only very recently come up with a neat way to pierce the fog....So, how’s the United States doing? Not so well. The US placed 24th (just behind Chile and just ahead of Portugal) among the 31 countries that are members of the OECD. 

Total health spending accounted for 8.4% of GDP in the Chile in 2009, one percentage point below the average of 9.5% in OECD countries.  The United States is, by far, the country that spends the most on health as a share of its economy (with 17.4% of its GDP allocated to health in 2009). Health spending tends to rise with income, and generally OECD countries with higher GDP per capita tend to spend more on health. It is not surprising, therefore, that Chile also ranks well below the OECD average in terms of total health spending per capita, with spending of 1,186 USD in 2009 (adjusted for purchasing power parity), almost three times lower than the OECD average of 3,223 USD.  

The Chilean authorities plan to raise budgetary allocations over the medium term for a variety of social programmes, including education, health care and housing. This incremental spending will need to be carried out in a cost-efficient manner to make sure that it yields commensurate improvements in social outcomes. Chile’s health indicators show that it fares relatively well in relation to comparator countries in the OECD area and in Latin America. But this is less so in the case of education, where secondary and tertiary educational attainment remain low, despite a significant increase over the years, and performance is poor on the basis of standardised test scores, such as PISA. Even though comparison with countries in the OECD area is difficult, a sizeable housing deficit has yet to be closed in Chile. To meet these various challenges, efforts will need to be stepped up to: i) narrow the disparities in performance that currently exist among schools with students from varying backgrounds through use of the “differentiated” voucher scheme and additional measures to improve the quality of teaching and management;  ii) improve risk sharing among private and public health insurers, while increasing the coverage of health insurance to a broader variety of pathologies under AUGE; and iii) continue to tackle the shortage of housing, while enhancing the quality of subsidised housing units and their surrounding neighbourhoods for the poorest segments of society. This paper relates to the  2007 Economic Survey of Chile (www.oecd.org/eco/surveys/chile). 

Comparisons of Chile to United States 
An interactive map created for GE's healthymagination by the Economist Intelligence Unit. on Health care inputs, outcomes and risks

Linking to news in Santiago and all of Chile

What is an English speaking expat to do when unable to read or understand Spanish and you want to know  the news in Santiago and all of Chile? 

Below are resources for English speakers and readers to find out what is happening in town and all around. They are also wonderful opportunities for English as second language learners to practice their new language. For the most part all reporters for these publications and online news outlets rely on unpaid positions to fulfill its operating needs, though, paid opportunities may arise from time to time. They also also offer non-credit internships for the budding reporter on holiday in South America.

Santiago Times, an English news source for events in Chile, is widely available on newsstands and accessible online. They require paid registration though some articles are free for viewing online. The Santiago Times was founded in 1991 as the first English-language online newspaper in Chile. the independent newspaper's main product is The Santiago Times, a digital newspaper published online five times a week. They also publish print special editions an average of 2-3 times a year. The Santiago Times is a partner with the newspapers The Atacama Times, The Valparaíso Times and The Patagonia Times, the travel information site Chile information project sites, and Expats in Chile network. Their reporting team is also responsible for producing the English and Spanish editorial content published on their website, This is Chile

Revolver < http://www.revolverchile.com/ > is Chile's only English-language digital magazine devoted to the arts and entertainment scene. Revolver also serves as the official entertainment and events magazine for the Santiago Time

Another service of Santiago Times is the Chile Information Project Site.  Daily summary 12 months a year of political and economic news sourced from and attributed to local media. The site incorporates a growing amount of original investigative material and provides information on Travel, Doing Business, Living in Chile, Business Directory.

I Love Chile is another  all-English media source for expats, visitors and Chilean English learners. Their mission at I Love Chile is to promote English in Chile and Chile in English. Its reports are frequently volunteers interning in the business or people like me willing to post an article or two for the fun of it.  

Pulse América- Chile   provides a succinct, impartial summary of the week’s news on a country by country basis. By synthesising the Spanish, Portuguese and French language media across Latin America, country specialists print a digest of what’s happening in all countries around the globe, including Chile.

Buisness News Americas Santiago-based service provides a daily business news from Latin America with free registration. It covers business topics relevant to all countries in South and Central America Information covered includes: Telecom, Technology, Electric Power, Oil & Gas, Mining, Metals, Infrastructure, Water & Waste, Banking, Insurance, Privatization, and Petrochemicals.

Other news sources that frequently report on events and breaking news in Chile include:

BBC- Latin America British Broadcasting for Latin America frequently includes current and breaking news about Chile.

The Guardian- Chile Bureau  News posted on the British "Broadsheet" related to Chile

Topix: Chile News is a news aggregator 

NTN24 News- Latin America provides both video and news articles of events in all of Latin America

Are you still needing to know more news? Then visit this link to find all the news outlets for Latin America in many languages.

Wednesday, March 21, 2012

Here's to my son Andres Martinez and to all with Down syndrome

To Andy: Carry on being who you are just as you are! We love you!!


March 2012 marks the 7th anniversary of World Down Syndrome Day and for the first time in 2012 this day will be officially observed by the United Nations.

Marching to elect Tim Kane, Governor of Virginia


 Emily Perl Kingsley. c1987 by Emily Perl Kingsley. All rights reserved

 I am often asked to describe the experience of raising a child with a disability - to try to help people who have not shared that unique experience to understand it, to imagine how it would feel. It's like this...... When you're going to have a baby, it's like planning a fabulous vacation trip - to Italy. You buy a bunch of guide books and make your wonderful plans. The Coliseum. The Michelangelo David. The gondolas in Venice. You may learn some handy phrases in Italian. It's all very exciting. After months of eager anticipation, the day finally arrives. You pack your bags and off you go. Several hours later, the plane lands. The stewardess comes in and says, "Welcome to Holland." "Holland?!?" you say. "What do you mean Holland?? I signed up for Italy! I'm supposed to be in Italy. All my life I've dreamed of going to Italy." But there's been a change in the flight plan. They've landed in Holland and there you must stay. The important thing is that they haven't taken you to a horrible, disgusting, filthy place, full of pestilence, famine and disease. It's just a different place. So you must go out and buy new guide books. And you must learn a whole new language. And you will meet a whole new group of people you would never have met. It's just a different place. It's slower-paced than Italy, less flashy than Italy. But after you've been there for a while and you catch your breath, you look around.... and you begin to notice that Holland has windmills....and Holland has tulips. Holland even has Rembrandts. But everyone you know is busy coming and going from Italy... and they're all bragging about what a wonderful time they had there. And for the rest of your life, you will say "Yes, that's where I was supposed to go. That's what I had planned." And the pain of that will never, ever, ever, ever go away... because the loss of that dream is a very very significant loss. But... if you spend your life mourning the fact that you didn't get to Italy, you may never be free to enjoy the very special, the very lovely things ... about Holland.

You are a man of tradition

You carry the weight of the world!

You care for others across the world

You are ready for action

You are an important part of our family

You are your own man

You are ready and strong enough to endure