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PSYCHOLOGICAL SELF DETERMINATION (watch the video clip!)

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Psychological self-determination is expressed in three different dimensions. In the first dimension people want to live their lifes the way they choose to live it. This is the sense of sanctuary. The second way people express their psychological self-determination is in the widespread desire for voice: we want to be heard and we want our voices to matter. The third way we want our psychological self-determination to be expressed is in our desire to be connected: we want to be part of communities.

News from Shoshana and Jim

Shoshana and Jim

 


Who Killed My Mom?: Reinventing Health Care in the Support Economy

 

Episode II:
After Mom died, the only person who seemed to know anything about her–her health and the likely causes of her death–was a man whom she had never met. He was the State Medical Examiner. How could someone who had never laid eyes on my Mom, who had never spoken with her, know more about her health than the doctors with whom she visited regularly? You’d think the State Medical Examiner would be some distant bureaucrat. Turned out to be just the opposite. He returned my phone call with the hour. He was kind and understanding. He spoke with me patiently and answered all of my questions. Later, I thought of more questions, and days later, still more. He rigorously returned my calls and never showed the slightest bit of boredom with my queries. He said that Mom was a ticking time bomb, just the sort of person who could fall over dead at any moment. And that’s exactly what happened. She fell like a tree. He carefully explained why.
Episode I:
My mom is dead. I still don’t know who killed her. There are various hypotheses. Did my mom kill herself? Did I kill her? Was she killed by her primary care physician, her cardiologist, her orthopedic surgeon? Other docs she saw? Was mom killed by her friends? My brother? Was it any one of the myriad pills organized neatly in their containers on a tray she kept on her kitchen table (that tray now sits in my linen closet: a sentinel, a reminder, a tale waiting to be told), or maybe the interaction among them?

My mom is dead. I have passed through the many stages of grief, charted and uncharted, and now I am looking for answers. Why? Knowing who killed my mom won’t bring her back. But whoever killed my mom may also be lying in wait, ready to kill yours. I don’t want your mom to die the way mine did–an unnecessary death. I am a scholar. Such are my skills. I intend to use them to try and prevent your mom’s death. Or your father’s. Or yours. Or that of any of your beloved ones. There is no real fix for health care in this country, or any other, that does not address the agents of my mom’s death.

In the coming days and weeks and months, I’ll be exploring these hypotheses and more in this space.

TSE community

Is the idea of a support economy a utopian vision?

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If you had described today’s world to any five reasonable people sitting around a table in the year 1910–before the real consolidation and diffusion of the then revolutionary new enterprise logic called managerial capitalism– they would have dismissed that description as utopian. The levels of education, health, recreational activity, living conditions and affordable goods that a majority of people in the developed world enjoy today would have seemed truly outlandish. Similarly in today’s world, a support economy seems too good to be true because it is interpreted through the lens of the now outdated enterprise logic of managerial capitalism. People have learned to expect adversarialism from corporations, and corporations have learned that they can get away with indifference, neglect, and exploitation of their end consumers.

Is deep support merely a new convenience for the wealthy?

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Individuals at every income level need deep support. In fact, in today’s environment wealthy people can paste together some version of deep support to enhance their lives. But everyone else-working single moms, dual career couples, blue-collar families-have urgent needs for deep support. That is why a critical component of the new enterprise logic is what we call infrastructure convergence. We argue that federations can use digital platforms to eliminate the replication of administrative activities across their enterprises. This dramatically reduces working capital and provides the opportunity for order of magnitude shifts in the cost structure of deep support.