Oh, 2016, the year it all went to hell. The year nothing made sense. The year we lost track of reality. The year Merriam-Webster made “surreal” its word of the year. For many, 2016 hasn’t just been awful and strange; it’s become its own Debbie-Downer catchphrase. 2016 itself has become its own meme.
Where were you when you decided this would be how we remembered the year? When you decided 2016 was pure trash, utter filth, a fire in a dumpster? Was it when David Bowie died? Or when Prince ended his purple reign? Or when you realized that, whoever won, Election 2016 was going to be a hot, smoldering mess? Was it Brexit? Was it Harambe? Which terror attack did it for you? Or maybe it was when Loretta Sanchez did the dab.
However you got here, citizen of the Internet, rest assured, you are not alone. (I am with you. I’ve been calling 2016 the worst for months now.) And as this year comes to a close, many are memorializing it online by pointing out how much it sucked, how much it aged them, how much they regret it. All of it.
But — and this is the strange part — by many measures, 2016 wasn’t nearly as bad as certain portions of the Internet have made it out to be. And it surely can’t be the worst year of all time. I don’t think so since my co-author and I just submitted and had accepted our book about Clinical Process Improvement, hoping to contribute to the improvement in health care in 2017 and the future. (http://www.sentiapublishing.com/search.php?Search=&search_query=orsini “Available on sentiapublising.com“)
For the nearly 63 million voters who supported Donald Trump, maybe this wasn’t a bad year at all; their candidate won. For millions of Americans whose wages went up, or who re-entered the economy (the U.S. has enjoyed an unemployment rate under 5 percent for months), maybe their year was good, too. The vast majority of Americans lived lives free from any direct personal effects from incidences of global (or even national) terror, or wars throughout the globe (not to minimize global unrest, which is a constant, and particularly troubling this year). Multiple measures of consumer confidence, in fact, trended up this year, in spite of months full of headlines indicating a world on the brink. Of something. Or a lot of things.
The markets are up, too. And more people have health insurance.
So, why then, is 2016 the worst?
Well, let’s start with the obvious: the election. There’s no need to recount it all. But it was a hot mess. Russian hacks, assertions of the size of one’s manhood on a debate stage. Leaks showing national parties seeming to conspire to elect a favored candidate. FBI investigations and Access Hollywood videos.
And of course, foreign affairs. With Syria as the central flashpoint, it’d be easy to see 2016 as the year the whole world caught on fire.
But there’s more than that. Some of the “2016 is awful” rhetoric might be about the way we all consumed the headlines this year.
Amy Mitchell, director of Journalism Research at the Pew Research Center, says what we’ve been witnessing in news consumption trends over the last few years has changed us.
“A lot of the shift to digital is presenting a news experience that is more mixed in with other kinds of activities,” she says. “You don’t necessarily go online looking for news each and every time. Somebody shares it, somebody emails it to you, somebody texts a link. And so many Americans are bumping into the news throughout the course of the day.”
Nikki Usher, a professor of media and public affairs at George Washington University, calls this recent phenomenon “ambient journalism,” or “when you’re constantly plugged in through social media and you’re constantly online and engaged in some way.”
And that — that constant bumping into news and online discord, that constant engagement — over time, it becomes an assault.
Every five minutes, another sad headline, another Twitter mention or fight, another shared link on Facebook, another push notification. Another hit. And even if the news isn’t even explicitly about us, trust, we’re still taking a hit.
And, Usher says, besides that aggression of immediacy, a lot of the headlines we consumed this year, particularly about the election, pushed a certain narrative: a nation, and even a world, completely and disastrously divided, perhaps beyond repair.
“Lots of crappy, bad things happen every year,” she says, “but you aren’t told over and over again that this just shows us how bad everything is.” And for Usher, there’s no escape. “Usually there are realms where there are types of coverage that provide a break in the kind of narrative of disrepair.”
Not this year. The NFL was overtaken with silent, peaceful protest. Your favorite pop star probably endorsed a presidential candidate in 2016. Even the highest-grossing film of the year, Captain America: Civil War, was a commentary on the modern national security state.
But culture always reflects the time. There must be something deeper, a certain logic or pathology that would lead thousands to deem this year so awful, and to declare as much, so publicly, and consistently, online, for months.
It’s the medium. Robert Hernandez, professor of journalism at the University of Southern California, says using social media to declare 2016 “the worst ever” is the latest example of how we use the Internet: ironically, with hyperbole, and usually, with a wink and a nod.
“It is the latest meme of the day,” Hernandez says. “It’s the next flavor of hashtag Thanks Obama. ‘Oh, I just dropped my coffee. Thanks Obama!’ ” “It’s how we cope,” says Hernandez, even as he acknowledges the very act of such tweeting indicates a certain level of privilege. “If you’re on Twitter, you’re on a mobile device, probably one of the newest ones, one of the new phones. [And] you’re one of the few people on
He’s right. For most of us, myself included, tweeting that 2016 is the worst, or even tweeting at all, is an exercise in privilege. The air in which one offers cultural criticism (including this very essay), memes and gif-able 140-character bursts, is rarefied. If your year was really the worst, you probably wouldn’t be tweeting about it.
We weren’t in this spot a few years ago — this collective, ironic, gripe-fest — during those glory days of tweeting about being bored in meetings or what you had for lunch, or being so numbingly comfortable in your own world that you put your home address on Facebook. That seems to be all over now.
Now it’s all irony, or sarcasm, or bombast. Saying 2016 is the worst online might just be us accepting that social media caught up with the lesser angels of our nature. Social media isn’t nice anymore. At it’s best, it’s just a little flip. Now our feeds are just a record of discontent, or the performance thereof.
So, 2016. Sure. Let’s call it the worst. But let’s also acknowledge that saying 2016 is the worst on Twitter says more about the tweeter, and the medium, than perhaps about the year itself. What are the top 5 stories in Health policy? Joyce Frieden from MedPage Today asked health policy experts to tell us in an email what they thought were the most important policy developments in 2016. These were the five most commonly mentioned.
- Election of Donald Trump as President/Obamacare Repeal. These two developments (or potential developments, in the case of Obamacare repeal) were often mentioned hand-in-hand by the experts we spoke with. With Trump’s election, “now the ACA [Affordable Care Act] might be repealed, or at least undone enough to collapse under its own weight,” wrote Kenneth Lin, MD, MPH, associate professor of family medicine at Georgetown University School of Medicine, in Washington. “By far, the most compelling story has been the vitriolic presidential election and the outcome that stunned the pundits,” wrote Edmund Funai, MD, senior vice-president for strategic development at University of South Florida, in Tampa Bay. “When and how much of the Affordable Care Act will be unwound will be top of mind.” The repeal “will be HUGE,” wrote Jonathan Weiner, DrPH, a professor of health policy and management at Johns Hopkins University, in Baltimore, “but I hope and expect that the bark of repeal will be bigger than its bite … Hopefully, if competence and ethics prevail among President’s Trump appointees and Congress, the silver lining could be that key positive attributes of the ACA will be retained while some of its weaknesses will be addressed and improved.” This is what I have been proposing.
- Skyrocketing Prices for Some Prescription Drugs- This issue gained prominence after hearings in Congress this fall that included testimony from pharmaceutical executives, such as Heather Bresch, the CEO of Mylan, maker of the EpiPen. “The sharpest point of health crisis in 2016 was the extreme price increases in drugs long available that should have gone down, not up,” wrote Thomas Getzen, PhD, emeritus professor of risk, insurance, and health management at Temple University in Philadelphia. Daniel Derksen, MD, director of the Center for Rural Health at the University of Arizona, in Tucson, noted that both insurers and pharmaceutical companies “[posted] record revenues for 2016, with consumers balking at the skyrocketing costs accruing to their pocketbooks.”
- Insurers Leaving the Affordable Care Act’s Insurance Marketplaces- “Withdrawals by major insurers from some exchange markets highlighted continued problems with the Affordable Care Act’s signature provision,” wrote David Howard, PhD, associate professor of health policy and management at Emory University, in Atlanta. “I was particularly struck by the withdrawal of BlueCross BlueShield of Tennessee from major markets in the state. BlueCross BlueShield wouldn’t abandon the exchanges unless they thought the problems with adverse selection were going to continue or worsen.” Michael Morissey, PhD, head of the department of health policy and management at Texas A&M University, in College Station, called the insurers’ exit “the big health policy issue in 2016.”
“A year ago there was great hope for the exchanges,” he wrote. “Many metro areas had several carriers offering coverage and even some rural areas were seeing entry of a second insurer. All of that changed in many states as the calendar continued to turn. Insurers began to get actuarially meaningful claims data and saw substantial losses. As a result, many carriers withdrew from markets and most of the remainder raised premiums substantially.”
David Becker, PhD, associate professor of healthcare organization and policy at the University of Alabama at Birmingham, pointed out that many insurers who raised premiums announced the increases shortly before the election. “Although the primary consequence of adverse selection and rising premiums is to increase the cost of subsidies to the federal government, the premium hikes were used to frame the ACA as failing to yield ‘affordable’ health insurance coverage,” he wrote. “To the average American, a 22% increase in premiums didn’t sound good.”
- Increasing Overall Healthcare Costs- “Health care spending skyrockets to nearly $3.2 trillion, or $10,000 per person, and grew at a 5.8% annual rate — levels that are unsustainable and call into question the ACA’s efficacy,” wrote Funai. “Once again, we have done nothing serious to contain health costs, expand availability of primary care, stabilize needed hospitals and emergency rooms, or address long-term care and mental health problems,” wrote Alan Sager, PhD, professor of health policy and management at Boston University.
On the other hand, “Medicare continued to experience moderate growth in costs, reducing the urgency of resolving the long-term funding problems with the program,” noted Howard.
- Expanding Insurance Coverage Through the Affordable Care Act- In contrast to the problems noted with the ACA’s marketplaces, several experts said the law’s positive effects were also a big story this year. “Obamacare extended coverage to millions of Americans, especially helping those most in need,” wrote Getzen. Weiner noted that the ACA achieved “the highest insurance coverage levels in the history of the U.S. healthcare system,” calling it, “The biggest achievement in U.S. health policy since the advent of Medicare and Medicaid in the 1960’s, regardless of any political rhetoric to the contrary.”
In addition to these Top 5, experts also noted a rise in U.S. overall death rates for 2015 that was reported this year, as well as a slight decrease in life expectancy. The death rate increase suggests, “that a major health crisis is emerging, and that lower income Americans really are being left behind by the globalizing economy,” wrote Steffie Woolhandler, MD, MPH, professor of public health at the CUNY School of Public Health at Hunter College, in New York City. “Recent rises in death rates are due mostly to so-called external causes such as suicide and fatal substance abuse, and (to a lesser degree) heart disease.”
But, also it is the New Year and time to make our New Year’s Resolutions. Well I don’t make New Year’s Resolutions but I thought that I would review the best way of coming up with your New Year’s Resolutions, how to reframe Your New Year’s Resolutions for a Healthy, Successful 2017. I was originally going to list the 50 best New Year’s resolutions and decided that suggestions on how to improve your own resolutions would be a better use for this weeks post.
As the year ends, we start looking forward to making resolutions that improve our human condition in 2017. The most common New Year’s resolution is, of course, the ubiquitous “get healthy and stay fit,” which generally includes the dreaded diet.
There have been many fads to accomplish this superhuman feat over the last several decades including the all-tuna diet, multiple fat-burning drugs of questionable efficacy and the big favorite of stapling the ear lobe to curb any and all detrimental behaviors.
Although 60 percent of us make resolutions upon ringing in the New Year, only about 8 percent are successful. Perhaps it’s time to reframe our resolutions so that we have a fighting chance of seeing them through.
Firstly, the definition of “get fit and stay healthy “should not equate to pounds lost or marathons run. Interim improvements are extremely valid and more likely to lead to long-term success than an epic failure out of the gate.
To start, define what “getting healthy” means to you. Do you have the stamina to do the activities you enjoy with family and friends? Are you satisfied that you feel good about how you present to others? Keeping healthy and fit should feed your self-esteem, not lower it. Set reasonable goals. If you have not been a runner in the past, running four miles a day is not likely to happen. Rather, start with a goal like walking or exercising 20 percent more per month than you do right now. Be honest about your baseline and then set targets for each month until you feel great.
We know more about nutrition now than we ever have before. Look up the information and make a list of recommended foods and incorporate them daily. Start small, develop a taste and then make intentional increases monthly until the end of 2017. A suggestion is to chart your improvements so all the world, including you, can see success.
Focus on feeling better – not turning back time. If you are a smoker, stop. Whether it is cigarettes or vaping (E-cigarettes) or anything related, the risk benefit-ratio is definitely to the negative. One in 15 cigarette smokers will die of cancer. Lung cancer kills more people annually than the other top three cancers combined. Vaping has been shown to deposit toxic chemicals directly into the lungs. For your own health and for your loved ones, make this a priority in the coming year.
Secondly, be a caregiver to yourself. In the U.S., about 43.5 million of us provide unpaid care to someone else every year. It is honorable; it is the right thing to do. But how many of us provide the self-care needed to sustain these efforts?
Start with sleep. Rest is required for rejuvenation but it has many other benefits, too. Sleep has been implicated in affecting depressive tendencies, accident risks, memory, life span, inflammatory response, creativity, attention, academics and yes, even maintaining a healthy body weight. Yet, at least 40 percent of Americans do not get the recommended hours of shuteye.
Add to that the fact that the number of people visiting the doctor to maintain their health continues to decline, according to the U.S. Census Bureau, and about half of us do not comply with recommended medications. Not surprisingly, our health continues to crumble. So, we are tired and ill, which does not lead to the get-fit-and-healthy goal above. Just like putting our oxygen mask on first in an airplane emergency, we need to work on ourselves – and then assist others. Not to the point of narcissism, of course, but we need to be strong to support those in our lives. So take your medicine, get some sleep and call in the morning.
Beyond the physical, we also need to nurture our spirit to find the nirvana of feeling well. Maybe it’s in the form of art or music. Maybe it’s in communing with nature by hiking. Maybe it is experiencing other cultures or food. Whatever the outlet, it should allow you to let go of stress so you feel calmer and happier, and it should make you smile if not laugh out loud. Laughter can relieve stress, improve blood pressure and even burn a few calories. It’s OK (and even necessary in this day and age) to schedule time for leisure and pleasure. It is even OK to relax, sit on the couch and enjoy a television show (in moderation).
Thirdly, give up non-productive anger. Whether your trigger is politics, inflation or taxes, ask what you can do to impact it directly. If the answer is nothing, let it go. Anger in itself can have detrimental effects on our health. Freely expressing your anger often impacts others around you, battering their emotional well being and productivity. It also increases fatigue, adding to our poor sleep habits, and is nothing but an energy drain.
While “focus on the positive” might sound like a slogan from a simpler time, it is as true today as ever. Use the five-to-one rule. For every negative statement you make, say five positive things. Keep track on a little index card. Or at the very least, refrain from saying five additional negative statements in a day. You might be surprised how quickly it becomes habit, but it won’t without some effort.
Lastly, practice kindness. Whether you focus on random or intentional acts of kindness, the effects will be more beneficial than we imagine. Kindness has been touted to improve success, cognitive functioning, energy and heart health; it has even been said to slow aging. Regardless of the science, kindness actually makes us feel better when we show it to others. More than that, it models the way for those around us to continue to pay it forward. It gives us reasons to get up off that couch and act. It connects us to our fellow human beings, the crux of trying to live in a community.
So, yes, make your resolutions. Make them count by making wise choices that help you incrementally find success. Don’t beat yourself up before you even get started by making goals not even an Olympian could attain. Make your goal self-love and satisfaction this coming year. In the end, 2017 will be a chronicle of the year that was and that story will be in the books.
Make yours a best seller. Make your 2017 the best year and continue to think about and work for a wonderful future!