My guess is that lots of folks out there aren’t in the game just for the money but would love for their work to make a real contribution to the places where they live. That’s what makes this development so interesting and exciting.

*For-profit corporations are required by law to maximize profits for their shareholders.

Excellent piece on life down in the trenches, as told by a primary care doctor, Jonathan Han, who practices in rural Pennsylvania and whom I consider a good friend. Every day in his office Dr. Han sees patients who come to medical attention only after having developed advanced disease, including incurable cancers, because they lack health insurance. Another convincing argument for why we can’t afford to roll back last year’s health care reforms.

I know — hardly sounds newsworthy enough for the front page of the Times. But these ‘therapies’ reduce the amount of sedative and anti-psychotic medication administered, meaning better quality of life for patients, at lower cost and with fewer side effects. In other words, if chocolate was a new experimental drug, people would be frantic to have access.

Not unlike chocolate and dolls is the therapeutic benefit of having a dog — in 2009 researchers at the University of Missouri found that elderly folks assigned to walk a dog twice a week were often able to give up canes and walkers, because overall fitness improved so dramatically. Good food for thought as we all contemplate new year’s resolutions.

A local hospital helps the King County poor using health care strategies gleaned from sub-Saharan Africa. Do I understand correctly? We’re one of the 50 richest counties* in America, allegedly the world’s most prosperous nation, but if you’re sick / poor you might as well live in Botswana?

Well. The full story is that an executive-level RN at Seattle’s Swedish Hospital will be training community health workers for neighborhoods in Sea Tac and Tukwila. These health workers will connect down-and-out folks with appropriate medical care plus services that help connect the dots, like transit passes, legal assistance, even microloans.

Integrating services is a slick thing to do, for two reasons: 1) it works, and 2) because health depends on more than access to good medical care. Better shelter and nutrition worked wonders for Paul Farmer’s tuberculosis campaign in Haiti, for example. Can it work here in the most literate city in America? Sure sounds promising. So stay tuned.

* as determined by personal per capita income

Indie bookstores are the best.

Perhaps the most striking lesson lay beyond the classroom door. One morning I visited a farmer’s market on the Clinic grounds, which is more of an anomaly than you might think; hospitals are far more likely to sell McDonald’s burgers than radishes by the bunch.

Turns out the farmer’s market is one small facet of a massive wellness push at the Clinic that focuses on weight and stress reduction, quitting smoking, and smart nutrition. Of course you already knew this stuff was good for you; the issue is committing to doing it.

At the Clinic a formal program to engage employees in their own health enabled the collective to lose 144,000 pounds in 2009. One man lost 30 pounds in eighteen months simply by deciding to take stairs instead of the elevator. As a result, while health care expenditures were on the rise everywhere else in the last two years, employee health care costs at the Clinic dropped 8%. Bending the cost curve, as the lingo goes.

In the months and years to come I’m betting we’ll hear more about like-minded efforts to promote wellness — much more. And not just because it saves money, but because we’re all starting to wake up to how unsustainably we live. A recent New York Times story about paying patients to take their medications would be a case in point.

This afternoon I ventured over to Elliott Bay Book Company’s brand new Capitol Hill location. Which turns out to be so very much like the old location. The same lovely stained glass above the entrance, the same chunky bookcases, and the good Rick Simonson puttering about the front of the house. They’ve really recaptured that wonderful feeling of the Pioneer Square store. However. This place also has higher ceilings, stunning windows, and lots of elbow room around the tables. Not to mention more skinny jeans, funky hair, starving writers, men holding hands. Sometimes newer really is better. Me, I’m just glad to see one of the best bookstores on the planet surviving these uneasy times.

I admit I wasn’t confident this day would ever come. But here we are, and Republicans are already threatening to use the bill as a weapon in the upcoming midterm elections. We’ll see.

These reforms won’t fix everything wrong with health care. Not by a long stretch. But it will bring health insurance to millions of people who didn’t have it before. At the risk of beating a dead horse, we need that. Desperately.