Pedro Angel Serrano

Gardener, stand up, Gay, photographer, ADHD inspired tweets. I believe that the Preamble to the Constitution is a list of duties to our fellow human beings.

[Pedro Angel Serrano @RevPedroSerrano]

4:14 Video
https://t.co/yBA4RwD35Y

[Joshua Reed Eakle 🗽 @JoshEakle]

It’s important that you understand what happened last night.

Last night, Stephen Colbert interviewed Democratic Texas Senate candidate James Talarico, a candidate who, by all accounts, is on track in the polls to flip Texas blue.

In response, Trump’s FCC reportedly threatened CBS if the interview aired.

CBS caved and pulled the segment, citing “financial reasons.”

In modern American history, no president has been more hostile to free speech than Donald Trump.

But censorship always backfires.

Here’s the full segment Trump didn’t want you to see.

[Pedro Angel Serrano @RevPedroSerrano]

UNITY!

[Wu Tang is for the Children @WUTangKids]

Powerful….yesterday, the First Amendment Troop staged a "ResistDance" to honor Renee Good and Alex Pretti on the steps of the Lincoln Memorial and in front of the Kennedy Center

Via: underthedesknews(IG)

[Pedro Angel Serrano @RevPedroSerrano]

Blank Template https://t.co/fp2PZnsECg via @imgflip

[Proud Native Americans @proud_native_am]

They will never erase the history of our Navajo Code Talkers. 🎖🦅🇺🇲

[Massimo @Rainmaker1973]

How cigarettes were once packaged in France in 1930.
https://t.co/CH7UeBU2lp

[Alex Cole @acnewsitics]

This reply is epic! 😂

[Wow Animals @WOW_ANIMALS1]

When you are wildlife photographer the goal is to blend in with your surroundings so that you don't scare off the animals

[Corey Ryan Forrester - WeLoveCorey.com @CoreyRForrester]

Flawless

[Alex Cole @acnewsitics]

Hahahaha Damn!

[Pedro Angel Serrano @RevPedroSerrano]

He looks like a fist.

[#NAFOViking @nafoviking]

The President of Finland just called trump a fat orange bitch👀

[Science girl @sciencegirl]

How stabilized photos of military dogs are taken

https://t.co/rBxo63g07u

[BrooklynDad_Defiant!☮️ @mmpadellan]

Holy shit, even in Alabama?
Something is happening.

[Corey Ryan Forrester - WeLoveCorey.com @CoreyRForrester]

Last chance to delete this buddy cause once Black women start talking shit to y’all you are gonna think what Bill Burr has been saying is the fucking script from a Reading Rainbow episode comparatively

[The Washington Post @washingtonpost]

Low-income Americans who voted for Trump say they are counting on him to keep their benefits intact even while his Cabinet picks and Republican lawmakers call on him to reduce federal spending.

[Amanda Stewart Sprowls @AmandaStewartAZ]

Chip, please consider working with folks like @mcuban who are doing the heavy lifting in the marketplace and proving everyday that market transparency does bring the cost of healthcare down significantly.

When my United Healthcare platinum plan tells me my pharmacy is Walgreens and my copay is 2x higher for a prescription than private pay at CVS or Costplus, we have a problem. If the government forces us to have health insurance, it is allowing for these monopoly powers.

[mygovernment @mygovernmentliv]

Here is the article I put out on X a while back
A Healthcare Model
1.0-Introduction
The current model of health care in the United States centers on the concept of insurance. Money is paid to an insurance company either by the individual, the individual’s employer or the government and the insurance company determines which medical conditions and treatments are covered for each individual. This is the fundamental problem.
1.1-Insurance Companies
Insurance companies in a capitalist system have their basic goal of generating income for their stockholders and not providing care.
Eventually, the insurer tries to make money by providing cheaper care. This is associated with the insurer not wanting to authorize certain medications or tests even if recommended by physicians. This limits the care that individuals can receive and sometimes prevents the patient from receiving optimal care.
Insurance companies substitute their judgement based on statistics for that of the health care team that know you best as an individual.
This applies even if the insurance company is in part funded by the government.
Of course, the government could make large numbers of regulations to protect the individuals but in that case the insurance companies will not be profitable and the individuals will eventually have insurance that is too expensive or have no available insurance.
1.2-Government run healthcare
Can the problem with health care determined by insurance companies be solved by a Government run system? Government works by establishing rules and regulations. These must fit all individuals and so cannot provide for the individualized treatments that optimize individual care.
Government is strongly swayed by special interests. If a powerful company recognizes that a change in the healthcare system will benefit it, there will be strong pressure on the government to make the changes advocated for even if they do not advance the cause of individual healthcare.
Government works slowly and is not agile in response to new ideas or new information.
A government run system reduces the values of ingenuity at creating new ideas and processes and enhances the value of agreeing with the status quo.
1.3-An alternative
It is impossible to develop a perfect health care system! But it is useful to explore new models to continue improving our system. One approach that may be of benefit is to build the healthcare system on the framework of existing trusted social structures. Why not use family and community as the backbone of a healthcare system? Let the people closest to you and who already care about you remain involved in your care! This process will be optimized by the use of AI, the universal EMR and extensive supervision and education.
2.0 Operation
A rough idea of the hierarchy of care in a community based system is shown in the figure.
2.1 Daily Operations
2.1.1-At the onset of illness
An individual that becomes ill can as always call an ambulance to be taken to a hospital if the problem is felt to be life threatening. However, the new choice would be to ask a certified member of the community who is nearby. This is likely family or neighbor who has received training. The conversation would be recorded by AI. The initial caretaker can decide based on existing protocols that the individual must go to the hospital immediately or can be evaluated in the home. The AI provides an immediate check on those decisions and helps target high risk situations. The information collected by the AI is immediately sent to a nurse for immediate review. The nurse can agree with the planned management or do a virtual visit if there are issues or refer the information to the next higher level in the hierarchy. Any additional data collected by the nurse are appended to the original data and reside in the universal electronic medical record (EMR) for immediate review by a provider.
While AI assists in forwarding information through the hierarchy, the community provider can obtain vital signs through an automated system as well as place the individual on video monitoring.
If the plans include therapy a local nurse will be contacted who will come to the patient to draw blood, place an IV, or administer medications approved by the provider. It the plans include imaging, the individual is taken to a local facility that provides the appropriate imaging.
This system allows an individual to receive care by people that are already in the community and speeds care. The use of AI and supervision at multiple hierarchies optimizes care and helps prevent decisions that may not be optimal.
Even if a patient is transferred out of the community to a hospital or diagnostic facility, once that evaluation is complete, the same team can stay involved throughout the episode of care if the patient is referred back to the community. This enhances continuity of care. AI can provide automatically or as specified by providers automated patient checks at regular intervals to assure the individual is progressing and improving as expected. Any issues detected by the AI can generate automated warnings through the entire system.
2.1.2-Soon after onset of illness
A physician regularly reviews all of the data and the actions taken and contacts the care team if there are issues. If there are any questions, a supervisory physician can be contacted for additional advice. In addition, the physicans and supervisory physicians receive regular statistical reports regarding the number of patients with reported illness and the treatment they are receiving. These are reviewed for outliers by both the supervisory physicians and an AI.
2.1.3-Overview—care is provided as close to home as possible with multiple layers of continuous monitoring both through trained providers and AI in order to optimize care.
2.2 Education
A system like this cannot be effective unless there is wide scale education.
2.2.1 Community level
Each community member should be exposed to basic care issues such as how to approach someone who might have a cold or allergy or nausea. There should be a wide scale training in basic CPR and a basic knowledge of using computers and the ability to use computerized vital sign monitoring. Most important is a list of conditions that require immediate referral to a hospital (chest pain, very high fever, altered mental status, etc.). This might be done during school and reinforced regularly. Because of the intense monitoring, individuals that do not make the best decisions will be contacted in real time and provided education. There will be regular educational events and ongoing monitoring. Only individuals who have met criteria in the community will be allowed to provide care. The patient will have immediate access to this list to use when illness is detected.
The performance of each individual will be monitored through the system to provide realtime feedback and education. An individual that does not have acceptable performance at a certain level will not be allowed to provide care above a specified level.
The key is that performance monitoring is not punitive as it is in many systems, it is meant to enhance care and build valuable connections throughout the hierarchy.
2.2.2 Nursing, provider and physician levels
Each individual providing carfe at a given level is given detailed job description that can be modified in response to ability. The AI can make sure that each care individual providing care has the necessary credentials.
Regular education and recertification procedures would be in place for these individuals.
2.3 EMR and AI
The use of a universal electronic medical record (EMR) is necessary because it opens up the information regarding a patient to care providers at multiple levels. This allows for real time checks and double checks to assure that the individual is being provided he best care. Also detailed knowledge of the individuals previous history is important in understanding the best approach during any illness.
AI is critical because it provides an immediate double check on care and then provides a synopsis of each situation to allow higher levels in the system to more readily view and monitor the individual. The AI also will be important for monitoring and care provision. An Ai would be immediately be able to identify a patient on video monitoring who was having difficulty breathing or having a seizure among others. In addition the AI would be able to remind community providers about recommendations from the higher levels regarding care of individual patients and be sure that it leads to expected outcomes.
2.4 Other Technology
Real time vital sign monitoring, computer controlled infusion pumps, real time audio and video and EKG monitoring are all withing reach and relatively straightforward to integrate with the EMR, AI and provider network.
Another critical technology will be the analysis of all the data obtained from this system on a regular basis so as to optimize procedures.
3.0 Costs
The costs of a system as outlined above can be low because it uses existing people and optimizes care at home rather than in expensive hospital settings. Also because individuals are cared for by their friends, neighbors, and colleagues, rather than personnel that have no specific interest in them as individuals, outcomes will improve.
This system would require a standard cost from each individual each year.
4.0-Other Options/Issues
A monolithic system is never right for everyone. Even if the system described above were implemented, there would still be an option for individuals to privately pay or use insurance to obtain care that they feel they did not get through the system. Of course, feedback on perceived or actual failures will be used to continue optimizing the system.
5.0 Implementation
Implementing a community based health system like this is a big change and with any change it will take some time to understand and optimize the new system. Thus, it is important that such a system be implemented first in a very small community (with their consent) and then as the ideas are optimized grow to larger and larger groups if successful.
Various counties or cities in the US should be offered the ability to vote on accepting such a proposal for healthcare.
Figure