social goal who is realisation requires the action of many other social economic sectors in addition to the health sector so basically in one thousand nine hundred eighty eight a group of primary care providers got together and had a discussion around nonny of the definition of health as we know it also talked about the need for governments involvement in terms of the health care system and he said that governments had a responsibility for health of their people and they in this should be fulfill only by provision of adequate health and social measures and we'll talk a little about the social medicine measures because we understand health health  in this new health care paradigm will sixty define our health this is a main target of governments international organization the whole committee is in the coming decades will be the table of all people by the world and this they said this by the year two thousand a level healthy were met them to lead social a economically and productive life in some of these things kind of matheson self and healthy goals are to be determined healthy goes  americans today possibly affected by things are curved so long ago african americans are free now in fact free for a long time and some would even see a post racial society she stay she had often heard europeans i would say you know that you know well i didn't own slaves and i'm tired of feeling guilty about what happened over one hundred years ago so get over it my response to them is that i am not a slave now nor have i ever been a slave the fact is i don't have any experience of being a slave ever two hundred forty six years of protracted slavery gear achieve the prosperity and privilege of the southern white progeny why spoil sport corresponding really gain the black progeny to a level of debt and suffering so again we've talked about trauma trauma as it relates to the best medicine have had i think that these are subjects that are very sensitive they evoke a lot of emotion and i think that one of the discussions seen generations that have been left in the dust as we just became by creation so i think that that's one of things that we have to understand our greatness of where there's one answer to the that has to be understood you can't have the same people are trying to attempt to run a new system and this is one of my concerns with the patient protection of forward health care because now we have the same people attempting to run a new system which maybe they don't buy into maybe we'll have much benefit you go see a lot of discussions around the use of metrics or data to determine health care outcomes america ranks somewhere between tween and thirty's in terms of health care outcomes there are many countries monaco being the first they have better outcomes cuba finland switzerland have better health care outcomes then the american health care system although we spend more money we spend more money we don't give value is inaccessible and is too expensive so when you pundits talk about why quote unquote the patient protection affordable health care act is not a do or should we can move to you don't hear what they offer in terms of the opposite so if this is not your plan is this not a plan you can buy into what would be the patient it doesn't always have said that a fifteen minute visit only benefits the provider and the health care system doesn't even visit the patient so we need to change their paradigm we need to look at how we can instruct people to be much healthier and to be in charge of their health to be in charge of the systems that the the they're in and i think that if we don't then we're going to have a lot more problems we can no longer put our care in the hands of folks that don't have our best interests at heart and in that same vein as we talk about health care systems again the originals of these things are willing porton i would point folks to a wall health report two thousand and eight  it's called primary care now more than ever and oh it's important because it was one of the original why pay papers by dr margaret chan margaret chan is a physician who in wool circles is well known but she is important in the fact that she's one of the first physicians to understand the sars epidemic an service delivery reforms and in the dishy talks about the reorganization of health services around people's needs and expectations of patient sinecure in other words to make them more socially relevant and more responsible pursuing healthy policies across sectors and by strengthening national and trans national public health interventions again the focus public health again the focus of help promotion of prevention  and i discussion around not making linear decisions in terms of health care organization but circular decisions so when we make decisions opposite in one else or opposite how in terms of wace procedures graft corruption so why that seven fifty six hundred fifty billion dollars figure because that's the cost of the patient protection afforded health care act so we save local government officials that are concerned that they will undercut health care services to the poor again i don't i don't think this can happen because the whole idea is keeping people emergency room keeping people from disease that is so expensive to take care of them and the outcomes poor that's what we've been doing so we need to change that and again she called for leadership reforms in regards to replacing disproportion on command control of one hand and lace a fair distance disengagement of the state of theirs by inclusive participation and goshi ation based leadership indicated by the complexity of contemporary health system w said that we are going to work together we're all going to function as a group and to provide health care issues and health care concerns in addressing these issues as a real real real multilevel multi factorial multi alexander book the new jim crow she says the death of slavery says the history of racial casting i say skin so would have it with the civil war and the idea of race and racial difference and die with the institutional slavery was put to rest but during birth to why supremacy over time became a religion of sorts a faith in the idea that people of the african race were be still the rice were inherently superior and the slavery effect were for blacks on good  senses of smell touch sight taste so imagine something so ingrained in you that you can smell it you can touch it you can taste it you can feel it imagine what that does to those that that brain we know that life experiences influence brain maturation as well as how the manichees on health we understand studies of from nature to or with the issue of trauma you know these are brain injuries this is brain trauma that affects the way a person thinks of the way they react again is a it's a multiple sensory  are often alter emotions i want to say that you know we have and want to thank everyone for watching our show i really look forward to the guests that are com is a way of trying to access this new health care system and and get the mindful ask questions for a lot the patients so varies become a part of the system you know everybody wants to have a free ride but this is not what we're talking about we're talking about a balance of providing services a low cost or minimal cost allows people to have health care on an ongoing basis no dinars no pre term and conditions i want to allow things to happen we have to up make it happen and again i am so honored to be a part of your experience and please start me e mail me education the