The Times They Are A’Changin’: Sunday musings…9/1/2024
1 Curse. “May you live in interesting times.” Ancient Chinese curse.
It seems to me that we have always ever had only interesting times.
2 Dylan. Bob Dylan’s music comes up pretty regularly in my college group. Usually in the form of another artist’s cover. I’m continually amazed by the quality of the music as written; so many artists with manifestly greater performative talents produce vastly superior versions of Dylan’s compositions. Hendrix: All Along the Watchtower. Clapton: Don’t Think Twice. Joni Mitchell: Blowin’ in the wind. Seriously, one could go on and on. And yet their performances are but veneer laid upon a brilliant foundation.
What strikes me lately is how timeless his lyrics are. Spend a moment or two with “The Times They Are A’changin'”. Written in the mid-60’s if memory serves, and yet each stanza could easily fit on stage this weekend. Generational strife. War simmering in foreign lands. Talking heads trying to talk over our heads.
Dylan the poet is the seer of change.
3 Change. “It’s never the changes we want that change everything…”: Graffiti on the walls of a decaying office within an abandoned foundry in Cleveland, OH. (HT @ExploresMr).
Goodness, there’s an awful lot of meat on that bone.
Those of you who are longish in tooth will recall that “Sunday musings…” was born on the “pages” of the old CrossFit.com. At least once each year calls for change in some aspect of CrossFit, or perhaps the bleating of those bemoaning some change that emanated from the halls of CrossFit HQ, would finally become sufficiently loud to trigger a “musings…” about change. These protestations almost always had a particular quality to them: the viewpoint through which the conversationists wished to propose or protest change was myopic to the point of seeking/seething over change that had nanoscopic scope. There was often an almost willful naiveté. “Thus and such needs to change/should never have changed because I feel…”. You could set your watch by the timing of these conversational threads whenever change might be blowin’ in the wind.
Re-reading the scribblings of our mystery savant I can’t decide if they speak more about miss-met expectations or unintended consequences. Covers both pretty well, actually. Change always happens; change is the only constant. I’m pretty confident that our philosopher in the foundry is not lamenting some sort of stasis, some lack of change. Pretty sure they are turning a keen eye on those who are active seekers of change. Again, to CrossFit and the crescendo of demands for change that followed the founder’s ill-advised public pondering of things not necessarily CrossFit. The change that people wanted was for the culture to become more like the aspirational culture seen on the nation’s op-ed pages. It was occurring, after all, at a time of peak identity politics.
What they got, what changed everything was the culture you see on the pages of a spreadsheet during peak financial engineering.
In my day job as a practicing surgical specialist I am constantly aware of both the mis-met expectations and the unintended consequences of the creeping consolidation of services and those who provide them in our American healthcare universe. The change everyone professes to want is “universal coverage”, the universal access of every citizen to a vehicle that will pay for the healthcare they use. The changes many wish for would lead to a single source of both funding and foundational structure, the federal government. Where once more than 75% of physicians were in privately owned practices in which the employees worked for the doctor and the doctor worked for the patients, the Affordable Care Act has driven consolidation to the point where nearly 70% of physicians are employed by massive corporations, both for- and “not for-” profit. Believe it or not, this has increased the % of people who are “covered”, who have health insurance that pays for all, most, or some of their healthcare.
What changes everything turns out not to be coverage, but what this coverage-driven consolidation has done to care. Dollar-driven care changes your relationship with the people who take care of you. No longer do you actually have a relationship with the people who take care of you any more than you have a relationship with the person who checks you out at Walmart. “Coverage” that drives doctors into ever larger organizations, be they faux “non-profits” like the Mayo Clinic and its peers or ever-larger practices owned by the numbers people who run private equity investments (like CrossFit), means that your care is now provided by people who work for someone other than you. The people who support the clinics where you receive your care report to business people, not medical people. Coverage isn’t caring. Coverage is a transaction.
What changed everything was that coverage isn’t healthcare; coverage is nothing more than a transaction.
On and on it goes. Change, that is. We have actually never lived as a species in a time where there WASN’T change, although it surely seems as if there have been times when similar changes occur over and over again. Maybe the fault lies in something altogether human, our inability to distinguish the differences between that which we want and that which we need. Perhaps that’s why so many of Dylan’s lyrics seem so current despite the fact that they were written 50+ years ago.
The line it is drawn
The curse it is cast
The slow one now
Will later be fast
As the present now
Will later be past
The order is rapidly fadin’
And the first one now
Will later be last
For the times they are a-changin’ (Bob Dylan)
“It’s never the changes we want that change everything.”
I’ll see you next week…
This entry was posted on Sunday, September 1st, 2024 at 4:34 pm and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.