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if I had won Powerball

Did you see the happy winners in the papers or on the internet? A “once in a lifetime” moment.

For most, winning the lottery is not the godsend they have dreamt of.

To suddenly become part of the one per cent is not easy.  Most fritter away their winnings, and end up much less happy than they were before.  So I have thought about this a lot. What would I do if I won a huge amount of money? Of course, its not at all clear to me WHY I daydream about such an event, as I am by nature not a gambling kind of gal. And, they tell me, you can’t win if you don’t play.

So its not likely to happen.

On the other  hand, somehow, maybe some day it WILL happen. So I should be prepared. Don't you agree?

Here is how I would spend my money.

Let’s just assume a check for $100 million after taxes and fees. It’s a nice round number, don’t you think? The first million would likely go to paying off all sorts of debts, such as mortgage, car loans, children’s student loans, and so on The second million (plus whatever is left over from the first million) would go to help secure the future for certain family members (on both my side and my husband’s) who are likely to need support down the line. The rest (about $98 million) would go into a charitable trust, or be used for direct contributions for a variety of purposes. While I can’t tell you what each of these would be (even though I mostly know), there is one thing that I would do right away:

Secure the future of pediatric health care in the Roanoke Valley and throughout southwest Virginia

Hmmm… Isn't’ it already secure?

The answer to that, in one word, is NO The future of health care for children is not secure anywhere, except perhaps in large cities with large, free-standing children’s hospitals, and maybe not even in those places. You see, children are our most vulnerable citizens. They have no power, they cannot vote, they have no money, and they are completely at the mercy of the adults who wield power in our society. They cannot march  on Washington, write letters to their legislators, or influence business leaders in the community. While we can see daily the impact of disease in adults in our society (lost days of work, addiction, obesity, crime, violence, end of life issues), the impact of lack of attention to children’s health care may only become apparent years or even generations later. We tend to close our eyes to it. The first thing that children need is AWARENESS of their needs. Then they need ACCESS to care (access=insurance). Then they need PROVIDERS who can provide excellent care.

Access is expensive.

Access to excellent, evidence-based care is VERY expensive and hard to find.

Think about it. Kids have the same organs as adults. They have a wide range of possible disease processes affecting their organs and systems. However, the great majority of kids are healthy, or at least start out that way. So, while ACCESS means having the same wide range of organ system specialists available, there are so very many fewer children with any specific organ system problem, that there is often not enough VOLUME to support more than a few of any specific type of provider. That means the pediatric subspecialist will work more hours, but be paid less than his or her adult counterpart. That means that for the most part, fewer physicians come out of medical school and choose to pursue a pediatric subspecialty (such as pediatric neurology, pediatric cardiology, etc). Recent data shows that few pediatric subspecialists are able to earn enough more than their general pediatrician colleagues over their working lives to compensate for the much longer training periods at low salaries, with large educational loan balances. And often only one or two or three of them share a practice location. Which could mean being on call every other night and weekend. That is why they gravitate to large children’s hospitals located in big cities where they may be able to work in groups of as many as nine or ten or even more—a much different lifestyle than that faced by the pediatric subspecialists who currently practice in the Roanoke Valley and Southwest Virginia. Almost everything we do for kids tends to take more time and may result in more cost, even though payments for services to children are often much less than the same service provided to an adult (that is a long story and might form the topic of another blog post). Pediatric equipment is more costly because it has to come in multiple sizes. Pediatric nurses have to be comfortable with multiple sizes and ages and developmental stages of children. And the list goes on and on. So, back to my desire to ensure the future of children’s healthcare in the Roanoke Valley and Southwest Virginia. How would Powerball help me to do that? First, I would build a building to house all of the OUTPATIENT needs of our children. All the subspecialists, all the services, all the community resources—in one place. This would help because we have so many children who have to travel great distances and it would be wonderful to have all the providers and services under one roof. It would help because it would give our providers a sense of community. They could more easily see each other, and communicate about their shared patients. They could more easily SHARE things, including having staff who could move between clinical areas as needed. I wouldn’t do this alone, of course. I would make a large donation and then ask the community to help. Why? Because unless the community is interested in the future of children’s healthcare and willing to make a commitment to it, it will never be as great as it can be. Total, we would probably need around $30 million to do this. It would pay off in benefits of making it easier to recruit those hard-to-find subspecialists, because there would be a permanent statement from the community that kids are important to our valley and the surrounding areas. Second, I would ensure that probably another $30 million be put into a fund (endowment) to help keep our subspecialists and other folks critical to pediatric health care employed and well-supported. The fund would generate yearly income to support education and research of young physicians and those still in training. It would take away a bit of the pressure our providers feel every day to do things that generate income when they would prefer to be teaching, learning or researching intricacies of pediatric diseases, or just spending more time caring for their patients.

So, what do you think? What would you do if you won a big lottery (powerball or otherwise), or inherited a huge amount of money? Would you consider helping me secure the future of healthcare for children in our area? Why or why not?

Oh, and by the way, I WOULD NOT stop working. I love what I do way too much.

  photo credit: tsand via photopin cc

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