During my adult lifetime, one of the words that has secured a place in the popular lexicon is 'dysfunctional,' a seemingly generic term meant to convey that things are pretty messed up, most often applied in the context of a family situation, particularly when referring to one's in-laws.

Dysfunctional got thrown around in the way a 16 year old girl uses the word 'like.'  It was similar to when people swear just because they can't think of another way to convey how deeply they feel.  When things were totally hosed at a level that seemed impossible to fathom, we simply pronounced the situation 'dysfunctional.'

I went into protest and vowed to not use the word.  It was a cop out.  It was being misapplied, a lame excuse for not thinking enough to come up with real words to describe how bad a situation was.  I became a word snob.

And then I read a piece from a psychatrist, one of the folks who really had a need to use the word dysfunctional.  He, too, had become weary of the overuse of the word, but instead of rebelling attempted to bring some clarity, to offer a working definition that would make it valuable again.

Someone or something is dysfunctional, he said, when they really, really think that what they are doing is helping, but in reality, everyone else knows that their attempts to 'help' are only making things worse.  Then it is not just bad, but it is dysfunctional.

That helped.  The word had meaning again and was not just a sophisticated catch all for 'things are really screwed up.' The more someone tried to fix it, the worse they made it.  That was dysfunctional.

On a related note, a recent article at ModernHealthcare.com states that CMS predicted, in its analysis of the proposed healthcare reform legislation, that roughly 20% of Part A providers that greatly rely on Medicare could become unprofitable over the 10-year projection window.

Let me make sure I've got this right. 

One of the problems we are trying to solve is that a lot of people don't have health insurance, so they don't go to the doctor, but wait until they are in real trouble and then end up in the ER, which is really expensive.  So we'll give them all health insurance so they can go to the doctor, but there won't be a doctor there because they went broke because they were paid at rates below their costs.  At which point that person, plus others who were just fine before we tried to help, ends up back at the ER where things are really expensive.

And this helps how?