health care

September 26, 1999

How are you all? Isn’t that what most of us say when we first greet somebody we know? How are you? Sometimes we really expect an answer to that question. When I ask how you are, I’d really like to know. Not just in some existential sense, but how you’re doing, how your health is.

The reason I bring this up is because if you happened to call right now and ask how I am, my answer would be that I have been feeling like crap for about two months. I have some kind of bug, an illness that just keeps hanging in there.

Feeling sick is the body’s way of yelling for help. So I have been seeking help at a medical clinic where they keep doctors who are dedicated to healing what ails us. Some people call them “health maintenance organizations.” Now, there’s an oxymoron.

So, I’ve been to see my doctor twice. One time my doctor was on vacation, so I saw another doctor at this clinic. This second doctor is one of the people who owns the clinic. The people who own medical clinics seem to be dedicated to taking a scalpel to our wallets, handing out prescriptions before they diagnose the illness, and then giving us the bum’s rush out the door. My estimate of the total time I spent with a doctor in three separate visits is fifteen minutes. That’s an average of five minutes per visit. It usually takes me longer than that to diagnose what I want to eat for lunch. The bill for these three visits? About $240.

On the second visit, where I was examined by the clinic doctor — well, “examined” is too strong a word — the doctor really only sort of glanced at me. Without even talking to me, he made up a diagnosis which, as best as I can tell, was off of somebody else’s chart. He then gave me a prescription for a drug and had me out of there before he told me what the drug was for. I actually had to ask the pharmacist what the drug did. The pharmacist didn’t blink at this question. I reckon pharmacists get asked this a lot: “Excuse me, but my doctor prescribed this drug — can you tell me what the hell it does?” In my case, the drug was to relieve joint aches. Now, these aches were a symptom that I was having, but not the actual condition or illness. I don’t care about relieving the damn symptoms, I want medical help to cure the problem.

The sickest thing in this country by far is our health care system. Actually, come to think of it, there is no health care system in this country. What we’ve got is a giant, nearly unregulated cash cow, a profit machine for the people who own the access to health care. Then we’ve got a lot of doctors who work for these pain profiteers. My doctor is a good doctor; I just wish they would let him actually practice medicine. I think that what my doctor does best is really time management.

As far as I can tell, clinic owners set it up so that each doctor is given about five minutes per patient. I know that is true for the Kaiser HMO group in California. Skimping on time like this, while the cost of health care keeps going up, is one of the biggest “eff yous” to people in this country.

It puts huge pressure on the health care providers, too. Under this scenario, my doctor has to do the best possible job calculating, on a moment-by-moment basis, to figure out who should really only get two minutes, just in case somebody really sick comes in and needs eight minutes.

And there are forty million Americans out there who can’t even get their five minutes of doctoring. That is forty million of us who have no health care at all — none, nada, zip. Are you one of them? To show you how crazy our system is, at the health clinic I go to, none of the doctors have health insurance. Why? Because that would make the owners of that clinic a bit less profit.

I’ve been there myself. I just went three years without health insurance. It’s pretty scary. The only good news for those of you without health care coverage is that most of us on it don’t get that much better care than you do. I’m on a plan now that has a $1,000 deductible and comes with a thick pamphlet that lists all the things not covered. I haven’t even finished reading that part yet — it’s a long list.

Within the last five years, I have two friends who were in near-fatal vehicular accidents. One wound up in one of the best university hospitals in the country — Stanford. He had suffered a stroke as a result of a motorcycle accident.

The accident was bad, but it was the hospital that damn near killed him. The hospital had exactly one nurse on shift in the intensive care unit at a time. What the hell does “intensive” mean, then? Shouldn’t there be more than one nurse on that floor? You can bet that there was certainly more than one patient.

So, my pal was in intensive care, half comatose, and thank God his wife stayed by his side. Over the course of the first few days, my pal seemed to be getting worse: his weight dropped, and you could tell just by looking at him he was getting worse. And he kept mumbling something about being hungry.

His wife kept complaining to the doctor that there was something wrong. The doctor did the usual pat-her-on-the-shoulder thing and in soothing words told her that there was nothing wrong. (I think about half the time these characters spend in medical school is dedicated to the study of soothing bullshit.) So, my pal keeps wasting away.

Finally, the nurse comes by — nurses are usually the only real medical help in hospitals, but to maximize profits, hospitals keep cutting their numbers — and actually checks out my near-dead pal. And what does she discover? The nurse saw that nobody had hooked up his bag of liquid nutrients, and that for three days my pal had only been getting saline solution pumped into him.

Basically, the hospital was starving him to death. You know what the doctor did? He blamed it on the nurse. Mind you, this was a nurse who had a whole intensive care unit to take care of by herself. Is it any wonder that you rarely meet a nurse who has anything nice to say about doctors?

My point here is that the whole damn “system” is sick. In a free-enterprise economy, unhappy customers would normally boycott the service they are unhappy with and force it to change. But with health care, what do we do? We just keep on letting it screw us over, or screw us up.

Every once in a while, somebody suggests that we adopt a national health care system to cover everyone. And when they do, geeze, people go nuts. “It can’t work. That’s communism,” they say. Speaking of communism, do you know that Cuba has the lowest rate of infant mortality in the world, while the United States has an infant mortality rate on par with Zambia?

The only thing wrong with a national care system is that whenever the idea is floated, the insurance and medical industries take all their money — and God, they have a lot of it — and go on the warpath to destroy the idea. These industries are far better at killing ideas to improve health care than healing whatever you happen to be suffering from. I’m sick and tired of this, and you should be too.

I’ve just returned from London, where they have a national health care plan. Sure, they complain about long waits, but people there tell me that they actually go get the care they need. It’s the same for Canada. The Canadians think we are idiots for living with the system we have. I always explain to them that we are not living with it; it’s more like we are dying from it.

And then there are those of you who argue that the government can’t do anything right, so we shouldn’t let them take over health care. Is it true that government can’t do anything? Do you get your mail six days a week? Is there a system of roads, streets and highways throughout our country that allow us to get from one place to another? Doesn’t your Social Security check arrive on time? Don’t fires get put out and most criminals caught?

Traffic signals are where we need them to be, many cities and towns across the country are clean and safe — that’s your local and federal government at work, folks. There are lots of things that the government does well; we just take those things for granted.

There is absolutely no reason why a national health care system would not work. It’s got to work better than the national “keep us all frightened and ill” system that we’ve got now. In a system based on profit, as we’ve seen in this country, the sicker we are and the longer we are ill, the more money the owners of HMOs and the pharmaceutical companies make.

In a socialized system — oh my God, he just said the word “socialized”! — there would be an incentive to keep us healthy.

The government would be motivated, too, by cost containment, which could also translate into a commitment to real health maintenance, nationwide.

We can do something about this: we can force our elected officials to come up with a solution to this issue. Let’s make this a number-one priority in the 2000 campaign. After all, if we are not healthy all the other issues seem kind of less important.

It’s all up to us. I’m going to vote for the candidate who talks about nationalizing health care. The rest of them can just get sick and stay in bed.