Home Care Program
Would Cut Costs
Usually the bell rang when someone wanted to gain
entrance, but this time there was a sharp rap on the door. I opened it
warily and just escaped a tap on the noggin as Dr. Ernest Crabgrass pushed the
door open and entered, brandishing his cane.
“Why hello, Dr. Crabgrass, this is a surprise,” I
said.
“Where’s Lapius?” he asked without bothering to
acknowledge my greeting.
“One moment please, I’ll find out,” I left Crabgrass
who still caressed his cane like a shillelagh, and marched to the living
room. “Crabgrass in the foyer,” I told Lapius.
“I don’t want to see him.”
“What should I tell him?”
“Tell him I have the mumps and difficulty walking.”
I turned to transmit the message and ran right into
Crabgrass, still waving his cane. “Don’t worry, Simon. I’ve already
had the mumps.”
Lapius gave Crabgrass a warm welcoming smile and
threw his arm around the still frocked shoulder of the uninvited guest.
“Goodness, Ernest, it has been a long time. Welcome, welcome. What
brings you to this neck of the woods?”
“I want you to sign this petition, Simon. I
won’t take ‘no’ for an answer.”
“And what petition is that? The one to abolish
Medicare?”
“Exactly. Here.” Crabgrass laid a smudged
paper on the table and handed Lapius a pen. Lapius took it, leaned over,
read the petition carefully and then marked a big X in the appropriate
space. “There you are Crabgrass. I’ve signed it.”
“An X won’t do, Simon.”
“You don’t think I will put my real name on that
ridiculous document, do you Crabgrass?”
“Why not?”
“First, because I don’t believe in the petition, and
secondly, because Congress is not going to repeal Medicare.”
“They should. They have no right to interfere
into medical affairs.”
“Well, I would agree with that. But they do
have the right to pay medical bills if they want.”
“But by paying medical bills they earn the right to
dictate to the medical profession. That interferes with our professional
freedom and I for one am against it.”
“Come now, Crabgrass. Surely you must
understand that we can’t go back to the old days where old or elderly people
were relegated to the back rooms of their children’s homes. They
certainly couldn’t afford protracted illness. Surely we can’t allow the
nest-egg for retirement of an elderly couple to be wiped out by illness.
That isn’t the American reward for industry and diligence and prudence over the
years.”
“Perhaps not, but surely it isn’t the American
purpose to preserve the nest-egg by dumping these people in nursing homes.
Have you seen any of these lately? Even the best offer little more than
anonymity and ignominy. Some of those people would be much better off
dying at home amongst their loved ones.”
“That’s a point, Ernest,” Lapius agreed. “Maybe
you should rewrite your petition. Instead of trying to wipe out Medicare,
request that it includes a home care program.”
“What is a home care program?” Crabgrass
asked. “More of your socialist mumbo jumbo?”
“Hardly, Crabgrass. It would be a program that
would permit the elderly to be taken care of at home. After all, the
average convalescent home costs a minimum of $5,000 per year per resident or
patient. For the same money most of these people could be adequately
taken care of at home by the family in conjunction with a home health aid.”
“My goodness, Simon, that would be open season for
larceny. The government couldn’t trust families to receive a $5,000
subsidy to take care of a sick father. They might blow it at the race
track.”
“Sure,” Lapius agreed. “Some might. But
then, some might not. Certainly a family would seem a more dependable
receptacle for subsidy for the care of one of their own, than the impersonal
management of a distant nursing home, in which personnel is always
changing. After all, Crabgrass, there are situations which are reasonably
self-governing, and it seems to me that family care at home for a sick person
is one of these.”
“How would it work? I mean, how would the
government know who is sick and deserving and who isn’t?”
“All the government would need would be the testimony
of the family doctor, and-or the affidavit of a social work agency to affirm
the need.”
“Ha ha, Simon, you are opening the floodgates.
People could fake that and steal the government blind.”
“Some might, but it would still be a hell of a lot
cheaper for the government to trust its citizens, than to distrust them and set
up a whole supervisory administration whose only job is to see that the
government isn’t cheated by its citizens. It would be more dignified
too. Actually by setting up utilization committees and Professional
Standards Review Organizations, the government castigates the medical
profession, and impugns the honesty of the doctors. I personally resent
it.”
Crabgrass was becoming impatient. He seized the
moment. “Ah, Lapius. So we agree. Medicare must go.
Sign the petition.”
Lapius sighed. “Poor Crabgrass,” he said
patronizingly, “You didn’t understand a word I said. It is you who must
go, not Medicare. Harry, show Dr. Crabgrass to the door.”