Nothing But the Best Too Good for the States


S. Q. Lapius was away.  He had gone to Europe to study other medical systems.  He was trying to prepare himself for what to expect when Congress finally instituted national health insurance. 


“It will come, Harry, in one form or another, mark my words,” he had said. 


I marked his words on the back of an envelope and decided to visit my friend, Frigid Budgett, in the Department  of Health, Education and Welfare.  Frig was more than hospitable when I called.  “Sure, Harry, anytime.  Try to get here between 10 and 12, during our coffee break.  I’ll have time to talk to you then.” 


I was late for the coffee break, so old Frig took me out to lunch instead.  A charming old tavern on the outskirts of Bethesda, MD. 


The waitress hovered over the table for a moment, but couldn’t get away before Frig ordered two double martinis.  “And what will you have, Harry?” 


“A glass of grape juice,” I said, lamely, not wanting to blunt my host’s hospitality, nor becloud my mind for the exposition about impending health care legislation. 


“Don’t worry one bit,” Frig reassured me.  “Nothing that the government has done so far has ever hurt the doctors.  We have you fellas in mind.  You ought to know that.” 


I wasn’t thinking of the doctors, Frig.  I was thinking of the patients,” I said. 


“Hell, Harry, that’s your job.  You have to take care of the patients.” 


“I know that, Frig – but for instance, is there any way we could get away from the semi-private room?  Builds wards for instance?” I asked. 


“Wards?  You crazy.  They went out with the depression.  That’s where the poor went.  You surely want better than that, Harry.  The government won’t pay for wards,” he said. 


“I guess not.  But these semi-private rooms are really not private at all.  They are public.  And the healthier patient always had the burden of taking care of the sicker patient,” I said.


“Sure, Harry.  I know what you mean.  Wards had their advantages.  But we can’t use the word ‘ward’.  Now we call them Care Units.  Sure we can build them, but, for goodness sake, don’t call them wards.  No congressman would be caught dead voting funds for a ‘ward’. “  


“Well, Frig, I think we should do away with the semi-private room altogether.  Make a hospital either wards, or all private rooms, or a mix of both,” I said. 


“Private rooms?” he virtually shrieked.  You crazy.  That costs money, man.” 


“So what.  The money creates jobs doesn’t it.  I mean it is not going to Vietnam, or Japan, or the Middle East.  It’s staying right here in the good old USA.  The fact is, Frig, semi-private rooms make for lousy medical care,” I said. 


Frig was well into his second martini. 


“Let’s forget hospital construction, Frig.  Why all the push for generic drugs.  I mean, why does the government insist that it has to force the doctor to prescribe the cheapest ‘equivalent’ substitute for a brand name drug.  You know damn well   the generic manufacturers are not obligated to demonstrate purity and bioavailability as are the brand names.” 


“There’s not a snap of difference between them, Harry.  Not enough to account for the difference in price,” Frig said. 


“But why go shopping for the public.  Why should Americans go second class.  I mean, when the government builds a space capsule, do they go shopping at hardware stores for cheap parts?  Or do they go to a contractor and buy the best available?”  I asked. 


“Of course, we buy the best…” 


“And fighter planes.  Didn’t you bail out Lockheed to the tune of $250 million so they could make us the best fighting planes available?” I asked. 


“What the hell are you, Harry?  Some kind of subversive?  Are you implying that we should send our young men up in inferior planes that may fall during a mission?  Don’t you think we have an obligation to protect our fighting men?  The best is none to good for them, Harry.”  Frig stood up from the table and placed his hand over his heart. 


“I agree, Frig, don’t get excited.  You’ll spill your martini.”  The threat calmed him immediately and he took his hand from across his heart and caressed the glass lovingly. 


“Nonetheless, Harry, when it comes to our fighting men, I repeat, the best is none too good.  Damn the expense,” he said. 


“I see.  But when it comes to the mothers and fathers and brothers and sisters of our fighting men, the best is much too good,” I commented. 


“I didn’t say that, Harry.  You’re putting words in my mouth.  It’s just that we haven’t got money for everything.” 


“Just one more question, Frig.  Is there any possibility that the government will pass a law requiring that liquor be bought by the generic name.  Scotch will be scotch, gin will be gin, bourbon, etc.  In other words, that the bartender will have the right to make any substitution he wants when you order a drink?” I asked. 


Frig tried hard to focus his eyes on me.  “I swear old buddy, you have come demented.  What are you trying to do, maim half the people in the country?  Can you imagine what would happen if bartenders were permitted to serve generics?  They’d be making the stuff in their bathtubs – like they did during prohibition.  Do you remember how many people died or bad booze during prohibition?” he asked. 


“Quite a few,” I admitted.  I paid the bill and helped old Frig from his seat. 


“Let’s get back, old buddy, or you’ll miss the afternoon coffee break.”