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.”