Squeezin’ the Juice
by SVEA SAUER
The day had to come when I would attempt to write about health care. You see, I am of the generation that had a personal relationship with my doctor. He returned calls. He knew what the inside of my house looked like because he made home calls, weather notwithstanding. When I was fully dressed we had a conversation in privacy following a visit to the examination room. He did not write a prescription, he handed me a little envelope containing the pills and though the pills did not perform miracles, they had the same psychological effect.
In the meantime, the world changed. The doctors and patients were the same but something happened to the relationship. I do not have to describe medicine today because we all experience it and its multitude of annoyances. We accept the change because we know the old-time doctor would have changed too if he had to pay for all the extras that modern science has bequeathed us.
How these marvelous improvements are paid for is now a problem for our ever vigilant congress which is now struggling with how to please the patient, the taxpayer, the insurance companies, and the pharmaceutical industry. The doctor is waiting at the end of the line. His opinion is assumed to be self-serving while he labors on with a patient load and an overhead that would fell an ox.
I grind my teeth every time I walk into a doctor’s office and see ten clerks managing stacks of insurance files while two nurses run around trying to keep up with the patients. Each patient expects to walk out with a prescription, just as in the old days they expected to receive a little packet of pills. So, now we have to deal with MedicareRx and is that a pain.
The public howls for change but blasts the president and congress for not doing it their way. Here’s what I have to say about that. Without a clear policy to guide them, members of congress must fight for individual preferences based on pure cussedness or an ideology they cling to like bats on a cave roof.
Any organization that seeks a solution to public needs must agree first on policy, then measure each suggestion against that yardstick. It seems to me that our congress has not even considered an agreed upon policy. Is health care to be the right of all citizens for whatever reason? If so, then how and at whose expense? Is cost of health care to be shared? Then, by what means -- insurance, private or public? A dole? And so forth. First must come some defined goal to deliberate, then the ways and means.
The president presented a policy to congress which has been rejected with no agreed upon policy to take its place.
If a city manager makes decisions, he or she must be guided by policy made by the city council. If a corporate president makes decisions, the board of directors must have made policy decisions first about the goals of the corporation. All organizations function well only when policy decisions are made and adhered to before planning procedures. It seems to me the government is flailing its arms and fighting at windmills and we will never have a decent resolution to health care questions until somebody pounds a gavel and says, “Agree on policy first!”
