A Nostalgic Vision of Healthcare

The healthcare debate has brought all-time record turnout at the political town hall meetings this summer and dominated both news coverage and parlor talk. Almost daily opinion polling indicates that the "very highly motivated" numbers are at record levels on both sides of the debate--extremely high on the side of those opposing "big government intervention" into what is nearly 20% of America's GDP. Not since the anti-war movement of the 60s have I seen the country so intensely divided about what seems to be an intractable issue. The House plan is over 1000 pages and three months of debate in the Senate has failed to produce any consensus there. Well, do you want to know how life got so complex and our problems so expensive and intractable? Just find an old GP (general practitioner or family doctor) that has lived through the progression from normal to neurotic and ask him.

When I was a kid there wasn't any health insurance as you know it today. We had what was called "major medical plans" that only kicked in if you were in the hospital for a while. When we got sick we went to the local doctor and paid cash. Income tax rates in the 50s and 60s were 75% for doctors so most all of them just put the $5 (about $35 in today's money) fee into their pocket. Most of them remembered America doing fine prior to the advent of income taxes some 40 years earlier and they had their own "people's resistance movement" against ever growing ever consuming big government. I don't recall anyone judging the doctors for that behavior; quite to the contrary, those old local doctors were lauded as the moral icons of the community.

These men were respected for sacrificing their lives for their communities. First of all they kept costs low for their patients. They would buy an old house in town and convert the living room to a waiting room, the kitchen to a medication room, the bedrooms to examination rooms and staff it with a single nurse that maintained the modest records and controlled the flow of patients. But never for a minute did we think "Doc" didn't have sufficient records; his record was vastly superior to what is in your chart today. See, he didn't need you to fill out a 4 page "history and physical"--but he very well may tell you, "You are having the same problem with your feet that your grandpa and your mom's brothers have." He knew that about you not from a computer screen (witch seldom captures sutler family traits) but because he lived in the community and treated or at least knew your family. He knew which (or may ask), "Which one of you boys was it that scored 14 points last night?"

Secondly, many of the doctors were on the school board and knew what was going on in the community. At least they knew who lived in 3 rooms in the country with little to eat and who lived in town where the septic tanks were only feet from the water well--he knew, because he cared, what kind of difficulties to look for in his diverse patients. When sports seasons came around, "Doc" would donate a Saturday to do 250 "football physicals" on every boy the Boosters could drag in to his office. And he had such powerful goodwill in the community that the Boosters would go around and say we need donations for a ball field and we are going to name it in honor of "Doc"--everyone from the poorest to the most greedy gave with a smile. America's heartland is littered with these memorials to those selfless men who gave so much to their communities.

Then third, he was guardian of the civil society. You could be sitting clear outside on the old cracked concrete porch and hear him dress down some parent that he felt was negligent of some aspect of parenting. "Doc" didn't need to call the sheriff, most would rather deal with the sheriff than face him. He may not be a regular at church services but nobody acted crude or used foul language around him. That was disrespectful to the entire community to disrespect the man that encouraged education, health, civic responsibility, personal accountability for and to your family and extended family and a general atmosphere of public virtue and mutual respect of all.

And a fourth thing, he kept life sane and uncomplicated. In those days before the government began pumping money into healthcare, suing the doctor was not the goldmine that modern lawyers have discovered. So "Doc" didn't practice defensive medicine; referrals were virtually nonexistent, there were very few "tests" and even prescriptions were rare. If you needed a shot he would go out to the kitchen and draw it up; if you needed pills he would get one of the huge bottles off the wall and get you out a hand full. If your father carried you in with blood pouring, the nurse would rush you to the front of the line where "Doc" would sew you up and give you a tetanus shot. No matter what, you were normally only there about 5 minutes and payed $5 in cash. But he would take time if necessary, if the couple were unable to plan or have children, he would patiently, thoroughly and clearly explain the reproductive process and when you were successful he would likely even deliver your baby!

Were these men supermen? Yes indeed! Did they just appear larger than life to a young man in his impressionable years? No indeed! You only need to drive through rural America to view the memorials that grateful communities gave to men that ALL knew were aspiring to the pinnacle of self sacrifice, service and accountability to their fellow man. The standard that they set called the whole community to a higher level of virtue, civility and self control. But not even these Titan's could stand up to the culture destroying flood of big government money. Yes, the progressives in their tender caring omniscience had a better plan to "fix" our healthcare "problems". I remember walking into the office one fall day and there was a sign that said, "effective November 1 all office visits will be $10." I was highly shocked! That was well over a half days pay for lots of men! It seemed so inconsistent with the character of the man we loved. I was in such shock that I only vaguely remember the sign beside it that said something about not wanting to deal with something called Medicare. Yes, the Great Society of President Johnson had intersected healthcare! Big government had come to help; complete with their oppressive burden of requirements that was going to force more people, taking more time, to provide care that couldn't be better than the personalize, caring and even sacrificial level we had been receiving.

Without going into boring and confusing detail (like the talk we can hear on the news today), let me just say that 8 years later we were hit with the other fist. With the HMO Act of 1973, big secular progressive government brought in their old ally and co-conspirator: big business. Big HMOs then PPOs and other inventions of big business began to take control. Insurance for your car doesn't pay for tire changes and gasoline fill ups, but now health insurance began to cover every routine service right down to filling a prescription. They inflated the costs and included every penny of health expenditure they could find in order to totally control (and thereby profit from every aspect of) healthcare. Insurance and provider working together, with the backing of the congressmen they bought, ran the cost of routine services so high that the option of paying privately became a joke. If you did not pay to play, they just priced you clear out. Soon they had captured virtually everyone in the net of their system and then they went after the doctors.

When I was 4, my mom and dad held me down while one of those great doctors (a young one) removed a foreign object from my nose. They teased me for decades for screaming, "no dokker no". In 1992, I hired that great old (by then) doctor to do some work for a healthcare institution I was operating. My soul wanted to die within me as I watched this Titan lumber about in the chains of governmental and big business regulation not unlike Samson in his prison when his strength had been drained from him. And not him only, doctor after doctor told me the same story, "I am sorry Jim, I can't contract with you because I had to sign up with the big PPO that bought out the local insurers." They just wanted to take care of their patients and friends that they had been seeing for years, but now big business had control and could make those people go to what ever physician would sign up with the "plan." So now doctors were losing control of how, where and for how much they would provide services. They were moved into expensive buildings and supervised by directors only interested in the bottom line. A modern and legal form of enslavement; and the worst kind, where you actually sign the agreement as if you concur or lend it your approval.

Well folks, this old guy that remembers when Titans walked the earth is getting kind of choked up here as he recounts how the secular progressive minions brought down those giants and chained them and enslaved them and make them extract every possible penny from the communities they once so nobly served. It is not good for an old man to let the anger rise up within him when he thinks about how the government wants to fix his healthcare again. To start with I am sure I cannot afford another fix! I know my country cannot afford another fix; those costs would put my grandchildren into virtual slavery trying to pay just the interest on the trillions we would borrow. It isn't bad enough they have taken away my ability to make my own decisions and be accountable for myself and my family, and took away the liberty and dignity of our doctors, but when they want to enslave my grandchildren...that is even against the Constitution. Thomas Jefferson said, "...we shall consider ourselves unauthorized to saddle posterity with our debts, and morally bound to pay them ourselves; and consequently within what may be deemed the period of a generation or the life of the majority." I want the government to take its big business buddy and just get the hell out of my life and let we the people go back to managing our own lives.



If these omniscient progressive masterminds feel so compelled to fix something, why do they not start by repealing the laws giving big lawyers and big business the power to ravage us? For instance, look at Missouri, Mississippi and Texas that have passed tort reform laws and cut some premium costs up to 40%. Why do they not take away regulations that allow only half a dozen insurers (out of near 600) sell insurance in a given area? Wow, strike that, that would be capitalism. Folks, capitalism has not failed America...America has failed capitalism. We have choked capitalism and blamed it for coughing, all the while putting a chain of slavery around our own neck. Again Jefferson, "the government big enough to give you all you want is also big enough to take away all you have." Is the promise of the Nannystate to take care of your every need, worth the surrender of you liberty, dignity and the right for people to control their own lives? Can't we "just say no" to healthcare reform?