We are a commune of inquiring, skeptical, politically centrist, capitalist, anglophile, traditionalist New England Yankee humans, humanoids, and animals with many interests beyond and above politics. Each of us has had a high-school education (or GED), but all had ADD so didn't pay attention very well, especially the dogs. Each one of us does "try my best to be just like I am," and none of us enjoys working for others, including for Maggie, from whom we receive neither a nickel nor a dime. Freedom from nags, cranks, government, do-gooders, control-freaks and idiots is all that we ask for.
Never, ever, use the term “health care” in my presence.
There is no such thing, and the words - and whatever concept, if any, which lies behind them - is anathema to me.
A word to the wise: medicine is an art, not a science. Yes, it is built on science, but it goes far beyond science which is why it is more of a priesthood than engineering. Not to disparage engineering, which I respect enormously. But the entire concept of the kind of Internist/GP medicine which I and many others practice is built on an idea of an intimate relationship and committment to an individual person and their life.
Medical treatment does exist, and so does “having a doctor” to keep an eye on your life and physical and emotional well-being and to take a professional/personal interest in your life, and especially in any "lack of health".
Nothing called “health care” does any of those things.
Doctors care about you; "health care" is an industrial/economic/bureaucratic concept in which you are little more than a potential expense item, but preferably a profit center – whether the "system" - to borrow a socialist concept - is a government monopoly or an HMO or insurance company or whatever.The industrial/economic concept does not “care,” nor does it “provide” “health.”Only God and nature can provide health, and only a physician with whom you have a personal relationship, and with whom you have a personal contract, will “care” about you, because that is what they were made for.
In the modern-day “health care” environment, I am beginning to see that people have deeper and longer relationships with their electricians and plumbers (and I am not referreing to Lonely Housewives) than they do with “health care providers,” and it burns my ass, because that is not what being a physician is all about. It used to be that the specialists were the ones without the long-term relationships with patients: you were referred to them for a particular purpose, which they addressed, and then they came back to you. Nowadays, with “health care,” there is no “you” to come back to. When I see what is happening to Medicine today, it makes me want to cry.
Let me just tell you this: when I had my heart attack at 64 and my doc came into the ER and checked my EKG and said "Ed, it's an MI but you're gonna be OK and get back to work in a week or two", from a guy who had known me for 20 years, it meant more than you could imagine.
If the “health care consumer” wants doctoring to be a cheap commodity offered by a random Dr.-of-the-day “health-care provider”, well, it’s their choice. Do not come to me for that. I believe I have much more to offer than that.
But health – that I do not have for sale. No-one can sell that. And “care” is never for sale, is it?
The last doctor I had any kind of personal connection with died eight years ago - I called for an appointment, he was gone. I never knew.
But even he I had only known for two years, and had seen only twice. Since then, I have never seen a primary care physician more than once before he or she was no longer my physician - either because he was dropped by my insurer, my insurer changed and he was no longer covered, or he moved on to greener pastures.
Several of them I have never seen. I have no current physician, but the last one I saw has moved on - I don't know where she went, and she isn't covered by my current insurance anyway. And frankly, I don't care. I'm tired of trying to follow the trail, tired of requesting that my records be sent from one office I never visited to the next. I have trouble even remembering where the records are.
I don't know how my insurance works. I'm not even really sure what physicians do. Make diagnoses on scant evidence. Prescribe drugs, supposedly vital to your health, that they will refuse to refill if you haven't seen them for a while.
It's too frustrating. I'll just look after my health on my own. I'm too busy to get sick anyway.
Good for the Old Doc. I count myself fortunate that I have always had kind and patient doctors caring for me, despite my obnoxious ways. Growing up abroad we had the safety net of socialized medicine in case of disaster (ie: job loss--could someone explain to me the logic of tying your health insurance to your employer? Private citizens should be able to deal-shop on their own for health insurance at the kind of reasonable rates charged to corporations.) but paid a benevolent and expert private M.D. to give more specialized care to the family lunatics. It worked.
In adult life I benefitted first from the de facto socialized medicine provided in college and grad school, which kept me alive despite more than a touch of the family curse. If you were YAVIS enough, you could get free counselling.
In the last 18 years I have seen the same internist, and later a specialist to keep the family curse manageable. Both are wise, long-suffering, and have kept me alive thru horrific times. I can fairly say that no medication can substitute for old fashioned knowledgeable care, the kind that only develops over years. You need somebody who knows all your wicked ways and coded language, who can tell when you are malingering or about to expire. I am convinced that both my M.D.s think me a head case, and I doubtless am. But their compassionate and respectful treatment of me has kept me alive.
HMOs and health care are only for the young and healthy who, like all vigorous animals, need only shots, perhaps birth control, and periodic checkups.
I should add that, despite the frequent ranting in these pages about the evils of socialized medicine, my family have been cared for by exceptionally dedicated and decent doctors within the evil maws of National Health. Their doctors pay house calls, earnestly talk for an hour at a time trans-atlantic with us about my parents' psycho-social needs, without ever a HIPAA form being brandished. My father has had the same doctor for 25 years, and they get caregiving by loving village girls who speak English, work hard, and don't steal the silver.
I realize that there must times when it royally sucks to be a physician these days, partially because of the excessive demands and expectations of us patients, partly because of liability, partly because of evil insurance, HMOs, etc. But it is a holy calling, albeit mundane and stressful in the details. There isn't another vocation I consider as valuable.
In my youth I was a minister. I would much rather my children became doctors, as another young relative already is (plans to do work in developing countries or the slums of her home). Believe they will do far more good than I was ever able to do with sermons and loving arms.