Better Way Through
Trust
Daily Observer
Lapius demanded that the cab let us out about a block from
the house, “to get my circulation going,” he explained. He was literally fuming. He resembled a dragon as he stomped angrily
on the icy walks, twin jets of frost spiraling from his nostrils. As we entered the house he started to stumble
and reach out for support like a blind man.
“What
happened," I asked, trying to balance him.
“Did the brandy go to your head?”
“Don’t
be ridiculous. It’s my eyeglasses,” I
reached for my handkerchief and polished the mist from his lenses. “There, that’s better,” he said.
It
took him a few minutes to divest himself of scarves, boots, sweaters, etc. with
which he had girded himself against the winter winds. “I think,” he said when he had finished,
“that I need another brandy to settle my temper.”
“Still
stinging from that argument with Dr. Hardline?” I
asked.
Lapius laughed. “Hardly. I’ve known
Johnny for a long time. We have a go at
each other every so often. Keeps me on my toes.
No. The problem is that although
I disagree with his tactics, I can’t disagree with his position. The government is often quite predatory. It encourages the private sector to develop a
fine resource, then gobbles it up. But what is worse, in the gobbling, prevents
the resource from being expanded and refined.
After all, the trust it has placed in the profession of medicine as well
as the pharmaceutical industry has paid off handsomely. Sure it subsidized some areas but the fact is
that the medical profession has exquisite tools with which to fight disease,
and the pharmaceutical industry has come up with remarkable medications that
afford a longer and happier life (medically speaking) for many of our
people. The fact that much of this is
beyond the financial resources of many is not the fault of either the profession
or the industry, but of the economic system.
It seems unfair to attack medicine and the pharmaceutical industry for
something that is the fault of the government itself.”
“Sure
is a problem,” I said hopefully.
“But
not insoluble,” said Lapius ignoring the irony. I had poured him a small liqueur, hoping that
after the brandy, he had consumed, the sweet drink would put him to sleep so I
could watch a fight on TV, but I had, as always, under-estimated his capacity.
“The
problem is, Harry,” Lapius continued, disregarding my
television commitment, “that the government has mounted a vicious attack on the
medical profession, using the proposed regulations to subvert the image of the
doctor in the eyes of the public. They
have done much the same to the pharmaceutical industry. It is one thing to propose corrective
legislation, but quite another to demand utilization review, and to require
that before a doctor can admit a patient to a hospital the reason for admission
must be screened by committee. This
places in the mind of the public the proposition that no doctor can be
trusted. That he keeps patients in
hospitals too long in order to line his own pocket. They have by these tactics, undermined the
people’s faith in the medical profession.
They attack our probity and ethic by so-called remedial laws. Yet individually they trust us enough to come
to us when they are ill. The
pharmaceutical industry has played a large role in the pharmacological research
that resulted in a wonderful assortment of miracle drugs and vaccines, and for
drugs that have been the basis for brilliant research into medical physiology
at the universities. Yet they too are
under attack for the cost of these drugs to the public. If the pharmaceutical companies can’t earn
money to plow back into research, the research will stop, and no new drugs will
be forthcoming.”
“Well,”
I interjected, in order to give him time to sip the liqueur, “whom the gods
would destroy they first make crazy,”
“The
quotation, Harry, is, ‘Whom God wishes to destroy He first deprives of reason,’
ascribed to Euripides.”
“Well,
you know what I mean,” I said lamely.
“That’s
neither here nor there, Harry. The fact
is, that instead of creating edicts, the net effect of which is to sully the medical
profession, the government could solve a lot of its problems if it would stop
being so suspicious. Not worry about
utilization so much, but proceed on the certain knowledge that no patient wants
to stay in a hospital longer than necessary.”
“But
we have a hospital bed shortage.”
“Then
build more hospitals.”
“But
that’s expensive.”
“Everything
is expensive. Look how expensive it is
to set up bureaucratic watchdog agencies.
They could use that money for better purposes.”
“How?”
“Simple. If I have a chronically ill patient at home
who, because of the illness and nursing needs, is becoming a burden to the
family, why can’t I call an agency, recommend that they pay for a nurse or
homemaker, and have it done pronto.”
“That’s
childish, Simon. Look how much chiseling
and kickback there could be.”
True,
it might cost a billion in chiseling, but this way they lose a billion in
surveillance. Let’s make a swap. My way would create more jobs,
give the doctor more flexibility in dealing with difficult social
problems. Place the responsibility for
the care of the elderly or family who would accept the responsibility, if only
they could get some assistance. You say
I am childish. Of course, I am. The problem is that we have been behaving as
adults. Creating slick
systems that stifle our initiative to get things done and to help people. What we need is a return to childhood
innocence, where a direct problem is met directly, where a well of trust
exists.”
“Ha,”
I laughed. “You want everyone to trust
each other. That is a laugh.”
“It
is nothing to laugh about. If someone
has an accident they are invariably picked up out of the road by a first aid
squad, people who voluntarily place themselves on call 24 hours a day to help
their neighbors in the community. They
are a Godsend, particularly for the unfortunate person who suddenly finds
himself tangled in the wreck of a car.
The government now wants to professionalize them, and to do this
suggests that the first aid volunteers do not know enough about resuscitation,
cardiac arrest, internal injuries, and what have you. The direct inference to the public is that
you can’t trust this remarkable person who volunteers to help you when you are
in trouble. I construe the whole thing
as an unwarranted and vicious attack.
There must be a better way to improve health services than to attack the
people who established them in the first place.”
“I
am sure you have a suggestion to offer.”
“As
a matter of fact I do, Harry. There must
be a return to the basic tenets of the founding fathers, that
in the long run the divergent interests of a free society will balance out for
the common good. In order for people to
have faith in its government, the government must have faith in its people. Get me some more of that delectable potion,
Harry.”
“Do
you trust me, Simon?”
“Implicitly,
Harry.”
“You’ve
had too much to drink. Go to bed.”
“Nonsense,”
said Lapius, as he struggled from his chair to refill
his glass.