Barriers To Health
Daily Observer
When
a man the size and general girth of S.Q. Lapius gets
beside himself there is a lot to contend with.
At the time I didn’t know whether or not to take it seriously, but word
had gotten into the newspapers that Lapius had
decided to give up his citizenship in the
True
or not, the item caused a splash, and important people were calling. The White House sent feelers to find out if
the rumor was true. An agent from the
FBI was interviewing neighbors. The
phone rang constantly, and now Lapius was jawboning
with a senator, the receiver held tightly to his ear when he wanted to hear
something, but when Lapius was shouting he held the
mouthpiece of the phone in front of him like a microphone, as if he were
addressing the American public.
“I’m
not going to tell you anything about my private plans, senator. Whether or not I renounce my citizenship is a
very personal matter. Why don’t you
check with the state department and see if it’s true? What?
They consider it a confidential matter?
Good for them. Now don’t get
upset, Senator. One doctor less in
“But
trust me, Senator, I won’t leave immediately, not,
that is, until I have finished my book.
You didn’t know I was writing a book?
It has a great title. It will be
called the ‘Medical Archipelago’. The
title is reminiscent you say, but what is the book about?”
“The
book is about the vast administrative system in which patients, doctors and
hospitals disappear into an infinite bureaucratic limbo. It will describe in detail, the destruction
of the system of free enterprise and individual liberty by the government of
the
“Perhaps
it is Senator, but in my view it is just window dressing. The presidency is the last political arena.”
“It
was a great show you people put on in the impeachment proceedings,
Senator. Any stranger here would envy
us, the way we toss our leaders around, vox populi, town meetings and all that. But we know better, don’t we, Senator? You have us strangling in the noose,
fashioned by the congress of codes, rules, regulations and legalisms that will
ultimately deprive the American people of the best that medicine has to
offer. What do I mean by such outrageous
statement? I’m glad you asked.”
“You
are trying to skinflint the public out of decent medical care. You are worrying yourselves to death about
the cost of health to the nation. Here
is the Congress of the United States that has given atomic reactors to Egypt
and Israel, that for years paid farmers extraordinary fees to plow under their
crops, that has subsidized railroads, trucking and airlines, each in turn, that
gives away munitions to friends and enemies alike, that paid 30 billion dollars
a year to subsidize an illegal war, that has moth ball fleets of useless ships,
graveyards in the desert for outdated tanks and planes, suddenly worried about
the cost of health of its own citizens.”
“The
government which never to my knowledge had a serious concern about waste, suddenly has become cost conscious when it comes to
medical care. So you have erected a
vicious circle of legal barriers that prevents communities from building to
their needs. Suddenly every hospital bed
has to be filled; suddenly it is less evil to have patients on stretchers in
the hall than to support an empty hospital bed; suddenly it is more serious to
have vacancies in the coronary care units than to have a patient die for lack
of special care; suddenly you are going to force the patients to buy generic
medications instead of trade-name drugs, despite the fact that you don’t have
the manpower to police the generic drug makers who will pop up like poppies in
Turkey.”
“I
am aware of the abuses of unbridled capitalism, but if there has been a
successful capitalist industry it is the drug manufacturers who have, by virtue
of their research and productions, produced medicines that have saved the lives
of millions. They will surely be
dismantled if the results of their research and quality control methods of
production can be borrowed gratis by any cluster of businessmen who smell a
dollar on the generic market.”
“You
are so worried about wasting American dollars on American lives that you have
committees that force doctors into conflict, that urge them to discharge patients
from the hospitals at the earliest possible moment, yet you don’t permit more
hospital beds to be erected even by private investment. You create monetary incentives for brief
hospitalization, and are erecting policing agencies to insure that these
policies are being carried out. You
don’t worry about the money you spend on policing medical care as much as you
worry about spending it on medical care itself.”
“Suppose
there is waste in health care? What
difference does it make? We should have
a surplus of health care, not a deficit.
The nascent ideal of the founding fathers, the credo on which the nation
was created, was based on consideration of the individual. You won’t save the individual by catering to
the public at large, but if each individual is properly cared for, the nation
as a whole will enjoy good health.”
“In
other words, Senator, in your zeal to distribute health at the lowest possible
price, you have stifled incentive, imposed a government monopoly, and created a
situation where most new medications and innovations in medical instrumentation
now originate overseas. A sad state of affairs for a nation that prides itself on
initiative and inventiveness.”
“I
don’t disagree with your intention that all Americans should have medical care. But I am ashamed of your pocketbook
considerations. If you want to
distribute health care and subsidize the medical welfare of all of us, then do
it. Damn the expense and full speed
ahead. Since there is nothing else you
have to say on the matter, Senator, I think I’ll close off now.”
“What
was that all about, Simon?” I asked as if I didn’t know. “Are you really going to yield your
citizenship and move to
“Of
course not, Harry. That is a silly
rumor. Besides, there is nothing that