Just A Boy And His Dog
It comes to this, then: the dog is better served than the man. Perhaps this is as it should be, considering the relative amounts of mischief and mal-intention we might fairly assign to the account of each species in the operation of its affairs. Maybe this is fair and proportionate and those of us who find ourselves built of Homo rather than Canis DNA should accept the rightness of such a world. But it looks to me more like I'm being buggered by my fellow man than punished by god or nature or blind chance.
I took old Prince to the vet's Monday. He'd been feeling poorly for several days and showed no likelihood of just puking on the rug, purging himself of whatever had come over him and getting on with life. His discomfort disturbed my conscience enough that I took an hour off work, collected dog and checkbook, and set out to see Dr. Mugnai, DVM.
We waited about fifteen minutes after walking in unannounced. On those occasions I've felt similarly sorry for my suffering children and made a specific appointment with an MD we've been forced to cool our heels among the copies of Us, People, Good Housekeeping and Travel (very sharp minds and deep interests, these physicians!) for seldom less than half an hour and sometimes much more than an hour. But I did not come here today to complain about doctors.
After we discussed Prince's symptoms and she listened to his heart for a few seconds, we had a diagnosis, a prognosis and a treatment plan. Symptoms: Labored breathing, runny eyes, edema, lassitude, weakness and a lack of his usual desire for cheap, vile smelling food. Diagnosis: congestive heart failure. Prognosis: fatal, irreversible. Treatment: Lasix, 12.5 mg and Enalapril, 5 mg, morning and evening; give him extra water, expect him to pee frequently.
This probably closely parallels the prescription for the same condition in people, accompanied of course by the standard exhortations to lose weight, stop smoking, exercise frequently, avoid stress and always wear a seatbelt and a helmet. It may seem an imperfect and inadequate response to such a grave illness, but it's what you can do-it's palliative care intended to make the last weeks or months or years of man or beast more comfortable before Old Shep goes "where the good doggies go" and you and I begin our regimen of eternal and unrelenting hellfire.
The whole business cost us forty-nine dollars and ninety-six cents. Now, I won't tell you I haven't felt screwed by veterinarians in recent years. Some bills are laden with needle and medical waste disposal fees and charges for all sorts of laboratory diagnostics that a reasonable person might expect would be covered by the office visit charge. I do not mean to imply that veterinarians as a class are less motivated by money or less inclined to extract it from their suffering patients than people doctors, however pleased I have been with the ministrations of our Doctor Mugnai.
But you can see that for just under fifty dollars we received what we needed, including a two-week supply of the drugs that are the best chance for a return to a good quality of life for this geriatric patient. What we did not get was a demand that we present our insurance card so the office ladies could piss away most of their working hours filing massive amounts of paperwork and arguing with representatives of insurance companies about the propriety and cost of our care. There will be no chance that some cubicle-dweller in Milwaukee or Mumbai will consult his or her computer and pronounce our treatment or our medications not covered.
It was a clean, decent transaction between the afflicted and his health care provider. Not dissimilar from my several visits to Dr. Matt G. Boname in Oxford New York for tonsillitis treatment (and once for wound closure) in the late nineteen-fifties: Dad handed over full payment from his wallet.
But of course medicine is more expensive and complicated now than then. Ordinary persons cannot afford to pay from their stagnated incomes for service. Now we routinely pay (or our employers pay) insurance companies far more than we ever likely would have had to pay to doctors and hospitals for all but the gravest of illnesses. For these thousands of dollars a year we get policies that then require us still to hand over a co-pay when we get doctoring or drugs; we accept deductibles, according to our desperation, of five or ten thousand dollars which means, effectively, we still pay out of pocket for almost all our health care.
Then, when we get truly, seriously sick, we discover our condition is not covered or only partially covered or some parts of the protocol are not approved or some drugs our doctor thinks are good our insurer doesn't like. Every year our premiums increase. Every year fewer of us can afford even a crappy, overpriced policy that will abuse us the greatest when we need it most. For those still, in President Obama's words "happy with what you have", we may be pleased that our employer is paying most or all of the cost but we may still find he has bought a defective product in our name.
The United States of America has the worst, most unfair, most immoral system of health care funding of any modern, wealthy nation in the world. It enriches insurance companies, their executives, the lobbyists they hire and the Senators and Congressmen they buy. Right now your representatives and your president are working very hard to buttress and extend that system.
If health care (not health insurance-health care) is a basic human right, not a privilege of wealth or circumstance, it ought not involve a third party that siphons off profit. Civilized persons and nations everywhere agree. The solution, the answer, the system in universal application (with local modification for the historical and cultural particularities and peculiarities of each nation) is called by the annoying and unwieldy name of single-payer. In this instance "single" means government, means paid out of general revenue similarly as roads, parks, police and fire protection and national defense.
Turn off your radio. Do not listen to the lunatic ravings of Rush Limbaugh and Sean Hannity. Do not try to make sense of the right-trending, middle-of-the-road-proclaiming coverage of this issue by network or cable television or the mild-mannered apologists at Public Broadcasting (except for Bill Moyers who with his frequent guests tells you pretty much what I'm telling you here). Do not, please, consider nine out of ten members of Congress other than fully complicit in the maintenance of the status quo, however much their rhetoric assures you they're seeking "reform."
Senators and Congressmen want the insurance companies to continue to make immense sums of money. They are not troubled by the waste, by the cost, by the inadequate care, by the deaths of thousands. They get all the doctoring they want and for free. President Obama told us before he turned the affair over to Congress that single-payer was not under consideration. Candidate Obama of course was very clear that it was the only acceptable solution, but then we have all been disappointed at the evaporation of hope and audacity since he's been breathing D.C. air haven't we?
The "public option" never amounted to much, but it upset the insurance executives so even that lame half-measure was abandoned. There is considerable salivating over the notion that everybody might be required to buy the expensive and inadequate products of the insurance industry. I suppose if the National Association Of Lawn Furniture Manufacturers contributed as many millions to our representatives as the insurance boys do Max Baucus and Olympia Snow would see that we must all be forced to buy flimsy plastic chairs and three-legged tables, too.
A small number of representatives, almost exclusively Democrats, who receive no time on the interview shows and are ignored or reviled by their party leadership and their president, say they support government funding of health care through Medicare or a parallel plan. I expect when the deal finally goes down most of them will climb abord the president's bug-ridden, bloated, status-quo-or-worse express. Nobody who is a player as the game goes on wants anything remotely resembling a fair and honest system because that would make life difficult or impossible for their friends in the insurance business. President Obama has not "lost control of the debate" as they opine on NPR. He is getting the debate he asked for when he cozied up to your insurance man in those secret White House meetings of which he refuses to release the attendance roster.
When (don't hold your breath waiting for this) you hear of a bill, a proposal, a plan that will render private insurance obsolete, support it. Otherwise, don't waste your time writing letters or attending meetings or contributing money to the cause. And please, try not to get sick. Nothing good will come of that. Unless, possibly, you're a dog.
Mr. Cooper lives out his uninsured days on a quiet, potholed road in Alna, Maine. He continues to chip away at the bills for his detached retina surgery of 2008, which he finds greatly preferable to handing over thousands annually to useless, inefficient, corrupt, evil insurance companies. Prince the sheltie succumbed to his heart disease Tuesday afternoon. Dogs die. They all do. He still has the white shepard with the old gunshot wound, the raggedy wheaton terrier and the dachshund who bit his daughter's baby and was exiled to live with the equally curmudgeonly old man. And don't forget the pair of cats. He sometimes answers particularly challenging or provocative or appealing mail sent to him at email@example.com.
Another brief note for my CommonDreams readers: No hard facts here, no inside secrets, no shocking revelations. Not, in fact, worth your while to read, I'd say. So don't, please, read it and then complain that it seemed shallow and obvious. I write to annoy and disturb and provoke and inform and delight my neighbors, a good many of whom still fervently believe "private enterprise will do it better." I ask CD to reprint me here only so one more voice may be hurled out into our national wilderness of ignorance, perhaps to be forwarded here and there to a somewhat open mind.