Saturday, October 22, 2005

The HMO-Free Generation


How different would North American-wide Universal Healthcare be today if only Tommy Douglas had been born in, say, Wyoming, instead of Saskatchewan?

One thing for sure. There would probably be a lot less of this:

Home medicine is a big industry these days. A recent network survey by one of the major evangelical organizations indicates that one out of every three Americans will experiment this year with a variety of do-it-yourself home cures and quack remedies ranging from self-induced vomiting kits to alpha/beta brain wave scans and multihead, blood-magneto suction-drums to measure percentage of true body fat.

Others will test themselves daily, in towns and ghettos all over the republic, for potentially fatal levels of blood glucose, or use strange and expensive litumus tests to screen each other for leg cancer in the femurs and the ankles and knees.

We are all slaves to this syndrome, but in some ways it is a far, far better thing....Last Saturday night I went out to snack bar at the Geneva Drive-In near the Cow Palace and performed tests on a random selection of customers during the intermission period (of a double-feature).

The results were startling.

Huge brains, small necks, weak muscles and fat wallets - these are the dominant physical characteristics of......The Generation of Swine.....

(In the snack bar), I found the heart-rate machine.

The directions were clear enough. "Deposit 25 cents and insert middle finger. As a rule, the lower your heart rate, the better your physical condition."

It had the look of state-of-the-art medical technology, a complex digital readout with ominous red numbers on a scale from 60 to 100. Anything under 60 was "athletic"; 60 to 70 was "well-conditioned"; 70 to 85 was average; and after that it got grim.

Between 85 and 100 was "below average" and over 100 said, "Inactive - consult your physician."

I tested (my assistant) Maria first, and she came in at 91, which shocked even casual onlookers. She wept openly, attracting the focus of a large crew-cut uniformed cop who said his name was Ray and asked me for some "personal or professional ID".

I had none. My attorney had run off, the night before, with all my credentials and press cards.

"Never mind that, Ray. Give me your hand," I said to him. "I need some human numbers for the baseline.".........

Ray moved into position, looking as spiffy and bristly and confident as a middle-aged fighting bull. I slapped another quarter into the slot and watched the test pattern seek out his number.

It was 105, and a hush fell over the crowd. Ray slumped in his uniform and muttered that he had to go out and check the lot for dope fiends, perverts and drunks.

"Don't worry, " I called after him. "These numbers mean nothing. It could happen to anybody.".....

The crowd was thinning out; Maria had locked herself in the ladies' room and now I had nothing to work with except a few vagrant children.

I grabbed a small blond girl who was 10 years old and led her up to the machine. "I'm a doctor, " I told her. " I need your help on this experiment.

She moved obediently into position and put her finger into the slot. The test pattern whirled and sputtered, then settled on 104. The child uttered a wavering cry and ran off before I could get her name. "Never mind this!" I shouted after her. "Children always run high on these things."

Her little sister spat at me as they backed away like animals.

I grabbed another one, a fat young lad named Joe, who turned out to be son of Maggie, the night manager, who arrived just in time to keep Ray from calling the SWAT team to have me locked up as a child molester.

Little Joe registered 126, a number so high that the machine offered no explanation for it. I gave him a quarter to go offf and play the Donkey Kong machine on the other side of the aisle.
Hunter S. Thompson, Generation Of Swine, Summit, 1988
First published in the S.F. Examiner (Wee Willy Hearst Edition), Dec. 15, 1985

All of which makes one wonder if any of the somewhat-less-than-reputable private Health Maintenance Organizations in the United States ever use video games and/or codeine-laced pain relievers to brush off unprofitable families with bad credit and/or the audacity to show up at their processing centers when they are sick.

I'm not entirely sure about that, or whether former Fristian cash-cow, HCA, is one of those less-than reputable HMO's.

But this much I do know.

The area around the Cow Palace in South San Francisco is not a place you want to let your kids run around free, at night, these days.

I know this because I used to live in the Bay Area.

And because of that I also know how much it costs to belong to an HMO. My wife, myself and our infant daughter belonged to one of the best of the quasi-public ones in NorCal. It cost us $500 per month, which I have had GWNorth branch-plant neandercons tell me is cheap compared to what we in Canuckistan actually pay in taxes. But then I tell them that this was the most basic rate and that on top of it there were user fees for every visit and co-pays for almost every prescription and for every single procedure that cost more than nothing at all. And then there is the rationing and the constant worry about what will happen if one of you gets chronically sick (ie. cancellation or, at the very least, a ramping up of coverage costs). And on top of that, here's the kicker - these things are completely restrictive in terms of who you can see and what you can have done. In other words you can't choose your own doctor, they chose them for you, and the doctor has very little leeway with respect to what procedure can be done.

Pretty ironic, huh. The great capitalist system totally restricts your choice even when you pay for it yourself, while the evil socialist universal system lets you to make at least some decisions yourself or together with your doctor.

All of which has nothing to do with quackery, the point being that our family was lucky enough to be able to afford to be in a solid HMO that overall, despite the deficiencies, we trusted. That is not the case for millions upon millions of Americans who, sadly, are often reduced to self-diagnosis and/or self-denial when it comes to chronic, even life-threatening, symptoms.

Of course, if one is a complete and total maniac, one can always choose to jig even the quack-o-meters if one has a death wish.

Ray was still hovering around with a worried look on his face. I was beginning to feel like the night stalker, a huge beast running loose in the neon swamp of the suburbs. Ray was still asking about my credentials, so I gave him one of my old business cards from the long-defunct National Observer.

"Not yet," I said. " I want to take another reading on myself." By that time I had loaded up on hot coffee and frozen my right index finger in a Styrofoam cup that Maggie had brought from the office.

Ray stood off, still confused by my relentless professional behavior, as I dropped my last quarterinto the well-worn slot. The test pattern locked into a freeze pattern, unlike anything else we had seen to this point. The numbers rolled and skittered frenetically on the screen; people stood back and said nothing....and finally the test pattern settled on a number nobody wanted to read.

It was double zero. I had no pulse. It was official - as final as some number carved in white granite on a tomestone on the outskirts of Buffalo.
Hunter Thompson, ibid.

Momma Mea Culpa Update: As notorious fact checker and all 'round cautious commenter lenin's ghost points out, Tommy D. was not actually born in Saskatchewan.


No comments: