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Sunday, July 5, 2009

A Needed Rx

Bob LOVES his car. He's had it for eons. He loves its styling, image and interior plus the oohs and aahs he gets whenever someone spies the car parked in front of his home or around town. Yes, Bob's car would be perfect...except for one minor glitch -- it's mechanically unsound.

It clanks, knocks, pings and gurgles anytime the engine is engaged. It belches plumes of smoke and odor. It doesn't always start when it's supposed to (some days Bob has to pop the clutch while coasting downhill to get it to start) and it sometimes stops at the worst possible moments. The windshield wipers and horn only work about one-half the time. And don't ever talk to Bob about gas mileage. He sometimes wonders if he would do better driving a Sherman tank!

At a recent gathering of friends on his back patio, Bob lamented the problem with his automotive beauty. "The time has come, dear friend," Frannie said, "to buy yourself a new car! You've got the money." Bob shook his head. "I just can't bear to part with her." "Well then," began Steve, "the only other answer is to get a mechanical overhaul. You're going to need to replace everything under the hood."

Bob thought about that for a minute. "Do you think that's the answer?" Everyone agreed and so Bob decided the time had come to get his magnificent car fixed.

The very next day he took his car to the repair shop on the west end of town. He described to the head mechanic the myriad of engine-related problems the car possessed. "Pop the hood and let's have a look see," said the head man. As he examined the engine compartment, Bob could hear the mechanic muttering to himself. Finally, the fellow came over to Bob.

"Heck, you don't need a new engine at all," the mechanic explained. "Don't you know this is the finest engine ever built?" Bob responded that he had always thought that, but the car's continuous mechanical problems had started to change his mind.

"All this baby needs is some fine-tuning!" exclaimed the mechanic. "It will cost you a pretty penny, but it will be good as new in no time at all." Bob was elated with this news. He handed the mechanic gobs of money. I can't wait to get her back out on the road, Bob thought to himself.

Unfortunately, despite all the time and money spent, Bob soon realized that the "fine-tuning" didn't make much difference in the poor performance of his vehicle. While some of the clanks and pings didn't seem quite so loud, new noises appeared out of nowhere.

So, he decided to take the car to the mechanic on the east side of town. He explained all the previous problems to the mechanic and told him of the shoddy repair job he obtained earlier. After taking a look under the hood, the east side mechanic said, "That other guy was right. You have the best engine anywhere in the world! The problem is that the other guy didn't know how to tweak it just the right way."

Bob was relieved. He was sure that this time his baby would be returned to mint condition. However, after handing over even bigger gobs of money, he discovered that the results were no better than the first repair. Some things seemed to work slightly better, but now there were even more new problems.

He ended up taking his beloved car to all the other mechanics in town. All of them agreed that he didn't need a new engine -- his engine was the envy of all -- they each thought it needed to be tweaked in a different way. Yet each tweak yielded the same results.

Finally, completely exasperated, Bob took Frannie's advice and bought himself a new car -- I think it was a Toyota!

The above story isn't really about a car; it's about the American health care system. On the surface, we Americans like to believe that we have the best system in the world, but world health care statistics -- both monetary and health-wise -- don't bear this out. We spend far more money per capita on health-related costs and yet we are sicker and don't live as long as the citizens of almost every other westernized democracy.

Most of us realize that our system is mechanically (systemically) unsound and polls consistently show that a majority of us would like to see some form of universal coverage. Unfortunately, our elected leaders (like the car mechanics) keep ignoring us by proclaiming that our system is the envy of everyone else and it doesn't need to be changed, just tweaked here and there. Yet, every time it's tweaked, the basic underlying problems are not solved and new problems arise.

Even worse, the above metaphor breaks down somewhat in that we can't employ the resolution that Bob did. We simply can't sign up for Canadian, German, or Japanese health care! So, we're stuck with the malfunctioning vehicle that's been foisted on us.

If you've been watching the health care debate in Congress, you must already know the engine will not get overhauled. It looks like the public option -- a very weak step-child of universal coverage -- will be mangled beyond recognition or scrapped altogether. The most likely scenario is that all Congress and the President will do is to tweak the sputtering engine which will continue to sputter and cough into the future.

But hey, it sure LOOKS great!

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