My friend Elizabeth from Atlanta Track Club and I were talking about our pets as she drove me to Hartsfield International airport this morning for my flight to Honolulu for this weekend’s marathon. I’d been in town emceeing last evening’s Atlanta Track Club’s All Metro Cross Country Awards Banquet, where Lovett High School senior Selena Tripoli and Milton High School junior Sam Bowers were named Ray Buckley and Jeff Benton Award winners as Outstanding Athletes of the season.
Elizabeth has a 10 year-old greyhound with a bad back, and she told me how her vet actually made a house call when her dog was too hurt to travel. My wife Toya and I have two cats, and we, too, sing the praises of our vet out in San Diego.
Elizabeth and I then remarked how vets today are actually much like how human doctors used to be back in the day when every patient was also an individual client, rather than simply an insurance policy holder.
The distinction, we decided, was important in the effect it has on society at large.
In their book The Vanishing Center for American Democracy, authors James Davison Hunter and Carl Deportes Bowman write, “many Americans are even more set in their view the government cannot be trusted; that its leaders (and the leadership class more broadly) are incompetent, craven, and self-interested: and that as citizens they have a little meaningful influence over the powerful institutions or circumstances that shape their lives.”
So while people rail at congress about the high tuition cost of college, or the cost of healthcare insurance, at this point, what is never questioned is the price charged by colleges or the fees for healthcare. Instead, everyone talks about how to offset those costs, whether it’s the rate for college loans, or how much and for what the insurance companies will pay for healthcare. Consumers are simply caught in the middle, while institutions argue, then tell me what I owe.
In a very real sense we have separated the patient from the doctor. Professional services like law and medicine used to be a very personal arrangement. Like Atticus Finch getting paid a of bag of potatoes for legal fees by Mr. Cunningham in the opening scene of To Kill a Mockingbird, because that’s what the man could afford in the Depression years.
There was once a ground-level connection between the service, the charge, and the payment. The imposition of middlemen on both sides of the equation has separated the two principals, us and our doctors, and taken us to a distance from one another.
What makes this system especially discordant is that the doctor’s office is one of the most intimate settings of our lives. It’s where we ask the most difficult question, “how am I?” To separate the humanity of the service with the understanding and empathy of the charge has made us a colder society, more purely transactional, and that, in turn, is its own kind of illness with a not very healthy prognosis.
Safe travels, and Happy Holidays to all.