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.



  1. Several years ago I ran for public office. Admittedly it was only local school board, but it was an eye opening view into the mind of the voter. People are indeed mistrusting of all institutions – even ones that are run locally. Not only do they not trust the people running them they have no idea how those services are paid for. When people would complain about taxes I would ask them what THEY were willing to live without. Should we shut down the library? Stop plowing the roads (the snow will eventually melt)? Turn uninsured people away from the emergency room since they can’t pay for services?

    Ultimately, they would come back with “Well…I didn’t mean that. I just want ‘them’ to stop cheating the system.'” Press harder – and people can’t fully define ‘them.’ They just have this sense that they’re getting cheated and they don’t want to pay for it. I’m fairly well versed in government spending – and it’s amazing how many people think we can balance the federal budget by cutting off payments to those welfare queens. Even if those welfare queens did exist en masse (and we all really know they don’t) – you could cut the ENTIRE welfare budget and barely make a dent in the deficits. If we really wanted to think about welfare we should cut corporate subsidizes – those tax breaks that companies get – when they are building their company on infrastructure paid for by taxes – and they turn around and offshore jobs.

    So, ultimately, in a democracy the ‘them’ is ‘us.’ We’ve created this government, and in vilifying it we have forgotten the many amazing things it does that we all desparately rely on. When you fly on an airplane in the US you’re reasonably certain the plane has been maintained and that it will safely leave and arrive at the airport – the maintenance is mandated by the FAA, who also oversee the TSA and air traffic control – all paid for by taxes. The internet we all use ferociously has been paid for by taxes. Over 99 percent of us can read and write because of the public education we received. Much of our health care is due to tax-payer subsidized research. Every business owner in the US has built their business in large part on an infrastructure paid for by the taxpayers. The libraries, the roads, clean air, the list goes on and on….

    So perhaps in “making it personal once again’ we can think about all of the great things we get from the government, and return to the reality that we are really getting a great deal for our money. Is there room for improvement? Absolutely. The Walmart Effect (great book by the way) has permeated our thinking – the idea that we can continue to cut and cut and cut costs (in this case taxes) and yet continue to receive. And if ultimately reducing/eliminating government is the end goal – which is what it appears to be for the pending administration – then we need to democratically face the reality that we are collectively not in agreement on the role of government and get an amicable divorce.

    Thanks for listening.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.