Vol. 4    No. 8
April 16, 2009 Archives
    When I think about healthcare reform, thoughts of my grandfather come to mind. He was a general practitioner
back in “the good old days.” He practiced medicine until the day before he died at the ripe old age of 87. He
carried around his black bag filled with basic diagnostic equipment and made house calls although he also had an
office where he kept appointments. I think he treated several generations of the same families in his practice.
   While he put his children through college and kept up the family farm — which was always a money loser —
“Doc Joe” lived a modest life. His office was modest and he lived in an apartment in Wauwatosa on Milwaukee’s
west side. He went to dinner once per week at the homes of his four children and was very frugal. He made no
vacation trips to Florida. I had the impression that he provided service regardless of the person’s ability to pay.
Medicine — and the farm — was his life. He was well respected in the Milwaukee area. Medicine was an avocation
as well as a vocation for him. Being a doctor — Hippocratic Oath and all — was who he was. It wasn’t a 9 to 5 job
that he left at the office. Being a doctor was his purpose in life.
   Now I have to say he practiced in “the good old days” because those days weren’t always that good for everyone.
Average life expectancy was a decade or two less back then and I am sure the racial disparity in healthcare was
probably a lot wider then than it is now. There wasn’t the expensive technology. Doctors were front and center the
nexus of the health care system. They were highly revered in the community. I think that was the psychic income
that they were paid.
   A lot has, of course, changed since then. I haven’t had a long-standing relationship with a doctor since I was a
child. My doctors have continuously changed because either they have moved on in our highly mobile society or I
changed employers who had different healthcare plans or I didn’t have health insurance at all. So now when I think
of medicine, I think of medical institutions or HMOs and not of an individual who has been involved in my care,
someone who knows me at all. Now I have met many wonderful, caring healthcare practitioners along the way. But
it all seems so impersonal and it seems at time that with each visit, we would begin the relationship anew.
   I have been paying my own health care premiums for the past 15 years. It’s a lot of cash even for “catastrophic”
coverage. I have a $1,000 deductible. So I have a tendency not to use the service at all, even when I ought to. In
some ways, this coverage makes me wait and I might end up with a severe illness that could have been avoided.
When I think about going to the HMO, I think about that additional $200-$300 I might have to pay in addition to the
$450 I pay each month. So I don’t rely upon preventative care. I rely upon the grace of God and the hope that I
have good genes that will see me through. I have to gamble with my health in order to afford any kind of care. It’s a
gamble that I — and society — might lose in the end.
   In the time since my grandfather died in 1968, medicine has evolved from a service to a business. As a small
businessperson, I understand the need to make money. I understand the need to make efficiencies and to keep up
with the latest technology lest I fail to survive the grueling competition of the marketplace. But in the end, I operate
a business to provide a service to my readers and advertisers. If I cannot provide a quality product at an affordable
price, I will be out of business. But with healthcare, it is different. While people might be able to live without this
newspaper, people cannot get along without healthcare. The demand and need is there regardless of the price.
The demands on the healthcare system are enormous. All of us expect to live longer than our parents did and there
is a big bubble of aging baby boomers coming along who will really tax the system. I could never pretend to really
understand its complexities and the level of planning that is needed to ensure uninterrupted healthcare services
into the distant future. I know there are tremendous financial requirements involved there.
   Yet, to some extent, I can’t help but feel that there has been a transference of the ends and the means as it
relates to healthcare. Instead of making money in order to provide a service, healthcare has now become a
commodity that is used to make money. The drive to maximize profits can come in direct conflict with that
Hippocratic Oath that my grandfather lived by to heal the infirm and the sick who came through his door.
I certainly don’t want to go back to the state of medicine that existed in my grandfather’s day. But I sure hope we all
keep at the forefront the noble mission of medicine, which is not business, but the health and well-being of
Reflections/Jonathan Gramling
                  Healthcare conundrum
Dr. Perry Henderson and other discuss
healthcare reform

2009 Production Schedule

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