Critical care

There are lessons to be learned by crossing the pond. England's National Health Service used to be cited as proof that so-called "socialized medicine" works for everyone, regardless of their means. My parents-in-law didn't pay a penny for lifesaving cancer surgery. They were neither rich nor poor, nor did they have any supplemental insurance.

When on vacation in England, I needed non-urgent treatment. The doctor and I had a tug-of-war over payment. He refused to accept any. Something about medicine being above economics.

A recent Associated Press story in The Chief reported that England's "junior" doctors, who are licensed non-specialist physicians, start at around $20 an hour. Hardly enough for a Ploughman's lunch. The doctors will likely be striking soon for a few days, as they have done lately to no avail. The NHS has fallen on hard times. 

It has gone down the drain. The" brain drain.” Doctors are bailing out and emigrating .

Canada is another nation to which critics of the U.S. system are looking with envy.  It is free but not freely available. Americans carp about the recommended interval between routine colonoscopies being extended from five to ten years in order to pander to insurance companies. But in Canada, you aren't eligible for one unless you have blood gushing from your rectum for four consecutive pay periods, as witnessed and certified by a human resources timekeeper and three physicians whose surnames must have exactly five syllables.

In the U.S., there are more insurance plans than species in the animal kingdom. Like human fingerprints, no two plans are the same. They are filled with elusive language and escape clauses. Our most creative minds are neither rocket scientists nor magicians of algorithms, but experts in billing codes, which are more treacherous to navigate than the Strait of Hormuz.

Our medical system is "complicated,” a word that is used to cover all bases of optional interpretations. By the way, why can't we just say what we mean without resorting to silly concealment schemes, especially when intent is obvious, such as "Schitt's Creek" or "Meet the Fockers"?

Entrepreneurship is the cornerstone (or baseboard) of American medicine, even on the level of private practice. According to Kaiser Family Foundation Health Tracker, the U.S. has the highest per-person health-care spending, but the lowest life expectancy among "peer countries.” Japan spends the least (less than half of what we do) yet ranks first. And their longevity exceeds ours by almost seven years.

Is it really due to socioeconomic factors, such as crime and poverty, and the disparity of available social services? Are all the causal agents visible? How is it that our drug costs are higher than the outer boundaries of the solar system and that efforts by the indigent to obtain medications from overseas are interdicted by federal officers?

Is there a tainted ménage à trois marriage among the FDA, insurance companies and the pharmaceutical industry?

Most people don't know that increasingly, doctors are joining huge hospital conglomerates, which micromanage them as though they were entry-level civil servants. Even doctors need self-affirmation, especially when the pressures they are under make them feel like passengers on the ill-fated submersible that exploded en route to the Titanic a few years ago. 

In view of this, might it be a good idea for even senior physicians to unionize? Can policy-setters and lawmakers think outside the box without throwing the box away?

According to the American Medical Association's Journal of Ethics,  there is no prohibition as long as "union actions are focused on improving care.” What about unions refusing to perform certain procedures?

Resistance to medical doctors being allowed to unionize is predicated on several pretexts and fallacies. One is that physicians are ineligible, because they are technically supervisors. The National Labor Relations Board shot down that specious argument.

Opponents trot out the lame, shifty, mothballed bogus alibi they use against teachers' unions: that it subordinates the interests of students or patients to their own material gain. Yet data shows patient mortality declined significantly in California after nurses unionized. The same would hold with doctors, whose every job action so far has been driven primarily by the goal of improving patient care and protection from systemic abuses. 

Union busters are enamored of error messages about the motivations of workers. And they'd like to enfeeble the NLRB, which has made some noteworthy decisions of late. One of them is particularly far-reaching, because it clarifies the hazy line between students as amateur college athletes and the realm of professional competition.

Earlier this month, a regional official stated the obvious: that players on Dartmouth College's men's basketball team are employees, even though they are part of the student body. The college's trustees deem the statuses mutually exclusive.

As employees they would be eligible to join a labor union, if they voted in favor. All 15 members of the team have already signed a petition seeking representation by the Service Employees International Union (SEIU).  If it comes to fruition, it would be a trailblazer for the NCAA. The Dartmouth trustees are appealing, and the NLRB has given them a March 5 deadline.

New fertile ground for unions is continually being discovered. Maybe it would be a good idea for a new board game like Monopoly. One is already being developed centered around the theme of the borough of Queens, and residents have been asked to nominate landmarks and locales. 

Many years ago, there was a skit on the absurdist cult 1970s television show "Monty Python’s Flying Circus” spoofing Spam, the anti-delicacy mystery meat. Everything was on the menu, but everything on the menu had Spam in it. There was no getting away from it. Media is making migrants the new Spam. They appear as ingredients in stories on every topic. 

Journalists are exploiting them. Henry Ford said that his Model T car was available in every color, as long as it's black. I can imagine assignment editors telling reporters they can cover any story, as long as it can be made migrant-related. 

Spam, like migrants in some respects according to some people, has gotten a bad rap, though unlike Monty Python, it is not fun to watch. Spam was a staple that helped British troops get through the Second World War. In the computer age, of course, it refers to a folder that contains mostly unsolicited updates about the end of the world and other cautionary tales.

Migrants are on a faster pace to becoming New Yorkers than many realize. Already they are indistinguishable from the rest of us as they dodge and scatter out of the way of unlicensed, uninsured, lithium-ion battery-run motorized electric scooters. What is the city doing about those sidewalk-jumping death machines? Is City Hall waiting till the body count reaches Battle of Gettysburg proportions before it does anything?

Get used to it. Life is dangerous. Venturing outside has its risks. So does staying at home, listening to radio ads designed to strike terror into our passive hearts. One of them features a voice like a Wild West gunslinger from the days of the ole frontier. He's plugging emergency food supplies in anticipation of an evitable apocalypse, such as a takeout of our national electric grid. He promises that the food will remain edible for 25 years.

Yummy! Today's rum raisin ice cream in 2049!! Bring on the Rapture!

And a little dose of it on the horizon.

The cessation of the College Board's profiting from the sale of New York City public school students' data, such as names, addresses and test scores. That is the upshot of their consent decree with the state attorney general’s office. Still, they have a Cheshire Cat smile on their corporate face, because the fine is only $750,000. Over the last decade, they reportedly raked in tens of millions of dollars, and almost a quarter of a million students' information was compromised just in 2019.

Well, a single column won't change the world. Neither a fifth column.

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