To limn, to reave, perchance to dare

"What do we live for, if not to make life less difficult for each other."
—George Eliot, Middlemarch.

I like lists. They limn patterns. I don't sit myself down, choose a topic, and scribble until "Aha!" strikes. Lists congeal of their own accord.

Take national health: two overlapping lists define it. Coverage heads one and expense tops the other.

Coverage The first item that coverage subsumes is, "not enough." Regardless of how good it is, and in America it can be extraordinarily good, from the recipient's standpoint there isn't enough to go around. Perhaps one could contend that there never has been and all societal models - communist, corporate capitalist, dictatorship, socialist, theistic - fall short.

I suppose we could dismiss uneven health care coverage as one of several sad but recurring themes in our morning newspapers, like a loss by the home team, $43 billion trade deficits, if it were not for the next item under the rubric "coverage": anger.¹

1. Patients display everything from annoyance at physicians for long waits for short appointments to bottled rage in the form of lawsuits for malpractice.
2. Nurses, who ostensibly chose their career to directly address the needs of patients, find their actions curtailed by understaffing as a result of a downward trend in the patient-nurse ratio and by an upward trend in paperwork. While the magnitude of a current or projected national shortage varies by source, few disagree that nurses do not retire gracefully as often as they burn out.
3. Physicians, themselves angry and helpless against both frivolous malpractice lawsuits and rising insurance premiums to pay for the successful ones, stage work stoppages, simply quit high-risk specialties such as neurosurgery and obstetrics. Some are unable to accept Medicare payments as payment-in-full and maintain a solvent practice, therefore they decline to accept any Medicare patients at all.^2,3
4. "Them" And we all know stories about heartless HMO's; about drug companies with their obscene profits derived from price gouging so blatant that seniors organize bus trips to Canada to fill their prescriptions; or perhaps stories about employers who, faced with the unyielding reality of their bottom line, implement
    

1. www.census.gov
2. New York Times, 02 Mar 2003
3. Time, 09 Jun 2003, p. 52, 60.

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