A Tale of Two Cities

I remember a surprising amount of things from my childhood, especially if they were special days and events in my life. One of my earliest clear memories has to do with kindergarten. I remember the first day – all of those new faces standing with their mothers. Some of them crying – others dancing with excitement and anticipation.


I remember the playground games, the big red pencils and nap time. And I remember the milk. 8 fluid ounces of cold goodness in those wax-coated containers. Kindergarten milk taught me a very hard lesson at an early age. It was because of kindergarten milk that I learned that we did not live in a classless society. Karl Marx would have made quite an example of the milk distribution in my kindergarten.

Milk came to us in cool metal wire crates, and it came in 2 classes. There was the plain milk and the chocolate milk. As I recall, the plain milk set my parents back a nickel, while the chocolate variety sold for a whole 7 cents a pop. Oh, those lucky few that got the chocolate milk – how I envied them. To a 5 year old boy with a carton of plain milk, the brown tinted Chocolate milk carton was like the Holy Grail.

It was not the economics of the situation that frustrated me. My dear parents gave me my 25 cents milk money dutifully every week, but conjuring up the extra dime each week for the chocolate variety was seen as wasteful to them – those were different leaner days.

I realize now that, even though I did not get what I wanted – chocolate milk - I did get what I truly needed – all the calcium and nutrition in my plain milk that my growing body needed. The content of the milk was what was truly important – not the luxury of the delivery system.

Which brings us to the subject of one of the most sacred cows in healthcare – equality.

Many people in health care will scream and yell that no one should be denied health care in this country – and I will generally agree with that statement. However, that does not mean that everyone should have access to the same health care delivery system.

If we are to provide health care for uninsured Americans, and in doing so, not bankrupt the country, perhaps we may need to start looking at new ways of delivering that health care in a more cost-effective fashion.

Perhaps.

Perhaps the uninsured might have to go to a free or reduced-fee clinic for their health care instead of a private practice.. Perhaps they might not see a doctor initially, but instead must first see a nurse, nurse-practitioner, or physician’s assistant. Perhaps they might have to sign a liability waiver before receiving this free or reduced-cost care. Perhaps they might be limited to receiving prescriptions for generic drugs, when such drugs are deemed appropriate. Perhaps they may have to wait longer to see a provider, and not have the luxury of an appointment. If they were to require hospitalization for a non-communicative condition, perhaps they should be interred in an open ward instead of a semi-private room. The bottom line is, they might have to deal with a no frills, lower-overhead practice in order to receive their free or reduced cost care.

Like that kindergartner, they may just have to deal with the fact that we do not live in a classless society, but nonetheless, everybody still gets what they really need. With or without chocolare syrup.


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