Socialized Medicine and Me: a Love - Hate Affair.

I had a pretty nice beginning.

Born free of charge, to a couple of pediatricians in a city that, even in its postwar funk, radiated beauty.

But things went wrong pretty quickly. Mom had to work; off to daycare I went, there to catch colds that led to ear infections that followed each other so quickly that, in the apparent absence of decent antibiotics and total ignorance of tubes to drain inner-ear fluid, became chronic by the time I was three. Only surgery could heal me. They tried, three times, and I just kept getting worse.

In ’68 we emigrated. Right after my parents passed the ECFMG, and could practice medicine, they found a good otolaryngologist. Unlike the doctors of my east-central European homeland, he had a microscope to operate with, and antibiotics specific for my problem. By 14 I was infection-free, though almost completely deaf in my left ear – the doctor had to essentially amputate my entire cochlea.

I’ve adapted; my friends and children sit and walk on my right side. But whenever my mother gets nostalgic and regretful about their decision to leave the Czech lands, I remind her that, had we stayed, I would probably be at least deaf, and possibly brain damaged or dead. By the time my American doctor got the infection out, it was a few millimeters away from the auditory nerve.

My older son had ear infections too, one after the other. He ate a drugstore’s worth of Amoxicillin by the time he was three, and the doctor made noises about tubes. But his hearing is perfect.

I haven’t told that story for a few years. I worried that it would reflect badly on medical training in the land of my birth, but, even more, on socialized medicine.

And you would think that I would be the most fervent supporter of private health care. Like Rush Limbaugh (well, unlike Rush – he got the socialized version, Hawaii style) I benefited – greatly – from the system as it stands. Not only did it help me finally get healthy; my parents’ incomes as physicians financed a long, aimless exploration through college, as well as sundry expenses after.

But once I grew up and the professional courtesy that, in my adolescence, paid for my routine care, ran out, I began to understand the costs of that private system. And once I began my career, in which I so often work with those in the lowest income bracket, I began to understand its inherent injustices.

I saw adults and children with chronic mental illness that couldn’t afford either the medicine most appropriate for their condition, or the talk therapy to help them deal with its impact on their lives. I sat in a meeting with a parent who burned his eyes on the job, but couldn’t afford to go see a doctor. I saw kids who couldn’t play sports because their parents couldn’t afford the costs of a physical.

Me, I was lucky. Two uncomplicated deliveries, and a bike accident, both subsidized by insurance companies that valued their relationships with school districts too much not to pay. But still, I made many phone calls, necessarily during work hours, to ensure that payment, and often it seemed that the goal of all those hoops was for the consumer to just get too tired or disorganized, and stop trying.

It rankled. Like my father, I grew the conviction that all medical care should be fee-free to all individuals. The failure of the Clinton plan broke my heart, and I was afraid to believe that the ascent of Obama and the Democratic majority would make any difference. I was wrong, of course. And a few Sundays ago, as I clicked between the HBO series The Pacific and the House vote, I felt relief and resignation about both topics by the end of the evening. Relief that the some objective had been achieved, but resignation that so much blood, real and figurative, had been spilled along the way, to achieve relatively little.

And yet. Perhaps the outcome was the best it could have been. Yes, I’ll have to keep making phone calls to make sure my medical bills get paid. But one hopes, fervently, that enough of a profit motive will remain in the system to keep the medical nightmare that pestered my childhood from becoming a reality here.