Health Care Problems And Other Dilemmas: Why It’s All About The George Washingtons

For many years, my summer and after school job was working at a flower shop that is now closed. This was a really long time ago. The owner, Joe, was a shrewd, funny and very opinionated character. He was smart, too, in the ways of politics. He predicted after the Watergate break in that the entire plan went all the way to the top and President Nixon would resign. I doubted his take then but over time, he proved to be spot on. He let me know numerous times how right he was.

One common theme of all of Joe’s diatribes was money or “George Washingtons” as he would call it. Any problem, scheme or episode in life was ultimately centered around money. He particularly used this philosophy around the government both at the state and federal levels. He was a very early “Show me the money, Jerry” type of guy. He was successful and knew the value of money both for the good it would do or the havoc it would wreak. He started his business from scratch and grew it via the sweat of his brow and family to be a rather large enterprise. Unfortunately, his family turned his property into condos many years after I had left.

Joe began his soliloquies by saying, “Champ, let me tell you ...” These soliloquies would last a long time. I thought about Joe recently and the various problems we now face. If Joe were alive today, I am sure he would be commenting on the following issues …

• Illegal drugs will never go away. Someone is making too much money up the food chain. Now there is a stronger push to legalize marijuana? That is nothing but a way to collect more money via taxes. Joe would be saying: “Champ, that’s why it is being legalized. Where will all the money go?”  

• A single payer health care system? It will never happen. There is too much money in all of the layers of bureaucracy and the various businesses in health care. At one-sixth of the economy, health care is too big a piece of the pie (too many George Washingtons) to just have it reduced. No one I am aware of ever states how much health care should be reduced before everyone is “happy.” Besides, who tells the insurance companies they are out of the medical insurance business? These companies are making too much to let that happen unless health care is mandated or taken over by the government. If a single payer system does happen, heaven forbid, how long will it take before long lines, denial of care and exorbitant taxes make everyone long for the good old days?  

• Some say the fix for climate change will be taxing carbon production. I can see Joe scratching his head and not being able to figure out how taxes will improve the climate. He would definitely tell me we would never see the money as the government appetite swallows it.

• Joe would lament the idea of the perioperative global period. He believed any job or item he sold was worthy of being paid. Knowing Joe, he would wonder how we let this happen.

You see, Champ, everything boils down to money. If there is money to be made, then things will continue on their merry way. We only find solutions when they potentially can or will generate more George Washingtons than the problem for one side or the other or both. Plug in anything you see that appears wrong or right or just plain doesn’t make any sense. It all revolves around George Washingtons, doesn’t it?

There was another great analogy to many of life’s problems that I overheard at a party. To paraphrase: It would be like trying to put toothpaste back in the tube. So maybe the job really is to make new toothpaste in a new tube. Once the paste is out, the George Washingtons take over and they will never fit back in the tube.

Dr. Wallace is the Director of the Podiatry Service and the Medical Director of Ambulatory Care Services at University Hospital in Newark, N.J.

For further reading, see “Advice To Graduating Residents Embarking On A Life In Practice” in the October 2018 issue of Podiatry Today, “The Questions Today’s Externs Can’t Always Answer” in the September 2018 issue, and “How Do You Know If You Are A ‘Good Doctor’?” in the June 2018 issue.