A charity no more

A. M. Rosenthal

September 28, 1993|By A. M. Rosenthal

I HAD doubts about the Clinton health plan -- too complicated, too much new bureaucracy, and where was the money to come from? So I went off to a hospital to visit the expert who means most to me.

I made right for his bed in the ward and stood by it. I did not ask how he felt. I could see, by his face and the heavy body cast in which he was still lying, so many weeks.

In the huge room were about 50 sick men. Around three or four beds, curtained white screens were drawn up, all day and night.

They meant "patient dying." That was all the privacy they got from the other patients in the ward, or the patients from them.

Two nurses moved about, trying to attend to 50 sick men.

I knew the story of the boy in the bed; no need to wear him out with questions. He was about 18 and a charity patient. It said "charity" in the records, no euphemism. That bothered him, a lot. He came from a working-class family; nobody had ever taken such a thing, charity.

His father died falling from a scaffold five years earlier. No insurance; every week, as he faded, his wife and daughters scraped money together to pay the hospital.

No money was left when the father died. The boy had none -- no money, not a little money but no money, a condition people used to some money often cannot grasp.

The hospital listed a prominent surgeon as assigned to the case, pro bono. But he saw the boy only on rounds every now and then. Every time, he had to be reminded by the bed chart or a nurse who the boy was. The boy noticed that, every time.

The orthopedic operations on the boy were done by residents, not the great man. The boy and his family did not know, which was just as well because they had no choice.

The operations failed, the doctors gave up. They said so, in his hearing. One of them told him he might not walk again. The boy cried a lot but he could not get comfort from his family because for the next two days no visitors were allowed and of course he could not get at a phone.

The food was awful. But a young carpenter next to him got delicious Italian snacks smuggled in by his family, and shared them. Sometimes on no-visit days, a basket was thrown down to the family and hauled up.

But I knew what bothered the boy as much as the smells, the unending noise and the failed operations. It was that word in the records and the faraway nod when the surgeon picked up the bed clipboard.

Sitting at his bedside, I said to the boy: "The president of the U.S. just put out a new health plan. It mandates doctor and hospital insurance for everybody -- upper class, middle, workers and people with no money.

"But believe me, it is very complicated and will create new levels of bureaucrats. It will cost business and many taxpayers more tTC money. Some jobs may be lost and the deficit increased. So what do you think?"

Well, this is just anecdotal. But the anecdotes we happen to live through add up to our lives. Certainly the story of that boy shaped me, because of course I was he and still am.

Revisiting myself in my head, I knew he would have turned his face away from me for even asking if he wanted care without "charity" stamped on his record and soul.

Most hospitals do not have huge charity wards anymore. But they have the equivalent -- poor people using jammed emergency rooms as first succor.

I have problems with the president, but however the health plan finally reads, this president, no other, has persuaded the country that like education and police protection, health care is a right, never a charity to be carefully noted on a hospital record. He can hang that great achievement on the wall, right now.

A.M. Rosenthal is a columnist for the New York Times.

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