“Why are you here, today?” the head nurse asks,
with that bemused half smile that can’t conceal
her awareness of her role in the play.
“Why, I’m here to address the Ampitheatre
On the subject of health care reform in the United States!”
I reply, ever confident that my role as the customer
will excuse me from impatients, and impertinence bordering on autism.
First, I want to acknowledge those
who couldn’t be with us today;
The stockholders, the 1% of us
who have to own more than 90% of the rest of us.
We understand that you had to attend to
more urgent priorities, so we’ve set out
some empty VIP chairs in your honor—right up front.
If only the thrill of the chase could protect you
from playing my role in Act Five.
Like that adrenaline rush, it’s never enough.
In Orchestra Left, welcome the hospital administrators,
degrees carved in Mesopotamian clay!
May your utilizations always be reviewed,
and your words drop like leaflets from bomb bay doors
on outcasts of most races, colors, and creeds!
We’ll join you by the high-risk pool when the anesthetic wears off,
And share a glass of the finest red.
In Orchestra Center, the durable medical equipment manufacturers!
My dad worked in hardware, too,
but he could have learned a thing or two from you
about thrift, economies of scale, depreciation, and
the occasional violation of ISO 9000 guidelines.
Welcome to our play!
In Orchestra Left, the pharmaceuticals!
How could we deal with the stress without you?
Your commitment to public service notwithstanding,
your cutting-edge cures, like 18 percent profit margins,
a measurable improvement over electroshock therapy
and boxes of leeches! We salute your ingenuity, Big Farmer,
pray that all natural consequences will spare you,
and pray again for generations to come, or sterility,
or suppressed research findings, whichever comes first.
The spotlight falls on the physicians!
Let the harsh white light misdirect our attention from
the MBAs and attorneys in the balcony.
Are they patenting our genes on those laptops,
avoiding exposure to viability, or
recalculating patients seen per hour?
It’s always so hard to tell.
Let silence drape the room in deference to
the dedication and skill of our doctors;
their collegiality, their freedom from superstition and error,
their utter lack of arrogance or presumption.
May their student debt be forgiven,
their billable absences excused, their handicaps beaten,
their every word published, and their right to practice medicine
restored in a polite, conflict-averse parallel universe of their choice.
Lest we forget the insurance companies—they’ve hired
2.4 lobbyists for each member of Congress in our honor.
Two million strong, conversations recorded to assure
denial of service, waiting for retraining and retooling
that never seems to arrive before we go on hold.
May the crucible of history overlook the broken bones,
the broken homes, the wine and cheese parties,
the bankruptcies, the board junkets, the desperation,
the third homes, the suicides, the private jets,
the marketing lies, the yachts, the claims and counter-claims.
Our attention spans grow shorter with each billing cycle; and
we don’t believe in evil, anyway—only maladaptive behavior.
Look in the diagnostic criteria under sociopath.
Why do we seek group therapy behind locked doors
instead of the pike? Because that’s what we do.
Before I fall into conscious sedation, I doff my foolscap
To the front-line staff and caregivers, fellow victims of cuts,
skillful, graceful lords and ladies of the bedside manors;
whose patience, work ethic, political savvy, and
remnant humanity prevail over the system daily,
despite the presence of everyone else in the room.
Keep those wings hidden under your clothes, people. If they see,
you’ll have the mother of all union battles on your hands.
Goddess knows that if it weren’t for the union,
You would eat dog food for dinner tonight,
and be sent to bed without so much as a mouthharp.
I haven’t forgotten the elephant in the room,
the answer to your original question;
the reason I’m here today,
without which all of this would not be necessary.
Please raise a glass of electrolytes with me to
our existential fear of pain and death!
If it weren’t for that, how could we ever have built
the greatest health care system in the world?