Nationalized - The Story

2009-04-30T21:30:00.007-06:00

Nationalized
By Kristi Joy Matovich
Copyright: 2009 Kristi Joy Matovich

He looked over the medical files. Years of careful records neatly stored for reference. Few would have been able to make sense of it all, he thought, only those who had been forced by circumstance to learn, and the doctors themselves. However that was though, he was quite certain that no bureaucrat was going to try to read, let alone make sense of, all these complicated documents. That meant that he had to write something as simplistic as is possible when dealing with medical lingo, and yet with enough proof to support his point.

Dr. Jared Torvan’s world had been pushed over the edge only eight weeks ago. Many of his countrymen, along with fellow doctors, were looking forward to the advances in care that would certainly be made soon. After a long offensive that began with shaky support in the first years of the 20th Century, proponents had propelled the United States into a nationalized healthcare system. The U.S. had supposedly “caught up” with her European allies by doing so. Ever since 1914, when the American Medical Association officially endorsed a small form of nationalized health care, the fight had really been on. Now, those who had fought constantly for years finally had what they wanted, but Jared already didn’t like it. He had even supported the effort recently, until just a week before it was signed by the President.

“Dr. Torvan?” One of his patients had asked, “What happens if the new government healthcare doesn’t let me get that particular medication any more? I mean, I’m worried because that’s the only one that has worked, and I know it’s the most expensive of all the options.”

Suddenly, he hadn’t really believed his own voice as he answered the older lady that her prescriptions would continue as usual. Would they? That evening he had looked into that very thing, and began having significant doubts about the entire system. For once he had been glad that he didn’t have a family of his own, as he was awake far into the morning trying to determine what it all really meant.

Now, it had been brought too close to home. A number of his relatives had various health issues, and they were already feeling the pinch of government regulations on their medications, care and access to information. Jared had become the family medical advocate, partly because he was a doctor and especially since he didn’t have familial responsibilities in his own home. At first he thought that they wouldn’t really need that much help. He didn’t have a lot of trust in the system, but surely it couldn’t be too bad when they had long histories of illness. He soon found himself wrong, so wrong that it nearly worried him to distraction.

A week ago, just seven weeks after the new system had been instated, Jared had expressed his concerns to a colleague in the area. His friend, Dr. Kent Reed, had tried to laugh him off. “Jared, come on, do you see any slack in your practice? Heard anything from the ER guys? People who have never been able to get proper care are getting it, and I guess the people who always have gotten it are too, right? So don’t worry, there’s always going to be a sob story from somewhere, there was before when it was all private too, remember?”

Jared had felt his stomach turn, but how could he hide the truth from him? “Kent, some of my family members have had chronic difficulties for years. They’ve been seeing specialists, some went partially ‘natural’ with supplements and herbs and stuff, but they all need doctors available to them.” He felt the need to drop his voice so they wouldn’t be overheard. “Kent, they can’t get it. No one will treat them. They’re having trouble getting prescriptions, simple things like antibiotics, because their situations are uncommon and insufficiently researched so no one believes them. My Dad even has a cardiac problem that isn’t uncommon at all, but the medication is very expensive, so they’re refusing to provide it. You know why? Because it isn’t life threatening, they claim it isn’t worth it. It’s early still, but I already have five patients who are asking me about similar situations.”

Now, Dr. Jared Torvan had called, written, emailed, accosted and cross-examined everyone he could think of in order to figure out how to help his relatives, as well as his patients. It hadn’t gotten him anywhere. His only recourse was to write official claims and hope that something came of them. How could he prove it? His mom had an immunologic disease that no one had really be able to figure out. The only thing she could do was stay on one particular antibiotic. That, at least, let her function pretty well. But no one treated immunologic diseases with long-term antibiotics! It sounded silly! His dad with the cardiac issues - how could he approach that? He had a three-year-old nephew who hadn’t been officially labeled with Down’s Syndrome, though the family knew that something was wrong, but now couldn’t get help. How could he prove it?

The stories went on and on, beyond his family, beyond his practice.

______________

“Thank you for watching channel five morning news hour. Over the past eight months, a significant number of medical doctors have arisen who are concerned about the effectiveness of the new nationalized healthcare system. Until now, those doctors have remained fairly silent, mainly discussing issues amongst themselves. But now, we are pleased to bring you a special guest, one doctor who has become so concerned as to feel the need to make his thoughts public.” The young woman turned, the camera now revealing Jared. “Dr. Jared Torvan, it’s a pleasure to have you on with us.”

“Thank you, Rhonda, and likewise.” How much of his apprehension could he get across in this setting? He only hoped this young woman, who likely knew practically nothing about medicine or how the new system really worked, would just let him talk.
“Dr. Torvan, let’s launch right into things here. Could you summarize just what it is about the healthcare system that bothers you?”
“Well, to start with, it doesn’t just ‘bother’ me. I see some very serious problems occurring that cause me as much concern as I have perhaps ever felt for any issue, medical or political. As for what causes those concerns, there is a long list, but a very basic form is this: There are people with serious health issues that need various forms of care including medication, therapy or surgery, who can not get it, and will not, because this system is their only option. No one can help them.”

Rhonda broke in. “But Doctor, hasn’t the government installed a way to redress grievances when things are overlooked or inappropriately handled?”

“Yes, that was built in to the system, but when you try to get the government to ‘redress grievances’ as you call it, you are not dealing with doctors who understand what needs done, but bureaucrats who don’t care…”

“Doctor! How can you say they don’t care? Why, these men and women were chosen particularly for this job and are well trained, are they not?”

“I didn’t say they don’t care in general. If you had let me finish I was going to say that they don’t care so much about the medical realities as they do the monetary realities.”

“Now, Dr. Torvan, of course the entire system was built in such a way that money does not influence what procedures are allowed, we’ve all read the information the government provided. It doesn’t really work the way you suggest…” She ended leadingly, evidently trying to get Jared to back down.

Jared sighed impatiently. “Rhonda, when is the last time you were at a doctor for anything besides a cold or something like that?” He paused as she acquired a rather blank look. “I would guess not since healthcare was nationalized. So, if you don’t mind, allow me to educate you and your viewers on just how this works in real life.” He turned toward the camera, giving up on this news reporter and her prompter. “I know that it looks promisingly fair and honest on paper. Pardon me for saying so, but so did the USSR and the People’s Republic of China. Off paper, we have some huge problems. I know of no better way to tell you of them than to recount personal experiences from myself, my relatives and my patients.”

Rhonda was glancing around nervously, realizing she had lost any control she had on the set. “Dr. Torvan…”

He ignored her, and kept right on going. “First, my family. My father and mother each need a particular medication in order to function at a good level. My father, a simple blood pressure medication, my mother, a particular antibiotic. Neither of them can get what they need. I quote here from the answer I received from those bureaucrats that are supposed to redress grievances, ‘The illness experienced neither impairs the ability to independent living nor is life threatening, and therefore, does not need treated.’ That is the answer I received on both counts. Allow me to mention that without these medications, my father’s blood pressure rises and falls continually, causing him fatigue, migraines and generally ‘impairs’ his ability to live a normal life. My mother easily catches any and all sicknesses to which she is exposed, and is also assailed by fatigue along with odd and uncommon symptoms.”

He paused for a breath, looked at the clock, and decided to rattle off as many of these situations as he could, before the woman interrupted him again.

“I have a nephew with serious brain damage similar to Down’s Syndrome. However, because he never received that diagnosis, I received an answer from the bureaucrats that he can not receive treatment by the entourage of specialists he has great need of because I couldn’t prove him to actually have these problems! Here are a few patients I’ve encountered and heard of: a fifty-six year old man with a history of heart attacks was unable to receive some of the preventative measures that many believed would help him. A twenty-four year old woman with Chronic Fatigue Syndrome had improved greatly while using a simple muscle relaxer at night in order to sleep - the first medication that had ever worked for her. Now she can not get it, because she has never been labeled with a sleep disorder - a label that is not warranted nor should it be needed in order to receive this medication. A sixty five year old man can’t get his pain medication for severe arthritis, a forty-nine year old woman can’t get her medications that counter her nerve damage, a twelve year old boy can’t get his medication for seizures, and neither can an eighty-two year old man otherwise in good health! All these people can’t receive treatment because life is not threatened and independent living is not impaired. Here I’ve only listed a very few of those who can’t get medications, simple things medically speaking. I won’t even begin listing those who need more complicated treatments, surgeries, specialists, et cetera and receive responses that they must wait indefinitely or that their situation is futile, and therefore doesn’t deserve treatment.”

Rhonda appeared to have gathered herself somewhat. “Dr. Torvan, you have mentioned some very alarming instances, but are these really wide spread, or is this something that you see only in this area?”

“I’ve talked to colleagues all over the nation. Listening to those who are willing to admit such things over the phone, I hear the same stories over and over. People simply can’t get treatment.”

Rhonda actually looked worried, but still skeptical. “And you’re saying that all these people you mentioned have sent in official claims?”

“More than that, Rhonda. I sent in many claims personally - dozens of them. I write them as a medical advocate, and the fact that I myself am a medical doctor is supposed to help. Whatever government paid paper shuffler opens and sorts those claims is probably pretty sick of me by now. But I’m not going to stop. These people need representation, and many are simply too sick to represent themselves.”

“Well, we’re nearly out of time, but I’d like to ask, what do you plan to do in the future, are you going to make this into some sort of public crusade, or just keep working at it from the personal level?”

Jared paused, thoughtful. He hadn’t intended to go this far, but she had given him the perfect opportunity. How could he not, when so many needed help? “Rhonda, America has nationalized her healthcare. That means that what has always been personal issues are now the problems of the entire nation. We can no longer make the decisions for ourselves. Instead, a bunch of bureaucrats that supposedly represent the whole nation make those decisions. So, by definition, this is no longer a personal issue, it is an issue that everyone must become involved in, and involved on a national level.” Jared gathered all the moxie he could, and said what he feared could start a fire storm. “I and a few other colleagues are working together to find the best way to fight this system, and we will be doing all that we can, far beyond these claims. We will not stand for these patients being treated this way. Nothing is worth this, and we will find a way to put an end to these despicable acts.”

Rhonda sat shocked, but roused when the music started, just as she was programmed to do, and said flatly, “Thank you for your time, Dr. Torvan, we really appreciate your thoughts. When we come back, we have an unbelievable story from our very own Rick Graves, don’t miss it.”

______________

Jared’s phone was ringing off the hook by the time he got home after stopping in at his practice for a few hours. His answering machine was nearly full, and he was almost regretting that he had said what he did.

A few of the recorded messages were from close friends and family congratulating him on the interview. Some were from a few small time reporters for the local newspapers asking if they could get a statement from him. The majority, though, were from people thanking him for making their difficulties public. They didn’t know that anyone in the medical community really cared, and they were overjoyed, also wanting to know what they could do to join him in this effort they seemed to assume he was heading up. He would have to listen to those more carefully later, and find out how to make his phone number private. The message that really caught his attention seemed to be from Dr. Kent Reed. “Hey Jared, would like to meet with you. Call me.” That was odd. Kent loved to talk, even when no one was listening, and he hadn’t even said who he was.

______________

That evening, Jared met Kent at a small restaurant. After a few words regarding how the interview itself went, Jared dug in.

“Kent, what’s up? You’re acting really strange, is something wrong?”

“I called from the office, and to be honest, I didn’t want anyone to know I was calling you.” Jared gave him a confused look. “Listen; remember when you first mentioned your concerns to me when this had just started? Well, I looked into it, and found exactly what you did. All of it, and some of it worse. It’s a crazy mess. But I haven’t done one thing about it, you know why?” Jared shook his head. “I don’t know what to do, or how to do it. But mainly…” He paused, glancing around nervously. He continued in a near whisper. “You know you could get in huge trouble for this.”

Jared sat back, surprised that this was the reason Kent was meeting with him. Dr. Kent Reed, of all the doctors Jared had ever met or heard of, was the one who was always willing to apply new ideas in medicine, giving anything a chance to improve a particular case. Jared said as much, and then added, “I saw you as being the same outside your practice. Aren’t I doing exactly what you’ve done for years, and had great success at, by the way, just not regarding a medical procedure?”

Kent shook his head forcefully. “You don’t see what we’re into here, do you?”
“We? I didn’t know this was a ‘we’ venture yet.” Jared received a glare for his comment.

“‘We’, as in doctors in general. I think you missed something huge, and now I only wish I had talked to you about it sooner, and maybe you wouldn’t have done what you did today.”

“I did what I felt needed done. People…”

“Jared, stop. Just listen. In the interview you mentioned that a lot of these decisions about provision of care are monetary, right? Well, apply that thinking to yourself, actually, all doctors and medical personnel. Who pays us? The government. And right now, what is the government to us? I can tell you what it isn’t, it’s not like a private insurance company. When we were receiving our actual checks from the insurance guys, we still weren’t beholden to them. Why? We were always handling at least three or four at a time. Now, it’s different. The government gets its money from the citizens, sure, but it’s paid out totally different. We only have one way to get paid, and that’s through the government, and we don’t have one darn thing we can do about it.”

“Of course I know how I get paid, Kent, but I don’t follow.”

“Just what I said at first. You think those bureaucrats are just following the money, so-to-speak? What do you think this whole system is designed to do? Surely someone figured out that the doctors, of all people, would know what was going on, and someone figured out real good that they don’t have to worry about us. Why? Because for us to survive, for our families to survive, we have to play along so we can get paid. We have to treat and not treat whoever they say to, with whatever treatments they say we can use. And I can assure you, anyone that makes too big a fuss is going to get canned, and that may not just mean fired, either.”

They were both silent for a while.

“You’re saying that I should back off?”

“You can’t do anyone any good if you don’t have any income, or a license to practice, right?” Kent waited expectantly.

“Wrong.” Jared stared at the table for a long moment, and then looked at his friend. He spoke slowly, but with a determination that flowed strong. “I can’t stand by and watch this. Someone has to do something. I can understand others being too concerned about their families and things like that, but that doesn’t apply to me. I can’t bring myself to not help all the other families that are going through such trying times.” Kent tried to interrupt, but Jared held up his hand for quiet, and continued. “You’re right about the risks, and you’re also right that I hadn’t thought that far. But I have now, and I’m not going to back down. We’re only in the first year, how much worse is it going to get? A lot of people are predicting that the entire system could be bankrupt in five years, if not sooner. Remember when Hawaii had that universal child health care deal? They ran out of money in seven months, and had to quit the program.”

“So let it run itself out, and we’ll be fine. There’s no need to expose yourself to so much trouble and risk.”

Jared shook his head, ideas springing up faster than he could talk. “That won’t work. In Hawaii, there was still a private system left, so everything worked out okay. Now, though, there isn’t a private insurance company left in the country. What will happen if the government just suddenly has to shut everything down? There’s no infrastructure, there wouldn’t be any prerogative on providing or receiving care, no guidelines for doctors to get paid, any of that. The government must be the instigators - not of new companies, but of a phasing-out period. The current system would have to be slowly deconstructed to give the private sector time to rebuild what was lost.”

Kent sighed resignedly. “It would appear I’m not going to talk you out of this. You’re deep in it. Scary part is that what you’re saying makes so much sense.”

“I’m not really that ‘deep’ yet. Frankly, on the whole I’m thinking out loud.”

“Well, I hope it works, and please know that I’m with you on most of this, but I can’t put my family at risk.”

“Would you do me one favor?” Kent shrugged in response. “Would you at least give me a list of people that you think would be interested in some sort of action? I don’t even know where to begin myself, but someone, somewhere, needs to start talking and thinking about what can be done.”

“Sure, Jared, I’d be happy to, as long as you leave my name out of it. And as for what to do, sounds to me like you at least know what you want to ask for; this phase-out idea makes sense, you know?”

______________

Jared, ever since that first television interview, had wanted to speak directly to the nation, and not just the public. He wanted to communicate his message to the lawmakers in Washington D.C. who were supposedly representing the good of the people. Now, they themselves had given him a soapbox on which to make his stand – literally.

“Dr. Jared Torvan.”

He stood, and walked up to the stand. After some formalities, he began in earnest.

“I am here today to testify regarding the gross discrepancies, no, the outright wrongs, that have occurred since this government nationalized the American healthcare system over two years ago.” He looked around the congressional hearing room, one of the larger ones, he was told. All he saw staring back was cold faces holding colder ears. They weren’t going to listen to what Kent had called ‘sob stories’, and yet, they needed to hear them so badly! “I would also like to mention a few actions that I believe would bring this country to greater heights medically than will ever be possible under the current system.”

Politically analytical, that was how he had to speak. He was a doctor; of course he was analytical, but political? Not. However, he summarized his points with the best explanation of his views that he could muster.

“When a problem is individual, it can be dealt with as such, by people who care. When a problem that is normally experienced and dealt with by a single person is nationalized, things become far more complicated. That issue must now be handled with the perspective of the entire country’s welfare in mind. In our current situation, this always leads to the problem being pronounced ‘not worthy’, even as that individual trades capability, wellness and life for incapacitating pain, incessant sickness and even death.”

______________

Dr. Torvan was now a widely recognized name. The movement he had started was growing, and the website a friend had put up helped a great deal in handling that growth. It gave them a sort of portal through which to broadcast their message to the curious, as well as a central place for everyone to come for the latest news.

Jared had to admit that he was particularly fond of the motto that he had insisted upon being at the top of each page. He figured that if a person only read the motto, it would be enough to let them know what the movement was about. It read:

“The individual cannot have his own unique problems appropriately handled by an entire nation.”

It was the most succinct sentence he could come up with. Others had suggested more catchy things, but, call him a political dunce, he wasn’t in to ‘catchy’. He wanted concise truth. In his own mind, he computed it with the idea that the problems of an entire nation can not be handled by one individual - the basic tenants behind the idea of a democratic-republic.

As for news, Jared had taken to writing short letters about what was happening and where things were going. He also put in little bits of explanation for those who hadn’t been involved for very long. He didn’t do much with the website, but he did know how to ‘post’ things. His most recent letter had just gone live, and he was pleased with it.

"It has now been two and a half years since the medical issues of the individual were made the concerns of the entire populace. Those who see the wrongs being done by the government have done what they could, and have much to be proud of. The Congressional Hearings of last week went well. Our ideas were by no means welcomed with open arms, but neither were they fully disregarded or punished as of yet. As I spoke, I saw our so-called representatives go from disgust of our principles to acceptance that they have some foundation, and not only in theory, but more importantly, in reality. Few are willing to act, but a near-majority recognizes that the problems exist. This is recognizable progress!

"Of course, there have been setbacks. The legislation we were so hopeful for - and that could have helped so many - was killed almost before it was born. But, we have learned from that experience, and are taking different tacks. Those of us who are the most visible and heard - the voices, if you will, of our movement - have had various personal difficulties. Many have experienced public ridicule, while more have lost friendships and medical partners. In what is for now the extreme case, such as my own, jobs have been lost, licenses revoked, and family members have received pressure. Add to that the knowledge that these actions against us will likely increase before they decrease, and I truly admire the perseverance of all those involved.

"Quickly, for those who are newer to our movement, let me reiterate the reasons we are experiencing these personal difficulties. Actually, I can tell you in six words what all of these problems lead back to: power extended through monetarily influenced decisions. From the care that is provided to the doctors who are paid, it’s about making the money work. Most people particularly have trouble connecting the dots to the doctors, though. Here’s how it works: Doctor ‘A’ doesn’t like the national system, sees the problems, and therefore works against the continuance of that ailing system. Doctor ‘B’ may or may not like the national system or see the problems, but either way he keeps quiet. Doctor ‘A’ is jeopardizing the power of the bureaucrats, Doctor ‘B’ isn’t, so Doctor ‘A’ gets tossed. Simple as that; absolute power corrupts absolutely, ending in the survival of the weakest. Also stemming from this is the rapid decrease in medical students. Who wants those kinds of stipulations for employment?

"However, even with all the hurdles to jump and arrows to duck, we will not give up fighting for what we know is right. For now, I am still handling aftershocks from the hearings, but we have a number of ideas waiting in the wings. Those will be acted upon as soon as possible. I am not going to pretend that we are on the verge of victory, or that we even have a complete view of how to attain our goals. It may take quite a few years - perhaps five or more - before we return our healthcare system to a private endeavor. We are, though, making small yet recognizable headway, and that will continue as long as we do, and I for one am not going to stop."

- Dr. Jared Torvan, non-practicing physician

______________

Kent was meeting with Jared at that same small restaurant where the latter had first hatched the ideas he was now disseminating. Kent, although still very reserved, supported the movement in small ways, and helped his friend brainstorm when he could.

They discussed the letter Jared had put on the website, and all that had been done. Kent saw that his friend was as enthusiastic as ever, but seemed fatigued.

“So, Jared, is it worth it? If you had it to do over again, would you still have started all of this?”

The reply was immediate, but didn’t appear merely habitual. “Absolutely. I may not be able to practice anymore, but I must work to help others be able to do so in a free manner, without dictates from bureaucrats.”

“How long do you think this will go on?”

“You read the article.” Jared avoided Kent’s gaze.

“Is that what you really think?” Kent said, as he sensed much hesitation in Jared’s tone.

“No, not really.” He conceded. “I think it will be much longer than that.”

“How long?”

“The first moves towards government run healthcare in America started in the early nineteen-hundreds. I think private healthcare may take as long to rebuild as it did to tear down in the first place. I hope I’m wrong, but I rather doubt it.”

“Wow.” Kent hadn’t expected quite that long an estimate. “Too bad it took doing it to realize what it would mean.”

“Actually, we had a fine way to realize what it would mean. Europe and other countries had tried and tried again to make it work, even as the process continued to be disastrous. Crazy thing is, even though nationalization was originally presented as a way to bypass the high cost, corruption and ‘limited’ availability of private health care, what did Europe experience, and what do we have now? Even higher costs as taxes skyrocket, horrible corruption of the bureaucrats and an enormous lack of availability. I think my next letter will pound out those points a little more thoroughly.”

“Sure wish someone would have spoken up. Couldn’t anyone comprehend that a bad idea is a bad idea?” Kent meant it rhetorically, but Jared rolled right on.

“Oh, many did, but too few paid too little attention. There’s no good in looking back now, though. We’ve got to do what we must, and it’s going to be a very long and hard road. We’ve all been nationalized, and it will take a lot of work to make the government recognize us as individuals again.”