Family Practice

When ‘The Dog Ate It’ Might Have Been Better…

It was like most winter Sunday afternoons, with me and the kids lounging around watching old movies on TV and watching the snow fall, when Paul said, “Oh, crap, I have a report due tomorrow!” “What?”, I said, “When did you find this out?” “It’s because we got the new teacher a few weeks back,” he said evasively. “What does the new teacher have to do with this,” I asked, feeling my annoyance rise. Paul started stammering, flustered. “It’s not my fault! I offered to do it lots of times, since like 6 years ago, but our old teacher wouldn’t let me, and now suddenly the new teacher wants it like tomorrow, and so now I have to do it by then.” That threw me. “Wait, what? You’ve known about this for 6 years and you’re only now getting around to it?” Paul’s voice rose as he got defensive. “You’re not listening! I told you, the old teacher wouldn’t LET me do it, and suddenly the new teacher wants it tomorrow!!” “Ah, god,” I said, exasperated but hardly surprised, “Well then I guess you’ve got some work to do. Turn off the TV and get cracking.” I didn’t even bother to ask what the report was about, and Paul grumbled as he stumped off to his room. Like I said, pretty much like every Sunday.

I didn’t see Paul for the rest of the afternoon. At dinner, when I asked him how the assignment was going, he just said “OK” in a tight voice and went back to his room after finishing. Paul emerged around 9 that evening, looking proud and defensive. “I finished it,” he said, “do you want to read it?” “Sure,” I said, “let’s have a look.” The title was “Health Care For America.” “Wow,” I said, “that’s a big topic,” trying to conceal a growing  concern at seeing what a complex issue he had to tackle and the limited time he’d allocated to do it. “That’s what the teacher told me to do it on,” he said, and when I reminded him that he’d told me earlier that this was something he’d volunteered to do for the past 6 years, he just said dismissively, “Well, whatever, the teacher said it would be ‘so easy.’ Do you want to read it or not?”

The report was pretty slim, and started with a list of things it was to achieve: provide coverage for everybody that was cheaper than their existing coverage, provide more options, save the country money, and be “something terrific.” “Um, ‘something terrific’? Isn’t that being a little presumptuous?”, I asked, trying to sound non-judgmental. “That’s what the teacher told us it had to be,” Paul declared, his voice rising, “Those were the teacher’s exact words! ‘Something terrific’!!” “OK, OK,” I said, trying to calm him, “I guess it’s good to be optimistic. Let me read some more.” I started into his description of what he was going to do, and a sinking feeling started coming over me.

“Uh, Paul, there seem to be a lot of gaps in here, and inconsistencies, compared to what you said you were going to do at the start,” I said, choosing my words carefully to keep him from storming out in anger. “Like what,” he demanded, jutting his chin out. “Well, for instance,” I started, unsure exactly how to put it, “it seems like you don’t really cover everybody. It says you’re going to give people tax credits to help them buy insurance, but it doesn’t sound like you’ve given any thought about whether the credits would be enough for them to actually afford it.” Paul frowned and said, “You completely missed the key point: choice! Everybody will now have the choice of whether or not they want to buy insurance! The tax credits are there to help them if they want it.” “OK, but it says here the size of the tax credits depend only on age and not on income. That makes it look like a lot of people with low incomes won’t really have a choice since they won’t be able to afford it even with the tax credits.” “But it’s their choice!”, he replied indignantly. “Do you want me to force people to buy insurance? Or force everybody else to pay for it? That’s un-American! And if they choose not to use the tax credits, that saves the country money!” “Well, OK, but it still sounds like lots of people who have insurance today will no longer have it under your plan, whether it’s because they can no longer afford it or because they choose not to buy it,” I said. “Is that a good thing?”

I could see Paul starting to get frustrated in the way he does when he’s cornered. “You don’t know that. Maybe those people will choose to buy insurance instead of, like, a new iPhone! Or not!” He grinned smugly. “After all, it’s their choice, and that’s what’s important in a free country, right?” I managed to keep from rolling my eyes. “We ‘force’ people to buy car insurance,” I asked him, “is that taking away their freedom?” He scowled and said dismissively, “That’s to protect the rest of us! There’s lots of stupid drivers out there! And people can choose not to buy car insurance if they choose not to drive!” “So who protects ‘the rest of us’ if an uninsured person needs expensive health care,” I asked him, “who pays for that? We all do anyway, don’t we, in higher medical costs? And can people ‘choose’ not to get sick?” Paul glowered at me. “Well that’s not my problem, is it!”, he shouted back, grabbing the report from my hand and stomping out. “You just don’t get it! It’s about choice!”

I didn’t see him again until dinner the next night. Paul was looking surprisingly chipper. “So, how did the report go today,” I asked, expecting his mood to darken. “Great,” he chirped, “I got an A!” I couldn’t keep the look of surprise from my face. “An A? Really?” “Yes, really,” he said, looking at me smugly. “Guess you were wrong, huh? The teacher said my plan was ‘super!’ I really like this new teacher!”

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