Peter Shelton

Let the Conservative Rumpus Begin

Posted in Confessions of a Grandpa, Watch columns by pshelton on March 24, 2010

After the health insurance reform bill passed the House on Sunday, I called our in-family doc (daughter Cloe is a radiologist in Albuquerque) to get her take on the changes.

We’d seen Cloe and Adam and baby Alexander in Farmington just a couple of days before when Cloe was moonlighting at the hospital there and Grandma and Grandpa drove down for an overnight overlap at the Hampton Inn and Suites.

The motel halls were stuffed with sleep-immune high school baseball, softball and tennis teams there for a big tournament weekend. But we didn’t care. We hadn’t been together since Christmas. Alex at 18 months was a wry, self-aware little man compared to the last time we’d seen him. Cloe was suddenly great with child. Her second, a girl, is due in May. And Adam, dear Adam, the non-traditional stay-at-home dad, needed to be taken skiing (at Hesperus, just across the Colorado line) by his father-in-law.

On the phone Monday, Cloe admitted she’d missed the dramatic Sunday night vote. She had just returned home from a routine, seven-month checkup. Violet, as she is being called in utero, has extremely long legs, as revealed by the ultra-sound images. “Maybe she’ll be a volleyball player,” Cloe mused. Cloe, together with her sister, was a star volleyballer at Ouray HS in the 90s.

In the background I could hear Alex shrieking, ala Where the Wild Things Are, as he careened his Tonka truck down the hall and out into the living room. Maybe, Cloe speculated, the new law will call for fewer CT scans and MRIs and ultra-sounds in the future as a way to reduce health-care costs. Certainly they are over-ordered now as doctors try to assuage their patients’ desire for certainty, protect themselves from malpractice, line their own pockets, and justify their $10 million machines.

The tenor of Alex’s cries changed, and off-phone Cloe asked, “What’s the matter, Mr. Z? Is your diaper pinching you?” For her part, Cloe has not been able to resist, with either of her pregnancies, the temptation to walk into her own radiology department at University of New Mexico Hospital and demand a fresh set of pictures of her growing baby. The fridge is covered with them.

“Maybe radiologists make too much money as it is,” she said, more question than statement of fact. “So, some cuts [in Medicare reimbursements for imaging, a likely component of reform] may be OK. Then again, all specialists—surgeons, radiologists, cardiologists—have more school, more training, more expertise, more debt.” Cloe is in her fourth year of residency. She and Adam barely get by on her salary and the moonlighting. She hasn’t been able to even think about starting to repay her medical school loans. That won’t happen for another two years at least. And they’ll likely have to borrow more money to get through a fellowship year she’s been offered in Boston.

“No, no, Sweetie,” Cloe cooed, not to me. “Not to put that envelope into Daddy’s water glass.” And then to me, “He’s really into putting stuff into things—his truck, his bath, a water glass. . .” Cloe has long decried the costly system of doctor training in this country, a system which regularly mints new doctors burdened by hundreds of thousands of dollars of debt. They have to earn big bucks to get out of hock. This isn’t addressed, as far as either of us knows, by the new legislation, although it is a piece of escalating health-care costs.

The other part which Cloe isn’t sure will change under the new rules, is the disastrous state of Americans’ health in general. Preventable stuff: obesity, diabetes, high blood pressure. “Maybe,” she said hopefully, “with more people covered by insurance, more people will get regular care, and the problems won’t so often reach crisis stage. Maybe.”

The screams of joy in the background I recognized as the ones that burst uncontrollably from Alex when his father whips him upside down by the legs and mashes his face into Alex’s belly.

Cloe has always had a strong sense of fairness, so she is pleased that President Obama and the Democrats have done something, imperfect as it is, toward that end. Perhaps it comes from her Berkeley-era, peace- and civil rights-marching father. Or maybe it derived from her time in dirt-floor birthing rooms in Madagascar. Or from her year studying in France, where the single-payer system (that’s “socialist” to you, Rush) is so universally popular there is no cause to yell and scream about it.

She knows she will be OK in the long run, once she gets out of her debt hole. She doesn’t need to be rich. But the debt worries her now. I can see it in her eyes, hear it in her voice. If Cloe had her druthers, I’m quite certain, she would reform not just the inefficient, barely moral ways health care gets paid for in this country, but the way we take our brightest and most dedicated and make them pay (and pay) to become care givers.

One Response

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  1. Mary Ann Dismant said, on March 25, 2010 at 2:24 pm

    Peter, What a polyphonic piece you’ve written for us this week. (Please be impressed by “polyphonic.” It simply means I listen to Colo. Public Radio a lot.) You do manage to make us aware of real aspects of medical care, esp. the high cost of preparing the care givers. The other melody playing above these bare facts is your inviting us into your daughter’s life, including son-in-law, 18 mos. old Alex, and long-legged Violet-in-utero. We, your readers, are distressed for Cloe’s financial burden, that it is observable to you. But there is also a great warmth in your including your family in your columns.I have a Conservative acquaintance who says, “Not to worry. It’s all going to be overturned in Nov.” Yah, Right.

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