Gotham Diary:
Platelets
2 July 2012

Later this morning, I’m due at the doctor’s, to have blood taken. The blood that was taken when I had the infusion of Remicade two weeks ago showed an abnormally low (but just abnormal) platelet count, which could mean, as the rheumatologist put it on the phone, “nothing,” or it could, I surmise, mean that I’m going the way of Nora Ephron. Life is so exciting!

I wonder if anyone one finds it strange that I have not mentioned the Affordable Care Act in these pages, not once, I believe. I am certainly not opposed to its provisions, and I was as pleasantly surprised as anyone by Chief Justice Roberts’s unexpected support for the Act as a tax. But ever since “health care” was very prematurely rushed into Congress for its peculiar brand of intensive care, in the early days of Bill Clinton, it has been so clear to me that charging for health care properly must precede paying for it that I can take no interest in the schemes that have been unrolled over the ensuing two decades. They’re all definitively stupid, in that they attempt to bandage bruises from the knockings of a congeries of medical practices that was never designed to work smoothly or consistently for a large number of patients. On the contrary, it was designed, to the extent that it was designed at all, to provide the executives of large corporations with free health care: a classic example of American socialism for the rich.

But no one seems at all interested in the history of our medical plant. How did it become what it is? I don’t think that arrangements for the equitable payment of doctors’ and hospitals’ bills can be made by people who have never given that question much thought.