What We Talk About When We Talk About Health Care

A man comes in holding a shotgun, along with a sign that reads: Keep Government Out of My Medicare! There are others who come in, who are coming in, sitting down. Some of them have signs, too, but I don't notice them. I notice the guy with the gun. I think: this is like one of those dreams I had when I was young, when I was sitting in class and looked down and saw I wasn't wearing any pants. In fact, I'm pretty sure this is a dream. Why else would a dining room table be sitting in the third row, holding up a sign that reads: No Death Panels for Me!

While keeping an eye on the man with the gun, I ask the table what that means. Why would anyone want death panels for a table? Does he mean dividers? An extender?

The table replies (the fissure in the middle, where the divider/extender would go, moving back and forth, I notice, approximating the movements of an actual mouth) that you never can be sure what the government will do, especially one run by a foreigner who hates white people.

But tables? What does the government have against tables, I ask?

Who do you think took my chairs? he replies, and I shrug. How should I know who took his chairs. He goes on: When the first chair got taken, I didn't say anything. Then the second and third chair were taken. Still, I kept quiet. Finally, the fourth chair, my last chair, was taken. Now there is no one left to stand up for me.

When? I ask. When the Nazis come? I look around. Where are the Nazis?

You think this is all pretty funny, don't you, the table scoffs. You won't someday. Believe me.

I look over at the man with the gun. Carefully, dream or no dream, I ask him if he is aware of the fact that Medicare is, in fact, a government program. Along with Medicaid and the Veterans Administration. That around 55% of health care costs in the United States are picked up by the government, and so we're already over halfway to socialized medicine in this country, and have been for quite some time. In fact, I add—and here's the real kicker—these government-run programs are considerably more cost-efficient than their counterparts in the for-profit insurance realm.

That's impossible! a very small woman in the front row, holding a picture of President Obama, a mustache like Hitler's drawn under his nose, shouts.

Why is it impossible? I ask, keeping my eye on the guy with the gun.

Because everyone knows that all the government does is piss away money, you dumb son of a bitch.

I know, I know, I say, trying to be agreeable, since the woman looks meaner than the seventh grade nun who taught me math. And yet, I go on, perplexed, I have to wonder why the insurance industry is so worried about getting into competition with such a profligate bunch. You'd think they'd welcome the opportunity to make a point, about the glories of private enterprise—

They took my chairs! the table, interrupting, shrieks.

Right about then I notice a little man with a big head standing just above my left shoulder. He looks like Kazoo, from the old Flintstones cartoon, but I don't say anything. Remember, he says, half the people in the universe are below average.

I nod ever so slightly. I don't want the people in this room, in my dream, if this is a dream, to think I'm having a conversation with a little man with a big head hovering a few inches above my left shoulder. That would be crazy.

And keep in mind, he adds, that we have nutjobs, too. Only, I've noticed, Earthlings provide better entertainment for theirs. Especially this part of Earth. I like this part of Earth. It's very exciting, don't you think?

Who's he talking to? I hear someone in the crowd say.

I look out at the crowd. Why are you here?

To listen to you, comes one voice. To voice our concerns, comes another. When does the Bingo game start? comes still another.

What are your concerns? I ask, not really knowing what else to say. There's no way out, I see, but the door in back, behind the guy holding the gun.

He replies: We already told ya. We don't want the government running off with our health care.

And my chairs! the table chimes in.

Yeah!!! a lot of others shout.

But, I put in, hesitantly, Medicare is a government program.

You see? the man says. That's exactly what I mean.

Which is?

The little woman in front, with the Hitlerized Obama poster, says: You're just plain fucking stupid, aren't ya. You're nothin but a below average nutjob.

I tell them I really have to go. That I have an appointment with my psychiatrist.

The man in back slides the action on the shotgun he's holding. Not so fast, motherfucker. First you tell us where you stand.

On what, exactly?

On the Health Care Debate.

Oh, is that what we were talking about. I wasn't sure ...

That's cuz yer stupid, the little woman in front reminds me.

Well, actually, I'm in favor of a single-payer system, I say. I figure if I'm going to be shot, it might as well be over something. Maybe the noise of the blast will wake me. I look over my left shoulder to see if Kazoo is still there. He is, looking absolutely delighted. He confides to me that that's what they have on his planet, a single-payer system.

Medicare for Everyone! I shout, jubilantly, waiting for the blast. I'll either be a martyr for the cause or I'll wake up.

Amazingly, there is no blast. Not yet anyway. Kazoo, I can tell, is disappointed. The man with the gun says, I don't want no young whipper snapper taking my Medicare ...

No no, I point out, he wouldn't take it. He'd just have it. Rather than being uninsured and getting treated anyway when he runs his crotch rocket into a tree, and have those costs get passed on to all of us, since hospitals can't be looking like fancy hotels and not have something in the way of revenue to pay for it. I think we all agree that none of us want to be sick in some shitty-looking hospital ...

Let him get his own health care, the man insists. He has worries enough, wondering whether the government is going to take his Medicare.

Well, I admit, that is sort of the American Way. A patch quilt. Boutique plans, or the shit. The veterans have their health care, the old people have their health care, the poor people have theirs, people with good jobs have one kind of plan, and those with lousy jobs have another. Used to be if you had a job, I continue nervously, you had a plan, but that isn't necessarily the case anymore. And a lot of people who have jobs, who have a plan, have a really terrible plan, and they don't realize it, and don't care, until they get sick. And then there are all the people who are sick and can't get a plan, since why would a for-profit, private insurance group, whose job it is to make a profit for their shareholders, want to write medical coverage on someone they know already is sick? What kind of insurance company would do something like that? Unless it was required that they had to. I mean, you wouldn't take statistics in school unless you had to, right? What kind of nut would take statistics out of the kindness of his heart ...

You look like the sort, says the little woman in front.

I ain't never been sick a day in my life, says the dining room table with no chairs around.

Several in the crowd come running, offering to insure him on the spot.

Just tell me the government isn't going to run off with my Medicare, says the man holding the gun.

If you take that shell out of chamber first, I reply, bravely, foolishly, it's hard to say still.

He pops the shell out of gun, slips it in his pocket.

The government isn't going to run off with your Medicare, I say. We dope-smoking boomers aren't going to let that happen, I can promise you. It'll be our swan song. Wall Street bankers will be down to making five figures, from actual, non-subsidized by our tax dollars profits, before that happens, trust me. Look for boutique nursing homes. The return of candy stripers. I'm not kidding. Look what the boomers did for coffee. Remember when all you could get with noodles in it was spaghetti and meatballs? Seriously, you sleep easy tonight. Your Medicare is safe, as well it should be. Can I go now? Please? I'm feeling a bit sick—

Well, doncha be gettin sick in here, ya dumb son of a bitch, says the little woman in front. I wanna play bingo afterwards, and I don't want it smellin to the high heavens in here when I do.

I look up to see what Kazoo's thoughts are on leaving, but see he has already left. Poof. Off to someplace more exciting. The man in back with the gun agrees with the little woman in front. Get the fuck outta here, he says, opening the door for me.

Have a nice night, I say.

The door slams shut with a bang behind me, but I still don't wake up.