I am dumbfounded by the endless line of pilgrims on their way to the holy shrine of disability.  They come to me, relatively well-appearing, and express their intense frustration that their Medicare, Medicaid or Disability have not kicked in, have expired, or have not done enough to ease their sorrowful way in this dark, hard world.  Most of the ones I see are not paralyzed, not broken, not brain-injured or bed-ridden.  They look remarkably like…my partners and me!  But somehow, their back pain, their anxiety, their depression all seem to render them entirely unable to work at all.  Except under the table, that is.

I am flabbergasted by the young men and women who are angry that they can’t get Medicaid.  I am surprised by the well-to-do elderly who are bitter that Medicare doesn’t cover more of the things they either need, or simply want.

And I am devastated and stricken speechless by the way patients, who are not dying or in danger, look at me and say, ‘well I’d see my doctor, but all he wants is money.  He expects me to pay him and what am I supposed to do?’

The finances of medicine and the expectations of the populace are beyond anything I have ever seen in my life.  The main concern seems to be this:  why isn’t someone else paying for something for me?

I know some can’t help their situation.  But everywhere I go, everything I read, the message is that ‘someone else’ will always meet the needs of the individual.  Never mind that the government, or the insurance, is all a collective that takes from one set of individuals to give to another.

As taxes are set to increase, and fees are set to increase, and jobs are disappearing and benefits are extending, at what point will it all collapse, dear friends and readers?  This is not partisan; right and left are both guilty.  But more guilty is the human heart!  The human heart which always expects someone else to be accountable.

It cannot go on.  We cannot give endlessly to the irresponsible by taking endlessly from the responsible.  And physicians will eventually stop playing, because there is seldom even the compensation of true gratitude for the gift of free services.

One of our nurses had a minor infection, and came to see me in the ER on her day off.  She brought me a milkshake.  I never asked for it, and I would have helped her for nothing, and gladly.  But she offered a small compensation, a small gratitude for my time.  It was kind…and delicious.

But our world now is full of those who want only more, never less, and never paid for out of their own effort or even compensated by their own thanks.

The camel is straining, friends.  I fear it won’t be long.


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