"When did we see you, Lord?"

In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing (from the Hippocratic Oath)

A couple of days ago I was on the phone with my Mother. She has recently undergone cataract surgery for both her eyes - a series of operations that have brightened her outlook, both figuratively and literally.

Because of a program in the city in which she resides, and because she is on a pretty fixed income right now, the procedures were very nearly free. During our conversation I made the comment, "Hooray for socialized medicine!" Mother, a lifelong Libertarian and congenital contrarian, was quick to chide me.

"This is not socialized medicine," she insisted. "Socialized medicine would be terrible!"

This is what I would call a typical conversation between my Mother and I on such subjects, and it is a disagreement we have had for decades. For her, the Market (always with a capital-'M') is the Answer (again, you can almost hear the capital-'A') to all problems - social and personal and all the potentially-unhygenic crevices in-between. I am inclined to disagree.

I was in mind of this conversation these past couple of days as I came across the following two anecdotes, related to me by various friends.

First, one friend, just recently returned from five weeks in China, told of getting a cut on her ankle, which then got badly infected. After a couple days of just trying to let it heal on its own, the wound began turning blackish, and so she went to see a Chinese physician.

At the clinic, she was immediately seen by a (female) doctor, who instructed the (male) nurse, who in turn cleaned the wound and bandaged it properly. The infection was treated with antibiotics and is now fully healed.

Total time in the clinic? Less than an hour, with a translator, no less. Total cost of the antibiotics? $1.50. Total cost for the visit itself? Fifty cents, American.

The second story, slightly less rosy, involves a graduate school colleague of mine, who has taken part of the year off for medical leave. The leave is official, recognized by the University, and is, in effect, simply a "pause" in her studies. In other words, she is still a student.

However, she was recently informed, by the administrator of the school's insurance plan, that she would not be eligible for school medical insurance while she was on school medical leave. Never mind that (to quote the Book of Esther) it was for such a time as this that medical insurance was invented in the first place; my friend has been caught up in a bureaucracy with its own illogical logic.

While I am not privy to all the details of the discussion that followed, I am reasonably certain that the frank absurdity of this was noted to the administrator by my colleague.

The points I want to make here are the following:

1) as much as I may dislike the practices of the People's Republic of China on issues of liberty, I cannot fault them for having an inexpensive health care system that seems, at least on my limited knowledge of it from my friends who have been there, to work.

2) the argument often made against socialized health care - by my Mother and those of her mindset - is that such a system would be mired in bureaucracy and inefficiency, such that those who need care might not get it at the time they most need it. What I am observing, however, in my own health care and that of others, is a similar bloated inefficiency - with the added insult of an obscene price tag.

My evidence is all hearsay and anecdotal, I admit, but the physicians I have known who are idealistic and truly concerned for the full health and wellbeing of their patients were all encouraged by the partners in their practices to leave. One now works for the public health establishment. I have been acquainted with other doctors, as well, who were concerned chiefly with dollar signs. One such soul was recently involved in callously dispossessing Kira and I of our apartment when it became profitable to turn them into condominiums. So let the reader be aware I do have a bias in these discussions. Caveat emptor.

"Health care for profit" is not simply an oxymoron - it is a blasphemy. I think of another image - a college classmate, weeping openly at graduation, not for joy, but because she had both diabetes and rheumatoid arthritis and no job yet, and therefore no job-related insurance to replace the school's plan by which she would no longer be covered. She was weeping because, despite all the high talk of the Market and its forces of supply meeting demand, she was simply uninsurable - even if she could have paid the premiums, private insurance would have refused to cover the very conditions for which she most needed insurance.

I am aware that this is a complex issue, and I am aware that the answer is not simple charity. The Nazi's, after all, gave bread to the poor. But there must be a point at which reason - and reasonable kindness - prevails, mustn't there?

I do not care what it is called - whether it goes by the name "socialized medicine" or not - but there are countries all over the globe, of every stripe of politics and resource, that are delivering efficient and affordable, if not free, health care to their citizens. The quality of this care beats the best that the American medical market seems to provide; in fact, we're pretty low on the totem pole when it comes to the effectiveness of our care system.

So, to be blunt, call it what you will, but I am tired of waiting. Health care, by my lights, should be readily available, highly effective, and free. I have little interest in discussing anything short of that anymore. We can do it, and we aren't, and that is simple foolishness and petty jingoism.

So often humans are made to suffer so that the word choice of a few can be untarnished, or for some idiocy of ideological resistance. Systems put in place to preserve the systems themselves and not the lives put in their care.

We will be judged, I am told, by how we have cared for the least among us. They deserve better than we have offered them so far.