Lionel Shriver - So Much for That

Shep shook his head. “Glynis and I have always kept to a tight budget. Trying to build that nest egg for The Afterlife. We’ve waited for the two-for-one offer on shampoo. Bought toilet paper in the economy size of twelve rolls, single ply. Got the special on turkey burgers even if we were more in the mood for steak. Now it’s five hundred for this, five thousand for that … And they never tell you in advance what it costs. It’s like going on a spree, piling all this shit on the counter, and none of it has any price tags. We only pick up twenty percent in co-insurance, but that’s after the five-K deductible. One single lab bill – that’s a hell of a lot of toilet paper.”

“Double-ply,” said Jackson.

“I’m thinking, why did we ever eat turkey burgers? And then I remember that I’m not supposed to care. Ultimately, I don’t care. All that matters is Glynis.”

“That’s what they’re counting on, bud. That’s the whole scam in a nutshell. Same with Flicka. It’s your kid, right? So what are you gonna say, no we’re not going to treat her pneumonia – again – cause we want the kind of DVD that records? And, friend … I hate to say it, but for you this is just the beginning.”

“I know,” said Shep quietly, as they hung a left on Ninth Street and headed for Prospect Park. “Even to cover the last stack of bills … Well, you know I’ve kept this other account, where I put the proceeds of the sale of Knack once I paid off the feds. It’s earmarked for The Afterlife, and I’ve never touched it. But there wasn’t enough in our joint checking, so I had to tap the Merrill Lynch. I’d never written a single check on it. Number 101 went for the CAT scan.”

“My guess is you’re already on 115. Take my advice, and order another checkbook pronto.”

“Signing that first one was strangely emotional. Even if it’s ‘only’ money, as my father would say.”

“Yeah, ‘only’ the proceeds from over twenty years building your own business. ‘Only’ eight years of humiliation with Randy Pogatchnik.”

“It doesn’t matter. I just didn’t realize at the time what I was really saving for.”

“You ever think about it? Pemba?”

“No,” said Shep, and changed the subject. “I guess we’re lucky, though. We live in the States. Hey, we get the best medical care in the world.”

“Think again, pal. In comparison to all the other rich countries like England, Australia … Canada … I don’t remember the rest. Look at all the statistics that matter – infant mortality, cancer survival, you name it? We come in last . And we pay twice as much .”

“Yeah, well. At least we don’t have socialized medicine.”

Jackson guffawed. Shep wasn’t stupid, but he could be painfully cooperative. That “socialized medicine” bogyman went all the way back to the 1940s, when Harry Truman had wanted to bring in a national health service, just like the Brits. Nervous that doctors wouldn’t keep raking it in, the American Medical Association concocted this inspired cold war buzz phrase, which had struck terror in the hearts of their countrymen ever since. A genius stroke of labeling. Like when supermarkets came out with that “no frills” line, packaging a perfectly standard, decent product in stark, ugly-ass black-and-white, thus ensuring that no one with any class would buy it, at half the brand-name price. It worked. Even Jackson’s cash-strapped mother hadn’t wanted to be caught dead with no-frills tissues in her cart.

“You realize fortysomething percent of this country is either on Medicaid or Medicare?” said Jackson; history lessons always put Shep to sleep. “All this ooh-ooh about how we don’t want ‘socialized medicine.’ Well, we got socialized medicine, for nearly half the population. So the other half is paying twice. Your Mugs are paying for your Mooches’ CAT scans with confiscatory taxes” – confiscatory was a wonderful word Jackson had learned only about a year ago, and he used it at every opportunity – “and a second time for their own damn scans.”

“You sound so down on Medicare and Medicaid. But you’re not saying that you wish old and poor people didn’t have access to health care.”

Jackson sighed. That line was so predictable. Shep was a class-A Mug. For the ranks of complacent dupes to which, alas, Jackson also belonged, Shep Knacker could be the mascot. “No, I’m not saying that. My point is, guys with health benefits don’t think they’re paying their own medical bills. They cling to their precious employee health insurance as if it’s this great freebie. It’s not free! They don’t understand they’d be getting, like, fifteen grand more in salary if it weren’t for the damned health benefit! It’s fucking sad, man.”

“Money’s gotta come from somewhere, Jacks. Some big national thing would send taxes through the roof. There goes your fifteen grand. Worse, if you earn a decent living.”

“It seems like it’s all the same dough, but it’s not. Think about it. Every piece of paper that just landed in your mailbox cost money. Some officious twit was paid to fill in all those codes, and tick the boxes, and fire off copies to five other places. Thirty percent of the money spent on medical care in this country goes to so-called ‘administration.’ Fact is, there’s a wholly fatty layer of for-profit insurance companies larded between Glynis and her doctors, a bunch of bloodsucking greedy fucks making money off her being sick. And not one of them knows how to set a broken arm. Kick those assholes out of the picture, and for the same cost the whole country would be covered, without fifty different bills a week arriving in your mailbox.”

“ You of all people want the government to take over health care?” said Shep, shaking his head with a lopsided smile. “Jacks, you hate government. You’re an anarchist.”

“These companies are so in bed with government that they might as well be the government,” Jackson charged back, irked by Shep’s superior bemusement; yeah, maybe he wasn’t totally consistent, but at least he read stuff, he thought about things, unlike some people, who took everything they were told as gospel. “Why else do you figure that no halfway credible presidential candidate, Democrats included, ever dares suggest eliminating the bloodsuckers altogether? Besides, if the feds wouldn’t do it much better, they couldn’t do it worse. And the whole concept of insurance is to spread the risk, right? To pool the healthy people and the likes of Flicka together so it all evens out in the end. Well, what could be a fairer ‘risk pool’ than the whole damned country? Health care is about the only thing the fucking government should be good for. And maybe, just maybe, if you could at least go to a doctor without having to take out a second mortgage, people would figure that, okay, they pay taxes but at least they get something back. Right now, you get dick. Oh, sorry” – Jackson kicked a rim of raised concrete – “you get sidewalks. I always forget.”

He’d promised himself to shut up, to focus on Shep’s problems for once. Still, none of this stuff was off-point. “Hey,” he said, as Shep stared dully into the blanched, glaucous vista of the park, which in winter looked like a drawing that had been erased. “This isn’t an off-in-the-clouds rant, bud. This is about you and Glynis, right now, what you’re going through, and you’re not even paying attention.”

“Sorry. It’s just … well, we got our second opinion. From this pair of hotshots at Columbia-Presbyterian. They work as a team, an internist and a surgeon. And don’t get me wrong; they were great. In a way.”

“In a way,” said Jackson, forcing himself to listen. It wasn’t his strong suit.