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America's still best in first-class health care

| Thursday, July 10, 2014, 12:01 a.m.

We keep getting told the United States has fallen behind in this or that measure of health; that we don't rank first in life expectancy or access to doctors and medicines.

Yet at some deep level of national pride, don't we all believe — know — that American medical care is the best?

And what a pleasure it is to find this article of faith confirmed.

It happened recently in the GI (gastro-intestinal) Lab of a Pittsburgh hospital. Abdominal pains brought a fellow in who usually resists doctoring.

Long story short, there were routine tests elsewhere first, even a sophisticated belly scan by ultrasound. But eventually, high technology: an endoscopy. A miniature camera went down to the man's stomach to see what was going on.

On the appointed morning he showed up at the GI Lab, took off his shirt, put on a gown with strings at the back and climbed on a bed.

A pulse-check was clipped on his finger and something wrapped around an arm to squeeze and let go every few minutes for blood pressure tracking. “This may pinch,” said a nurse with a needle to find a good vein for something intravenous.

All these prelims took place in a ward with curtains between beds and plenty of brisk and genial professionals pushing around mobile computers and screen stations. No one appeared to be in a hurry, but no one poked along either, all uniformed in blue. Maybe the color of sky has been found psychologically more soothing than the starchy whites of tradition. A male nurse navigated the imbedded patient down a corridor noiselessly; forget the rolling iron cots of old — even the beds are high-tech now.

“This will taste bad,” said the gastroenterologist, spraying a couple of jets of anesthetic to numb the throat. Funny, it tasted medicinal, but not really bad. The patient tried to straighten the doc out on that and also have a look at what would be sliding down his gullet: a thin black flexible tube about a foot long with a bright light at its tip. But then he was out. That fast. Unconsciousness came with nothing like the suffocating ether of a childhood tonsilectomy long ago.

And in another moment (it seemed like), the doctor said, “Wake up. It's over. Looks good.”

Now is this first-class medical care or is it? The equipment, the people and the hospital, right here in Pittsburgh, in the land where science, too, races along the wheels of free markets.

Yet honesty compels a question. Isn't some credit, however grudging, due to the very socializing of medicine now taken for granted? Medicare and Medicaid create revenue streams. Federal aid subsidizes research and facilities. The insured patient with modest copays needn't even think about the huge actual billings of a great hospital, the gleaming equipment, cleanliness and staff. Yet somehow provision has to be made for millions more consumers, if not Obamacare, some kind of care.

How do we open up, and yet keep what we all know is the best in the world?

Jack Markowitz is a columnist of Trib Total Media. Email jmarkowitz@tribweb.com.

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