Goose Rawlings has the answer. And it's not what you think.
Anyone who thinks that our government cannot do good work needs to come to my home, where there is an example of government bureaucracy that has stood the test of time for almost 80 years.
It was built in the 1930s by the Works Progress Administration, commonly known as the WPA, a program totally funded by the federal government, one that provided employment to millions of people at a time when more people were out of work than at any other time in U.S. history.
Although our local example of government at work has been moved a couple of times, it is still standing in the back yard and still serving a purpose, although not the original one.
I’m talking about my grandfather’s outhouse, or privy, if you prefer. A vintage Port-o-let, for you younger folks.
I grew up around outhouses and used one on a regular basis right into high school. My parents owned a general store in a small town in the ’50s and ’60s. While the store had hot and cold water, it had no sanitary facilities inside other than a sink, so there was an outhouse in back of the store. It was the town’s unofficial public restroom, and it got a lot of use. It was my job to keep it clean and stocked with toilet paper.
One of my best memories from childhood had to do with the times I’d be pumping gas for some nicely dressed, obviously well-off people who had driven up in a nice car and they’d ask about the restrooms. I’d just say, “It’s in back of the store.”
Most of the time, folks would smile when they saw the privy and reminisce about their own early years. But some people refused to use it and chose instead to wait till they found something more to their liking. They just didn’t need it bad enough, I would always think. The people that did need it would use it, even if it wasn’t up to their standards.
They may not have liked it, but it was better than nothing.
There’s a similarity here to the Affordable Care Act - or “Obamacare,” if you will. The ACA could be called the “outhouse” of insurance programs. It provides both basic coverage and coverage for preventative care. Through tax breaks and subsidies, it is affordable for many people who don’t have insurance. It serves a basic need. It forces insurance companies to standardize their rates and provide the same coverage for all.
It is also one of the most controversial government programs in history, and everyone has an opinion. Even though most countries consider basic healthcare a right, many in our government look upon it as a privilege. Public opinion is mostly against the ACA, largely fueled by rumors and outright falsehoods.
Consider this: Most countries in Europe, North and South America, and Asia have universal healthcare for their citizens. Even those bastions of personal freedom, the countries of China, Syria, and Iran have universal healthcare. However, in the good old “Land of the Free and Home of the Brave,” we don’t. That is not only amazing, it is also disturbing. Compared to our healthcare system in America, nobody in the world delivers less for more.
The ACA is not perfect, but it addresses a basic need. It’s a good first step toward universal healthcare. It also has positive implications for pharmacy. You may not like it, but for the uninsured, it’s better than nothing.
It’s like the outhouse behind my parent’s store. There may be something better down the road, but you just don’t know for sure. Maybe you should use what’s available and not wait for something better. The ACA is just that, until something better comes along.
Jim "Goose" Rawlings is a senior pharmacist in central Indiana. E-mail him firstname.lastname@example.org.