The quest for mobility

My Dad needs a hip replacement; just called from the doctor's office--a doctor my folks have known forever. He'd have the surgery in March but for the fact that, as it turns out, Dad has some kind of HMO instead of Medicare coverage for this. Dad doesn't know how he ended up with the HMO: he knew only that he had Medicare. I need to investigate how he got the HMO. ("Are you paying for insurance?" I ask him. "No," he says.)

But now all talk of the surgery is suspended, though Dad has been unable to get around well for about a year now because his hip hurts. Goddamn system--goddamn confusing, convoluted system. I was uninsured long enough that I actively consider alternatives: "Did you ask the guy what the surgery would cost for private pay?" And then we calculate: better to pay for it out of pocket to get the surgeon they trust, or get it covered with a surgeon they don't know? You'd think it's simple: go meet a new surgeon. The system devalues relationships: they'll end up with a stranger, and my generation is used to the compromise. But they are of a generation that is deeply shaken by healthcare relationships with strangers; they'd rather skip healthcare if the option is somebody they don't know.

I watched Dad when he was in the hospital last year with his heart trouble--watched him trying to win over all the medical strangers that cycled into his room--telling them little jokes, smiling his sweetest smile, modulating his tone of voice so carefully--he never talks to me so nicely--and holding his pee instead of inconveniencing the nurses: straining with every cell to establish human connection. When I wheeled him out the front door on the way home we passed the cardiologist, who shook Dad's hand, and to this day Dad talks about what a great guy the doctor was--not because Dad lived, see, but because the guy took a minute to shake his hand.

Ultimately, again, Dad will bite the bullet on the hip, and the morning he heads off to the hospital he'll say goodbye to me like he'll never see me again. And me--so sure that he's wrong--so quick with the dismissal, the reassurance.

Would it be so hard, really, to just let people choose their own doctors?