The Nation's Pulse

...Thinking to draw out some witty or charming stories on the subject, the freshman asked Kerr to favor him with some observations on the particular changes he had seen...

...National Health Care: Solution or Disaster Medical care costs are rising, and a fearful howl is out for government to "do something...

...Artificial walls have been built around medicine, individuals are pre-vented from entering the field, incen-tives for private cash flow have been eliminated, and yet demand for services has been artificially increased...

...Not many here in this land today...

...K was making me keenly aware of my lack of a Harvard education...

...The freshman, hoping to brighten up the conversation, observed that Senator Kerr must have seen many changes in the Senate during his distinguished years of service --to which Kerr briefly nodded his assent...

...Six months of delicate negotiations and 8000 tons of bombs in Haiphong harbor --do you want some back is- sues of The Nation...

...The Bulgarian was so surprised, he mistook our report of their capture for a clerical error and set them all free...

...How's that...

...What was the Commission supposed to do...

...He waved from the back of the speeding boat...

...For his exploits Abourezk has been the beginning of 1969, the consequences of these efforts were so dispiriting as to call into question the ability of gov- ernment itself...

...This may be its en-during significance and why, to the author of The Politics of a Guaranteed Income, it can be considered a success...

...Yes how much of South Vietnam did the Saigon government actually control by the end of the war...

...In addition to their new pleasure of Abourezk-watching, Capitol Hillologists have bet:n cheered by Senator Vance Hartke's (D-Ind...

...They do not guarantee quality to the layman...

...In a speech purportedly about international trade, the silver-tongued sage wa.xed eloquent on the subject of airport neofascism...

...The methods chosen for licensing medi- cine, however, are so far from guaran- teeing quality care that many people today, particularly medical educators, are seriously questioning their value...

...Opening with a discussion of his modesty, he noted, according t6 the official text, that Hartke is The Alternative June-September 1973 I~e independent thinker" who "stands , alone...with less than a care for Villification (sic)program" against .9Expanding on this courage motif, eclared "I am badgered at airports this moment because I do exactly as any other members of Congress do...

...A bewildering proces- sion of solutions is being proposed, everything from organized labor's womb- to-the-tomb medical coverage (costs to be borne by taxes), to President Nixon's partly self-paid, partly tax-paid cov-erage...

...But by A Better Example of Washington Humor Well, the Greatest Show On Earth re-convened in January and once again Washington is agog and atwitter over the performances of some of Congress' leading men...

...The first people they kill, jail and torture are journalists and lawmakers...

...Too much so," he sighed, stuffing his pockets with paper clips...

...K shouted back...

...The prac-tice of medicine still consists of a large amount of trial and error, as can be seen by the fact that many physicians tell their patients, "Take this pill...

...Certainly not...

...More ominous still is the conspiracy between the press and airline officials...

...We actually caught some infil- tratbrs once, trying to sneak over the border disguised as peasants grazing their tanks --" "Pretty exciting, eh...

...his answer was lost in a round of mortar fire...

...In each state a small, government-designated group of doctors (the state's Board of Medical Examiners) is the final arbiter as to which medical schools may set forward their students as candidates for licensing exams, which individuals may practice within the state, and how many physicians that state will have...

...But Mussolini and Hitler and dictators in South Vietnam, South and North Korea, Spain and South America, and in little nations of despots all over the world...

...The final score was not announced...

...Hanoi originally wanted hine, but the Americans persuaded them to accept a stronger force...

...We're a proud group...

...Toward this end all states regulate and license the practice of medicine...

...But if the North Vietnamese were so stubborn, why didn't the Americans drop their bombs on the port instead of in the water...

...There is a very simple reason for these results: there can be no "one way" to practice medicine which government can bottle up into a form of license...

...Really, you can't go anywhere in Vietnam studies without realizing that the most crucial battles were fought in the polls...

...About half...

...I shouted...

...Kerr, a leader of the Senate's inner circle for years, was making some notes at his desk when approached by the freshman, who intended to introduce himself and, hopefully, to make a few ingratiating remarks...

...As you know --the United States does not support --filthy dic- tatorships...

...It is all a pattern...

...Some states require a relatively high score, with as many as 40 percent of the candidates failing many years...

...if it doesn't work, come back and see me...

...A proud group...

...I repeat: one of the better examples of Washington humor...

...The Hoosier solon has never been one to retire and quietly lick his wounds, however...

...I am something special...

...Watching the early rounds in the battle of the budget one is struck by the claims that Nixon has slashed Federal programs to the bone...

...step...

...K wouldn't stay to answer, but his rage was apparent even as he zig- zagged low to the ground, between the piles of dead and dying...

...Kerr nodded a perfunctory acknowledgment of this flattery and went back to his notes...

...The laws were created to discourage quacks and the mediocre, yet both flourish after more than sixty years of regulation piled upon regu-lation...

...Dr...

...But the North Vietnamese have invested heavily --in the reconstruction of their country --scrap iron, tank rippers, Phantom jets -A sonic boom shook a framed copy of the Bill of Rights off the wall...

...That FAP was not enacted is probably less important than that its history reveals its potential to have been enacted...

...it is a result of the ignorance of medical science today...

...Anybody who is anybody must be certified by var- ious capital wits, who use their keen sa- tiric ,sense and rapier-sharp intellects to hone such gems as the following (which is one of the better examples of Washington humor...

...Naturally, the Saigon people raised hell --dead set against Massachusetts --but we persuaded them of our good faith...

...Although in the Florida contest he again finished behind Wilbur Mills, it is reliably reported that his finish ahead of Mayor Yorty (.2 percent of the vote) propelled him into serious contention (one of the top five candidates) for the vice-presidential spot should Shirley Chisholm have captured the Democratic presidential nomination...

...Our duties are to police the entire area of South Vietnam and to prevent all military Infiltration...

...Members have not achieved academic attainments, many are even extremely outdated in their field...

...They agree with me...

...Then we have the best chance of choosing alter- natives which will eliminate the real problems, and encourage progress in the saving of lives...

...K picked himself off the floor and set back to work...

...I deserve until I am defeated, impeached, or shot, your respect...

...Despite their minimum qualifications, these board members are supposed to choose "good" medicine for their state while banning "bad...

...It is a long-standing tradition that freshmen must first put in a period of apprenticeship and homeworkdoing before daring to make their maiden speech...

...Concluding his discussion of the matter on an optimistic note, the Senator reminds us ~'I am an elected lawmaker...

...The New Hampshire setback sapped some of the momentum from the Hartke juggernaut, and he fin- ished tenth i~1 the Florida primary, with three-tenths of a percent of the popular vote...

...That is some-thing very special.' "He meant, of course, that the office of Senator was special, for it is, in his words, "as destined, to purpose (sic), to mankind (sic), to good for mankind as any poet, artist, inventor or philosopher-prophet (sic...

...I danced away from a falling beam...

...At least not as I read the real issues now before us...

...But as the country shrank, the job got much easier...

...And how much credit --went to South Vietnam...

...But it has ended...

...They do, however, set the practice of medicine in a form as unyielding as concrete because, while knowledge may change rapidly, laws do not...

...but it gets much larger when the tide is out...

...Answer: When he's James Abourezk...

...At $269 billion it is probably the most expensive bone in history...

...K waded hip-deep into the surf and threw his suitcase into a waiting barge...

...His address is fascinating and should be examined by students of either rhetoric or politics...

...in his book Medical Licensure and Discipline in the United States describes the current physician licensing practices...

...Congress had barely convened when Abourezk (AhCbor-esk) broke the hallowed rule that freshmen should be seen and not heard...

...How...

...The United States just sent its first 100 advisers to Hanoi...

...He repeatedly refused to undergo searches by airline security personnel before air flights, and attempted to alert the American people to this new and growing menace...

...He cleared himself, however, in the eyes of his followers by explaining his vote: "I didn't want my office bugged...

...Without either looking up from his work or pausing a second, Kerr is reputed to have pointedly replied "Freshmen didn't used to be so talkative...

...James Abourezk, watch out...

...No one knows...

...Are you implying that we've failed ?" "No...

...To ensure that we choose the best possible alternative, we must go back and discover exactly what has caused the current steep rise in costs...

...Here's the key to the washroom, would you leave it at the desk...

...State boards-do agree that a candidate should pass an examination before being li-censed, but they cannot agree on the subjects that should be included in the exam...

...K bristled...

...And just because that elected official does not know who he is, or otherwise abuses his office, that is no excuse for the questioner...

...as head of the CIA...

...Ex-president Thieu was so disheartened by the repudiation of his policies that he blew his head off, after cleverly tying his hands behind his back...

...But the South Vietnamese claim to see a light at the end of the tunnel --" He shoved off just as the first wave of black-pajamaed shock troops broke through the defenses...

...The Senate roll call began with Abourezk, who bravely and firmly cast his nay vote, only to be swamped by a sea of eighty-one ayes...

...Several thousand hamlet chiefs and military men followed his example --what shall I do with these pencils...

...Richard Broo khiser Alternative June-September 1973 think you are --Something special?' My answer was: 'Yes...

...You may remember the Senator's brief campaign for the 1972 Democratic presidential nomination, during which he courageously decided to speak out on the central issue of American political life, which until then was being ducked by the other campaigners...

...promises to provide the most drama...

...Any time a service or commodity falls into short supply, costs (and thus profits) will rise, acting as an effective, built-in incentive to increase supply by at-tracting people and cash into the field...

...He accused Richard Nixon of dictatorially conducting "foreign wars, both public and secret, of his own volition," of making "this Nation into the bully of the world," and of "moving us precipitously close to an authoritarian system...

...Your last bulwark against dictatorship...

...There has been peace in Vietnam for eleven years !" "Then when do you expect the peace to end...

...According to Derby-shire, at least two states frankly design their exams to "keep the number of physicians at a level optimal to the establishment...

...Everytime you ask a senator, or any elected official 'Who do you think you are?' you fire a bullet at George Wallace or Robert Kennedy...you assault the fabric, the very soul of this republic...

...All of which recalls Hilaire Belloc's brilliant poem, "Epitaph on the Politician Himself": Here richly, with ridiculous display, The Politician's corpse was laid away...

...K, how long have you been a Vietnam expert ?" "I've been on the International Commission of Control and Super-vision since 1973...

...The high spot of the battle came when Elliot Richardson was to be confirmed as Defense (ugh...

...I asked him what was going on...

...Abourezk seemed to relent in his fight to restore (in his own words) a "'profoundly conservative" form of government when he voted to confirm Nixonnominee James Sehlesinger, Jr...

...The laws which establish this shoddy screening definitely regulate and mold the practice of medicine, and yet those laws are arbitrary, capricious, and chaotic...

...in other states, the score is relatively low, and eight to ten years will pass between failed candidates...

...The reason is not hard to find: the free market and its balancing mechanisms have been de- stroyed...

...before that I was a full professor at Harvard --so I've really been a expert for quite some time...

...In 1910, the government began moving to close down some medical schools while restricting enrollment in The Alternative June-September 1973...

...Consequently the Senator finished just behind Sam Yorty and Wilbur Mills in the New Hampshire primary, garnering 2.7 percent of the vote...

...for I had longed to see him hanged...

...The government has affected the amount and cost of medical care in more ways than just the licensing of physi- cians...

...And finally, most ominous of all: "Go on the campaign trail with me...

...He asked for my white shirt which he fastened to the end of a golf club and stuck out the window...

...he shrugged and added them to the laze...

...K added his identification papers to the pyre and thrust a Russian phrase book in his back pocket...

...rewarded with one of Washington's most highly prized commodities: he has be-come the object of a riddle...

...Shortly after the peace, we encouraged him to resign so that the government could hold free elections and broaden its base --" "And the new base included --" "Eleven Vietcong generals, who began to kill, maim, and disembowel in the most democratic manner possible -- paper clips --blotter --pens -don't tell me they destroyed my pens...

...In fact, during 1972, America was riven between the advocates of immediate withdrawal, who wanted all soldiers on a given signal to run from their positions, dive into the ocean, and swim out to troop ships waiting beyond the three-mile limit, and ad-vocates of precipitate withdrawal, who would have made them throw down their guns first --but in the ensuing elections the more militant faction won out --" A spray of bullets interrupted the doctor...

...This is not physician ignorance or care- lessness...

...Because they might have hit some- thing...

...After introductions were made, the young legislator told Senator Kerr of his deep respect and admiration for him...

...sist on immunity of movement to and bm the House and Senate --on grounds Constitution (sic) Law, not on a point personal privilege or arrogance.- that am advised repeatedly how unpolitical I am to claim absolute immunity without shieled (sic) laws for news men, unpolitic to observe, and demand observance of respect and official courtesy for the office I hold under the Constitution and parti- cularly its First Article...

...It would seem our peace-keeping efforts have not been completely efficient...

...A United States Senator...

...Watch your television...the pushing, shoving and villification (sic) that surrounds anyDiane Alexander one who stands for office...The pushing and shoving and the shooting...

...We will be hurting our- selves by halting the brilliant along with the fakes...

...longitudinally, 40 yards...

...The Senator states that "a young reporter at an airport asked me: 'Who do you Eleven Years of Peace When I went to interview Dr...

...No" --A rocket exploded directly overhead --"but it's in the air...

...Dr...

...States also vary widely on the scores necessary for passing licensing exams...

...Yet no two state boards can agree on what constitutes quality medicine...

...Robert C. Derbyshire, M.D...

...Question: When is a middle-aged Lebanese a young Turk...

...Other administrations had adWelcome though it might be, it would dressed themselves to the same ends almost be unfortunate if Family with as much hope and energy...

...5.37...

...It makes no sense, therefore, to create rigid rules, then eliminate practitioners who do not conform to them...

...Latitudinally, 400 miles...

...Dr...

...Knowl- edge of the human body and its reactions is still too miniscule, despite recent almost-miraculous advances...

...Abourezk had little time for such niceties however, as he noted in his maiden speech, and proceeded to unburden himself of some memorable political troths...

...How were the members of this Commission picked ?" "We were all chosen from neutral nations --Cuba, Bulgaria, Tibet, or Massachusetts...

...The final tally: 81 to 1. Of his ordeal, Abourezk noted "I started to get a sinking feeling about the time they passed Hughes, McGovern, Nelson and Mondale...

...And how many men do you have for this purpose...

...This custom is best illustrated by the now-famous story concerning the late Senator Robert Kerr of Oklahoma and a nameless freshman senator...

...That is an enormous amount of power, and yet these board members are chosen, not for their medical qualifications, but for their medical-society or party politics...

...K of the ICCS he was bustling around his office, emptying his desk, and burning his papers in the center of the floor...

...return to the political wars...

...Showing the political prescience of his mentor, Abourezk led the fight against Nixon's "one man rule" by spearheading the opposition to Nixon's cabinet appointees...

...More- Beyond its substantive content, FAP also over, the events of the last three years had a symbolic aspect: it was a grand have established Family Assistance idea, a "first long step," said the as an item on the national agenda...

...Iron- President, "in the great task of our peo- ically, having failed for seeming too ple," the elimination of poverty and de- large, it may someday pass for seeming pendency...

...And who agrees with me...

...Only his equally cour-ageous mentor, George McGovern, heart- ily congratulated him, noting, with hi, usual brilliant political insight, that if Daniel Webster, Henry Cl,~y, John C. Calhoun, Robert La Follette, or Robert Taft were alive they would rush to Abourezk's side in the struggle...

...Unfortunately, an unusually large number of the good people of New Hampshire and Florida failed to recognize that free false teeth for old folks was in fact the central issue of American political life...

...Bella Abzug, watch out...

...While all of his acquaintance sneered and slanged, ! wept...

...One last question --when do you expect the war to end...

...It isn't only Democrats who liven up Capitol Hill, however...

...This time the subject was antihijacking searches at airports, and Hartke was agin 'em...

...The end of the peace is just around the corner...

...The artificial walls have been built around the field of medicine in an attempt to improve the quality of medical care...

...Of the incoming congres-sional crop, Senator James Abourezk (D-S.I...

...The absurd situation has therefore developed that what is considered "quality" in one state can he branded "illegal" in another...

...Why, then, has this influx of personnel and cash not occurred in the health services field, filling the current short-age and satisfying demand...

...The ICCS is pulling out...

...We've been hollering for a new Bulgarian ever since --don't suppose they'll want to send one, now --" "Whatever happened to President Thieu...

...I brushed the plaster off my pad and tried to get on with my interview...

...He concluded that Congress must retaliate by cutting off funds for the White House staff and for high executive branch officials, and pledged himself to "re-creating a viable democracy...

...He discussed the "kitty of more than one million dol- lars to 'get Hartke' "which he claims ha., been raised by business, but went on "] say, with Tonto, my faithful Indian guide, they are going to have to find the silver bullet-maybe they have one...

...Is that official...

...Abourezk wasn't exactly swamped with praise for the speech --in fact, it was greeted with near complete silence...

...In truth, it was not a first so small...

...This in-flow continues until demand is more or less satisfied, then the magnet loses its strength as profits decrease...

...The Causes of the Problem Today's increase in hospital costs comes primarily from a recent steady rise in salaries of health and medical personnel, a rise which has resulted mainly from a scarcity of personnel in relation to demand for their services...

...Now you were saying...

...And how much now...

...In less than a month the pride of Rapid City had violated Senate proto- col, become the subject of a riddle, tilted at enough windmills to last most men a full six-year term, and established him- self as a new darling of the radical chic crowd...

...The Republican National Committee headquarters, widely regarded as a staid, socially conservative bastion, recently was given a no-liquor on premises" ultimatum by Chairman George Bush, who apparently stumbled on an afternoon post-cocktail party featuring a touch football game between GOP staffers...

...Secretary...

...Instead of guaranteeing better quality medical care, the mishmash of anti-quated laws retards progress by pro-hibiting or discouraging innovations in medical-school curriculum and medical- care practices...

...I demurred...

...The war is over...

...Fourteen...

...How much aid did the Americans give Hanoi...

...Derbyshire counted a total of fifty-nine different required subjects, many ridiculously obsolete, yet still re-quired by law...

...And I intend to have it...

...Varying the courage theme slightly, he discussed his suffering at the hands of the airline Gestapo: "When he is searched at airports because he is investi- gating a horrendously malfunctioning agency of the federal government, he does not expect to be felt over with a cattle prod at airports...

...He held up several fistsful and reluctantly cast them into the flames.9 "What a waste, what a waste --" The rocl~et barrage was so intense I had to shout to make myself heard...

...I merely meant --" "Because if you are," he continued, I won't have it...

...so with characteristic zeal he bounced back again, bringing yet another vital issue before the court of public opinion...