Yes, indeed, Emma! Now, it seems to me that I learned in my high school civics class (Do they teach civics in high school any more? I went to high school in the late 1940s, shortly after the Big Bang), that a few old geezers scribble something like

We the people of the United States, in order to form a more perfect union, establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America.

on some old piece of parchment. But then, who (including our fearless leaders) pay any attention to such old documents anymore?

(Now, Firth, don't be snide!)

Kent, it sounds like things are working pretty well in your area. I have tried making my next yearly appointment (cardiologist) before I leave the office, but am told, "We don't book that far in advance." And it's a bit hard to time the prescription because sometimes the doctor renews it for three months, sometimes six, and sometimes a year. He doesn't tell me.

I sort of wonder if it depends on how many more payments he has to go on his Chris Craft.

I live in an area of the city (Seattle) that's rich (!) with hospitals, clinics, and doctors' offices. I'm just a few blocks from what the "locals" refer to as "Pill Hill." But they all seem to use the same standard recording on their telephone answering machines:   "Please leave your name and telephone number after the beep. If this is a medical emergency, call 911." 911, of course, is the city-wide emergency number for calling fire, police, or Medic One. Seattle, I am told, is a great city to have a heart attack in because if you call 911 and ask for Medic One, a well-equipped van with a couple of paramedics will often appear at your door, amazingly enough, within three to five minutes. They will give emergency treatment on the spot, then transport you to a nearby hospital if necessary.

Medic One is paid for by taxes. And it's one of the services the city is proudest of.

Medic One.

But once you get to the hospital, it's on your dime. Or your insurance company's, which the hospital will determine as you are being admitted. Or, in some cases, before you will be admitted. Stock question:   "Do you have insurance? How is this to be paid for?"

There is one clinic in my vicinity where it is possible to get an appointment within a day or two, sometimes the same day. "The Country Doctor." It has a small permanent office staff that makes appointments and handles the paperwork, processing insurance claims (if there are any). I don't know how the place is supported. The doctors, I am told, are volunteers who take time from their own practices and come in a couple of days a month. The clinic provides primary care service. But if you need X-rays or something like that, they have to send you to a nearby hospital that they have some kind of arrangement with because The Country Doctor has very little equipment, and most of that, as I understand it, has been donated. They have no facilities for a heavy-duty medical emergency. The care there is pretty darned good, considering. But you almost never see the same doctor twice in a row, so there is no continuity. At least, this was the way it was about ten or fifteen years ago.

I have been told that a factor that jacks up the cost of health care in the United States is one of the engines that drives Capitalism:   good old competition. If one hospital in a locality gets an MRI or a CAT scanner (mucho bucks. As in "Mega-!"), all the other hospitals in the area feel they have to have one too. And, of course, the cost of the gadget is divvied up over all the medical bills the hospital sends out (even if you don't get a scan yourself). In other countries, one CAT or MRI scanner in a locality is considered all that is necessary, and all the local doctors and hospitals send their patients there if a scan is deemed necessary. This keeps the cost of medical equipment within a particular locality down.

I have been told that, with its many hospitals, there are more CAT and MRI scanners in the city of Seattle than there are in all of Canada. And Canada is not bereft of such devices.

It has been said that the measure of whether a society is civilized or not is in how it treats its weakest members:    its children, its elderly, its poor, its disabled, and its ailing;   and in how it treats its criminals. Does it attempt to rehabilitated, or does it merely punish?

This has been attributed to many people:   Gandhi, Churchill, Jimmy Carter. . . .

It matters less who said it than it does that we heed it.

Don Firth