Brett Lewis was doing well. He had a good, steady job at the construction company, a nice pile of savings from the work he’d done since he was sixteen. He got along okay with women when the fancy struck him, but he felt no great need to settle down. And he was in peak physical condition.
He first met Dr. Shukti Prajapati when his boss at the firm made him go in for a routine check-up. He never bothered with those things, figured he knew his body best. Not like he smoked, and he ate healthy enough.
“How are you feeling today, sir?” asked the doc, and he was surprised not to hear an accent, because she was definitely not from around here.
“I’m feeling just fine,” he said, “other than the big fat check I’m gonna have to write for this check-up.”
“Most insurance policies cover this,” she assured him.
“Most insurance policies,” he countered, “are scams, which is why I don’t have one.”
“I see,” said Dr. Prajapati, and continued with the examination.
She wanted to say something pithy, like “Well, then I guess you have only yourself to blame,” but that would be unbecoming, not to mention unprofessional, and she could tell from the man’s body-language he was already uncomfortable with her—whether it was her race or sex didn’t really matter—and she was already on thin ice when it came to the hospital administration. they didn’t like her meddling with her patients by recommending insurance policies. They said it was none of her business; “Doctors should be doctors,” they said, “and leave the insurance stuff to the folks who know about it.” But wasn’t her job to care for the sick? Hadn’t she taken an oath to do no harm? If a family was financially ruined paying for a treatment that she recommended, with the result they wouldn’t properly feed themselves, wasn’t that her business as a doctor?
“Hmm…” she said, in her conversation with Mr. Lewis.
“What’s that supposed to mean?”
“No reason to be alarmed,” she said. “I just might have to run some tests.”
“Nuh-uh, I ain’t paying for no tests.”
“But this could be important.” She explained what she’d found at the possible implications. She tries to be as simple as possible without being condescending or imprecise.
“No, no, no, no, no,” said Brett. “Nice try, Shama-lama, but you’re not getting me with all your mumbo-jumbo, I ain’t paying for no tests.”
And that was the end of it, she thought. There was a chance he had a condition. There was a chance that condition could be life-threatening, but without insurance, the test would be pricey. Not as pricey as the treatment, of course, but for this man (especially without insurance) the burden might weigh more than the risk.
So Brett Lewis got his clean bill of health (with a caveat) and returned to work, while Dr. Prajapati returned to feeling uneasy about healthcare. Maybe her medical school teachers were right. Maybe her heart was too good for America, her commitment too wide.
There were problems with Britain’s NHS, but it couldn’t be as bad as this—could it? Pharmaceutical companies creating new drugs they don’t actually need to feed money into testing them to justify driving up prices on everything else? The best equipment in the world that no one could afford to use? Food that makes people sick? Common-sense cures barred from even research to keep profits high on expensive invasive treatments that shouldn’t even be necessary? And all the while, the only way ordinary working-class citizens can afford to take care of themselves when the worst happens is to pay thousands a year to private insurance companies that take every conceivable excuse to line their own pockets by raising prices and denying claims.
“You should buy insurance now,” she said to Brett Lewis just before he walked.
“They won’t cover you with a preexisting condition and this could become a problem.”
“Yeah, you’d like that, wouldn’t you?” he shot back.
But then it became a problem. Six months after this check-up, after assuming that it was all bullshit, Brett Lewis started showing symptoms. They were exactly the kinds of symptoms Dr. Prajapati had described. Uncanny, even. He put off going in—“Doctors are quacks anyway”—and didn’t even tell anyone—“I ain’t no snowflake,” he would say in the mirror, “I can take care of myself”—until one day he collapsed while at work.
“You will die,” was the verdict from these new quacks, “without proper treatment. “And it was burning a hole in his pocket.
“Don’t worry,” said his boss, “we take care of our own.” But was that fair to them? Asking that kind of charity? A man takes care of himself, takes care of his family, if he has one. What kind of man lets other men pay off his debts for him?
“The kind of man who’s fallen ill,” said Dr. Prajapati. She found him when he was admitted at the hospital and remembered him. “We can’t solve every problem ourselves,” she added, “the modern world is too complicated for every single person to know every single thing well enough to surive in it unaided. And the human body? Not even doctors can be expected to know everything by now, and never make a mistake. So where does that leave you?”
“It’s a scam,” he insisted, and she didn’t disagree. “They take and they take and they take, and what do we get for it? Debts that can never be repaid. And what choice have we got?”
“You can die,” she reminded him.
“We’d be better off without all this shit.”
“No, you would be dead,” she reminded him. “And there would be no choice.”
“I could pay for all this myself.”
“Can you, though?”
Of course he couldn’t.
“The system isn’t perfect. Of course it’s not. But is the answer to get rid of it altogether? Let every man fend for himself? Where would that leave you? No, if something isn’t perfect, the last thing you do is throw it away. What we need is to fix it.”
In the end, though, the entire point was rendered moot. Brett Lewis made a miraculous recovery just before his money ran out. He gave the credit to supernatural forces and earned a fortune from the book deal and endless subsequent touring.
And Dr. Shukti Prajapati went deeper into politics, ultimately abandoning the hospital for the bigger picture because she couldn’t bear to see people like Mr. Lewis spiraling into endless debt—and taking their families and sometimes even friends with them—just on the slim chance of one day being well.