What healthcare for the very, very rich looks like


Portrait of Dr. Gachet, one of the most revered paintings by Vincent van Gogh


I am sitting down the dinner table from a wealthy man when I hear him describing a term I have never heard before: concierge medicine. “$1,200 a month,” he explains, “and worth every penny. If I get sick on a holiday or a Sunday, my doctor answers his phone. Same-day appointments, prescriptions filled in an hour, no waiting for a nurse to call you back.”

Looking up and down the table, I expect surprise, some pushback, but nobody balks, so I go back to picking at my salad, calculating the value of $14,000 a year before taxes. Then I picture myself calling Dr. Lu or Dr. Charlene at home on Christmas morning. It’s me, my throat hurts, are you busy?

Money might not buy happiness, but for the wealthy it buys … and I feel I should say this with the French flair it demands … concierge de sante.

I recall the gleaming promises of healthcare that President Trump made within days of his November 2016 election. “We’re going to have insurance for everybody,” he told The Washington Post. “There was a philosophy in some circles that if you can’t pay for it, you don’t get it. That’s not going to happen with us.”

He told 60 Minutes he would replace Obamacare (the Affordable Care Act) with “great healthcare for much less money. So it’ll be better healthcare, much better, for less money.

Two years on, the president’s plan for better, cheaper, insurance-for-everybody still does not exist, but he took to Twitter on Dec. 14 to cheer a Texas court ruling on the ACA. “As I predicted all along, Obamacare has been struck down as an UNCONSTITUTIONAL disaster! Now Congress must pass a STRONG law that provides GREAT healthcare and protects pre-existing conditions. Mitch and Nancy, get it done!”

What kind of man gleefully chalks up a big win at the idea of vulnerable Americans losing their healthcare? The kind of man who has never laid awake nights wondering if he, or his children, can afford to see the doctor. A man born rich.

Mr. Trump sold himself to working class voters as self-made, but The New York Times has reported, “a vast trove of confidential tax returns and financial records reveals that Mr. Trump received the equivalent today of at least $413 million from his father’s real estate empire, starting when he was a toddler and continuing to this day.”

The Man in Black, Johnny Cash, is famously quoted as saying, “Success is having to worry about every damn thing in the world, except money.” Maybe, but I would argue that easily shelling out $1,200 a month for the privilege of calling your doctor’s personal cell phone 24/7 eliminates one very big damn thing.

An oft-reported exchange between F. Scott Fitzgerald and Ernest Hemingway went like this: “The rich are different from you and me,” Fitzgerald said, with Hemingway adding, “Yes, they have more money.” These days, they also have access to dark money and the colossal power to enact or withhold legislation, like healthcare and tax reform.

This time last year, the president had just signed his massive GOP tax cut bill—the creme de la creme of his first year in office—and told reporters, “I consider this very much a bill for the middle class and a bill for jobs.” And then he jaunted down to Mar a Lago for the long Christmas break and announced to the members of his private club at a dinner party, “You all just got a lot richer!”

At a candidate forum in Anderson County on October 18, a voter asked Congressman Andy Barr about how the tax cuts helped regular people like us, and Rep. Barr took the opportunity to boast about what a boon $2,000 a year is. How thankful we should all be! Two-thousand a year is a lot of money!

Well, I’m no tax expert, but I can multiply and divide and I know $38 a week is nowhere in the ballpark of, “You all just got a lot richer.”

Now, if I only had an extra $1,200 a month for concierge de sante so I could see my doctor before her first available appointment: April 25.