American medicine is the best in the world, but the best medical advice is this: Don't get sick.
We've got Medicare and Medicaid, pay-for-visit and managed care, and a prescription-drug benefit on the way to seniors, but actually getting delivery of the pills and potions can be more difficult than getting the legislation through Congress.
The delivery system of American medicine is overwhelmed. Getting through to the doctor is not easy, and after you finally get his attention there's the minefield of insurance claims, office bureaucrats, the pharmacists and sometimes the calico cat.
This is not exactly stop-press news, but I got an insight into how to ride the medical merry-go-'round the other day at a drug store in a Washington neighborhood of the affluent, the well-off and the powerful - and an illustration of why angry arguments over health care will be a permanent angry debate.
My prescription called for a drug that is powerful and often abused, and therefore hard to find. I called several pharmacies before I found a druggist who could fill it. He gave me a time to call for it; if the prescription is not picked up within a three-day window, the doctor must prescribe it again. "Come in Wednesday at 3 p.m.," he said.
When I arrived at the appointed time on Wednesday the prescription wasn't ready. "Come back on Saturday," the pharmacist said. "We had to order it." I had run out of my supply of the pills by Saturday, and when it wasn't ready I threw a little fit. A lady-like fit, but a fit. Diane, the harried pharmacist on duty, went back to a mysterious place in the stacks to see what she could do. Fifteen minutes later, she came back without my pills but with a sheepish expression on her face.
"Your prescription never got ordered," she said, "Somehow it got lost. We found it by the sink."
"Well, can't you fill it now?"
"No, no, we have to order it. It will take several days."
Another customer who pushed his way to the counter, taking advantage of my momentarily silent exasperation, found his angry voice. He had been waiting as long as I had and the clerk couldn't find his prescription, either. We played a temper-tantrum duet.
"Either fill my prescription or call an undertaker," my partner in frustration said. "Can't you see I'm desperate?"
Medical professionals do not usually appreciate death-bed humor (it reminds them that every patient dies). I confess: I raised my voice, and my fit became increasingly less lady-like. "I'm not leaving here until I get my medicine," I said. "You'll have to drag me out of the store."