'The Wheel of Life or Death' in the Casino of Care

‘The Wheel of Life or Death’ in the Casino of Care
by David Benjamin

“If your baby is going to die and it doesn’t have to, it shouldn’t matter how much money you make.”
— Jimmy Kimmel

MADISON, Wis. — My friend, Dr. Wilhelm “Doc Holiday” Bienfang, America’s foremost “idea man,” is sweating out the latest effort by the GOP to “repeal and replace” Obamacare, throwing roughly 30 million people off the medical dole. To my surprise, Bienfang is rooting against the so-called Graham-Cassidy Bill.
“I don’t get it,” I told him. “I thought you were devoutly true to the conservative doctrine that if poor, sick people are likely to die without health care, ‘they had better do it, and decrease the surplus population.’”
Bienfang replied that, although Graham-Cassidy is admirably cruel, he has “a better idea.”
He explained, “As you know, it’s a basic Republican axiom that the poor and sick are poor and sick because they’re morally degenerate. The GOP dilemma is to find a way to shunt these — hm, what’s Trump’s term?”
“Losers?” I suggested.
“Exactly!” said Bienfang. “How does a principled member of the Freedom Caucus contrive to dump millions of losers — including moms, grannies, cripples and infants — into the crapper but not seem heartless?”
As usual, I had no clue.
“The answer to this leadership dilemma, for centuries, has been to dazzle the wretched of the earth with a shiny object, diverting their attention from their misery while soothing the bleeding hearts who want to lend the losers a helping hand,” said Bienfang. “The Romans called it ‘bread and circus.’ Marie Antoinette called it ‘cake.’”
I said, “OK, but how do you distract — from the stark reality of their sickness — penniless people desperate to get treatment for breast cancer, cystic fibrosis, diabetes, pneumonia, heart failure? A day of Christians and lions at the Colosseum ain’t gonna heal what ails them. And they know it.”
“Ah, but they can drink, or smoke crack,” said Bienfang. “They can sedate themselves with Vicodin, Oxycontin, cheap heroin, crystal meth.”
“Your health plan is to make poor folks so unhealthy that they all die?”
“Wish I could!” said Bienfang. “But paupers are survivors. They don’t die at a reasonable pace. Even without maternity coverage, they’re appallingly fertile. And they vote for Democrats, who keep dreaming up ways to keep them alive.”
“So?”
“Luckily, there’s a time-honored, fail-safe pacifier of the poor: The numbers. The ponies. The Wheel of Fortune. The one-armed bandit!”
I was still a little confused. “Gambling?”
“Specifically,” said Bienfang, “the health lottery! The Casino of Care!”
“But there is no such thing.”
“Yes, but there will be. And it’s so simple even Trump could understand. After all, he’s a Vegas guy, right?” said Bienfang. “And he loves TV. So he goes on, and he says, ‘My fellow Americans, if by today, you don’t have health coverage on the job, or from Medicare or the VA, well, I wish you luck! Lots of it! Because every day from here on in, your only way to get cured is to lay down your chips, shuffle the cards, watch the little bouncing ball and roll those bones in the Great American Health Care Lottery.”
I was, of course, dazzled by Bienfang’s latest brainstorm. I understood that — as with all his ideas — Bienfang would be running the show, tucking away a tidy profit and greasing any politician who threatened to queer the deal. But I didn’t quite grasp how “Casino Care,” as he called it, would work.
“Same as any lottery, son,” he replied. “Every night, just before the local news, there’ll be a girl in a spangled bikini standing before a huge transparent orb. Inside the orb, a thousand bouncing ping-pong balls. Each ball, in every exciting, suspenseful drawing, holds the medical care dreams of millions upon millions of scabrous, dysenteric, obese, septic, senile, bleeding, broken, bilious, bulemic, infectious, infected, addicted Americans.
“Every night, the lottery babe plucks six balls from the orb and squeaks the numbers — from “1” to “1,000” — of the ‘PowerHealth Perfecta.’ If you hit all six you get health care — absolutely free — anywhere in America, from any doctor or hospital, for the rest of your life.”
“Wow,” I said. “But, Doc, six numbers from 1 to 1,000?” I said. “The odds of anyone, even among millions, hitting all six, would be astronomical.”
“Of course,” said Bienfang. “That’s why lottery players would have to buy a lot of tickets — at a buck a ducat — every day, forever. The revenue, for Bienfang Gaming Systems and Bimbo Supply, would be staggering.”
I almost asked whether money was the point. But Bienfang quashed my quibble. “Besides,” he said, “we’ll have lesser prizes. For example, hit four out of six numbers, and you’ll get free Emergency Room treatment for, say, five years. Hit three numbers, you score a year of health care, no charge. Two numbers gets you a prescription filled for a mere $35 co-pay. Plus, don’t forget the scratch cards!”
“Scratch cards?”
“Sure, let’s say your colon’s riddled with polyps. You drop by the bodega on the corner, cough up ten bucks and get ten colonoscopy scratch cards. If you get three little smiling cartoon bowels in a row, shazam! You get treatment. If not, well, you buy ten more cards and a bottle of Pepto-Bismol.”
“I gather,” I said, “that every medical procedure would have its own scratch card?”
“Medical, dental, psychiatric, you name it! Picture the thrill when some loser riddled with oral pain, scratches out a row of three happy teeth and runs out the door shouting with joy, ‘Root canal! I’m getting a root canal!’ Or the ghetto mom with terminal bone cancer, barely able to scratch, but weeping gratefully at a card that will provide her two whole weeks of pain meds.”
I was impressed with this wrinkle, but downright awestruck when Bienfang unveiled for me the “Wheel of Life or Death.”
“Every night, the climax of the lottery: the blonde uncovers the big wheel. Each little peg on the wheel carries the name of a terminal patient somewhere in the U.S. who’ll be dead in days without a new heart, kidney, liver, lung, whatever. As the wheel spins, on and on for two, three, four minutes — building tension agonizingly — the names of the contestants — er… patients flash on the screen. One will be saved. All the rest are goners.”
“Gosh,” I said, “that’s great TV!”
“True!” beamed Bienfang. “The ad rates will be astronomical.”
But then, he added that little note of humanity that has always endeared me to the “Doc.”
“Yes, son,” he said, “I’ll make the Casino of Care pay for itself. But more important is an ideal. Our nation will finally enact a health-care policy true to its rugged pioneer roots and to the words my sweet old dad used to mutter when he got too drunk to make it by himself to the toilet.”
“What was that?” I asked.
“It’s all just one big crap shoot, kid.”