A Health Care-ol, With Apologies to Charles Dickens

Originally published April 17, 2017

Donald Trump glanced at his watch as he passed through the cordoned-off press corps gathered to hurl questions at him as he hurried to Marine One.

“Mr. President! Are you serious about your threat to withhold health care subsidies as a bargaining chip with Democrats?”

“Didn’t you read my book? There’s a whole chapter about bargaining chips in Art of the Deal,” he called over his left shoulder as he picked up the pace. “It’s great. It’s incredibly, incredibly, um, great!”

“Mr. President! Aren’t you afraid you might lose again if you go back to healthcare negotiations so soon?”

Trump immediately stopped and turned away from the waiting helicopter on the lawn to glower at the reporter. “Lose? Lose?! I never lose! Losing is for losers and I am a winner! If I weren’t so amazing, people would get bored with all my winning. It was the Democrats’ fault Ryan had to pull the bill. And the more I’ve thought about it, Ryan’s a loser. So’s the Freedom Caucus. And so’s the Republican Party. I’m getting the picture, now, see? I’m going to have to take care of that mess on my own. I’ll have the Democrats doing whatever I want on health care. You really gotta read my book.”

The President held up both arms to stop the shouted questions. “That’s it. I have to get down to Mar a Lago if I’m going to make my tee time.” He took a couple steps, caught himself, and turned back. “Yeah, I’m meeting a world leader, a really really important big name leader, and we’re gonna to meet over tea and take care of some really important business. It’s gonna be great. Gotta go!”

Barry’s Ghost

When Donald Trump collapsed on his bed that night, his mind was spinning. He wasn’t thinking anything, his mind was just spinning. Suddenly, he sat bolt upright as a loud banging noise grew closer outside his door. Before he could get up to look, he realized he was not alone. A shimmering apparition hovered in the middle of the room. Trump nearly screamed when he recognized Barack Obama.

“Hello Donald,” the former President said with a transparent trademark smile.

“I heard you coming down the hall. How did you get in here, Obama?”

“Nah,” Obama chuckled. “That was just housekeeping dragging a ladder. Who were you expecting, Marley’s ghost?”

“Huh?” Trump looked puzzled.

“Never mind, Donald. I forgot. It was in a book. No, I’m no ghost. Don’t you think the FBI would have told you if I had died?” Obama saw Trump’s expression. “Hmm, you’re right. Maybe not. Anyway man, when you retire from the presidency, they give you some crazy cool gifts. The CIA gave me a prototype of this transporter they’ve been working on. Don’t need no Scotty, man, I can beam myself wherever! It will be really terrific when they get it perfected and I can get there as my regular self, instead of this weird hologram.

“Now, listen Donald,” the ex-President said, getting down to business. “I’m here to give you a heads up. I’m not the only visitor you’re getting tonight.”

Trump looked worried. “Wait a second, are going to tell me that three spirits are going to visit me tonight?”

“So you did read it,” Obama said with surprise.

“Pfff,” Trump scoffed. “I saw it on TV.”

Obama shook his head. “Yeah, well, you’ve got the idea. But, whattaya expect? You’re not only messin’ with the lives of millions of people, you’re gonna screw up my legacy. Now, before sunrise, three friends of mine are gonna show up and give you a little TLIC.”

“You mean TLC,” Trump said distractedly.

“No. TLIC,” Obama said and he started to laugh. “Time for a Little Intensive Care!” 44’s famous cackle echoed in the room for several seconds after his hologram dissolved.

The Spirit of Health Care Past

It was no hologram that materialized an hour or so later. Trump could immediately sense a supernatural presence, in that the wind blew through the closed window and a white-coated figure completed several aerial laps before screeching to a stop, suspended about three feet in front of and above the seated President, who sent off his Tweet before looking up.

“Hey, Marcus Welby M.D.?! I loved your show!”

“Yes, well, not exactly.” the Robert Young lookalike said dryly. “But, Barry said it would make you more comfortable.” Shifting to a more formal tone, he added, “I am the Spirit of Health Care Past. I have come to show you something you have never seen and remind you of things you have forgotten. Come.”

Dr. Welby took the protesting President by the arm and in an instant they were standing inside a curtained area of a 3-person hospital room. In the bed was a woman of about 40. Her eyes were closed and sunken into her gaunt face. Standing beside her was a man staring vacantly, with his arm around a girl of about 10. Tears rolled from the girl’s cheeks and to the floor as she held the woman’s hand.

“Why are we here?” Trump asked crossly. “I don’t know these people.”

“There is no reason you should,” said the spirit evenly. “But there is a connection. The man worked for one of the contractors who built your casinos in the nineties. When you declared bankruptcy, the contractor went out of business and this man lost his job and his insurance. Then the woman got breast cancer. Couldn’t get insurance or afford to get medical care. It used to happen all the time. When she finally got bad enough, she had to go to the hospital but it was too late for treatment. She’s about to die. The little girl will be left without a mother and the husband with hundreds of thousands of dollars of medical debt.”

“This wasn’t my fault,” a sullen Trump mumbled.

“You say that a lot, don’t you? No, it probably wasn’t, not directly. But, you weren’t President then. Now, you are. By the way, try to remember the woman’s face.”

Trump wanted to ask why, but now they were already looking down on a room with two men. One was Trump, who was watching a Yankees game. The other was seated at a computer nearby.

“Do you remember that?” Dr. Welby asked.

“I’ll say!” Trump said excitedly. “That’s the game that clinched the ’99 pennant!”

“No,” the spirit sighed. “I meant do you remember what you and that man were doing there?” Before Trump could make something up, he went on, “You and he, Dave Shiflett, are working on your book, The America We Deserve. He’s the author.”

Something in the spirit’s stare kept the President from arguing.

“Do you remember what you said in the book about American health care?” Welby asked.

“Um, I’m not really at my best after midnight,” Trump said meekly.

“I know. I’ve seen your tweets. The fact is, this is one issue where you were pretty consistent for about twenty years before you ran for President. Look at the computer screen. Shiflett is just finishing that chapter.”

“I’m a conservative on most issues but a liberal on this one. We should not hear so many stories of families ruined by healthcare expenses. . . . We must have universal healthcare. . . . The Canadian plan . . . helps Canadians live longer and healthier than Americans. There are fewer medical lawsuits, less loss of labor to sickness, and lower costs to companies paying for the medical care of their employees. . . . We need, as a nation, to reexamine the single-payer plan, as many individual states are doing.”

“I do remember,” Trump exclaimed. “That’s good stuff. In fact, I was saying good stuff about health care all through the campaign. Hey, did you know that I had the biggest electoral college victory in history? And I would have won the popular vote from crooked Hilary if there hadn’t…been…all those…” His voice trailed off as he realized the spirit had transported them to one of his campaign rallies.

“I’m glad you brought up the campaign,” Dr. Welby said firmly. “Let’s see what you were saying before you became President, shall we?”

Trump realized they weren’t actually at one rally. They were many places at once, hovering in the middle of a huge revolving stage with at least a dozen sets. There were rallies where he was addressing raucous crowds, also television interviews, press conferences, and a few with members of his campaign team talking. As the giant platform turned around them, he could pick up familiar phrases:

  • Repeal and replace Obamacare. Great health care at a fraction of the price and that’s going to take place immediately after we go in. Fast. Quick.
  • No one will lose coverage.
  • Insurance for everyone.
  • Healthcare will be a lot less expensive for everyone– government, consumers, providers.
  • No cuts to Medicaid.
  • No one will be worse off financially.
  • Get rid of artificial lines (state borders) to promote competition.
  • Everyone is going to be taken care of.

“I realize I’m just an old, fictional, TV doctor,” Dr. Welby said slowly, “so explain to me how you were planning to do all those things.”

Trump shrugged. “I don’t expect people to take me literally.”

“I see,” said Dr. Welby. “I do think a lot of people are taking you pretty seriously now, though.”

As the spirit sadly shook his head, he faded and President Trump was again in his room at Mar a Lago.

The Spirit of Health Care Present

Trump felt too wound up to sleep, so he began tapping on his phone. He couldn’t understand why he got so much grief about tweeting. He had a high stress job and tweeting had always been a great way for him to vent, relieve that stress, and take a 140 character mental break when he didn’t have to think about a thing.

At some point mid-tweet, he felt a stir in the room and looked up to see a middle-aged woman standing quietly at the foot of his bed.

“What are you doing here?” he demanded. “It’s like 2 AM. Are you one of the maids? How dare you come in without knocking?” He stormed over to escort her to the door and his hand passed straight through her arm. She stared at him appraisingly.

Without speaking, she touched his arm and they were aloft. He knew they must be traveling, but there was no sensation of movement. He could see nothing but the woman with him.

“You are the second spirit,” he said simply. “The Spirit of Health Care Present.” She nodded and he looked more closely. “You look familiar. How do I know you?” She looked directly at him and he recognized the sunken, haunting eyes of the woman in the hospital bed.

“I have been asked to help you see.” When she finally spoke, she was pointing.

Trump looked and saw himself being interviewed by a reporter. “Yeah, I see. I was there, yesterday. That’s me being interviewed by the Wall Street Journal. I look pretty presidential, don’t I?”

“You threatened that you would withhold the subsidies that people covered by the Affordable Care Act use to pay for their insurance. You implied you might use your authority to do other things to cause Obamacare to fail. You said that threat would get the Democrats to go along with your Repeal and Replace plan.”

“Well, yeah. That’s called negotiating.”

“So, you were bluffing?”

“Nah, I gotta be willing to do it or it doesn’t work. That’s how I win.”

“In spite of all the promises and claims you made in the past, you would be willing to destroy the system that provides medical care for millions of people? A system that probably would have saved my life.”

A retort froze on Trump’s lips as the spirit fixed him with a penetrating gaze. Then she was gone and he was on the edge of his bed back in his room.

The Spirit of Health Care Future

Before he could pick up his phone, there was a knock on the door. Trump shuffled over and opened it apprehensively. Relief flooded over him when he saw Tom Price, Secretary of Health and Human Services, standing there.

“Tom! Thank God. Am I glad to see you!” he exclaimed, as he reached to pull him in. But, his hand grasped only the air.

The figure threw back his head and laughed eerily. He passed through the doorway, and through the hulking president standing in it, and floated in a sitting-like position over a chair. Still laughing, he pointed at Trump and said, “Oh Donald, you shoulda seen your face. That was priceless!” His laugh rose to a howl. “Ha, get it? Price-less? No, I see you don’t. I’m the Spirit of Health Care Future, dude! It was Barry’s idea for me to show up looking like Price. He said you might not appreciate the irony, but he just couldn’t help himself.”

By this time, Trump was sitting slumped across from the spirit, reduced to silent mouth movements and looking like a bad imitation of Alec Baldwin.

“Been a long night, Donald?” asked the spirit with just a hint of compassion. “Well, gonna get a little longer. C’mon, dude.”

The window flew open, the spirit bolted through it, and Trump felt himself pulled along in the draught. In seconds, they were in a back corner of the gallery in the House Chamber. Nancy Pelosi was at the podium, gavel in hand.

Trump came alive suddenly. “Hey, I thought you said you were the future spirit! This is the past! She used to be the Speaker.”

“She did,” the spirit who looked like Tom Price agreed. “But, it’s 2021 and she is again.”

“Wait a second,” Trump said slowly. “Are you saying I lost the House before my second term?”

“No, I’m saying you lost the House in 2018. You didn’t lose the Senate until 2020. Oh, and I’m afraid you didn’t get re-elected.”

“No way,” the President said, without conviction.

“‘Fraid so, dude. See, that game of chicken you were playing with the Democrats backfired on you. I kinda pushed you, that is, Tom Price kinda pushed you to really sabotage Obamacare, once the Democrats realized you weren’t really offering them any serious compromise. You stopped most of the subsidies so most people couldn’t afford the premiums. You gave the insurance companies that weren’t already scared off lots of loopholes, so they were able to start excluding pre-existing conditions again. And you weakened the mandate so many more healthy people opted out. Within a year, you made your prediction come true: Obamacare imploded.”

Trump seemed genuinely puzzled. “But, that’s a good thing, right? I mean everybody on the right wanted to kill it.”

The spirit spoke quietly, but his eyes blazed. “Everyone on the right in the swamp wanted to kill it. Real people wanted health care that worked for them. They believed you when you promised it to them. So, when the light dawned on millions of people who had voted for you and trusted you that they or someone they knew was screwed, your approval rating bottomed out. And you took lots of members of Congress with you.”

Trump started to speak, but the spirit held up his hand. “Hold that thought, Donald. We have one last stop.”

With a sense of deja vu, the shaken future ex-president was again an invisible bedside observer. This time, however, the hospital room was empty except for the bed’s occupant.

“We did travel backward this time,” Trump whispered. “I know those eyes. I was here already with the spirit of the past.”

“No,” the spirit of the future corrected. “This is the daughter. She inherited the gene from her mother. She got the bad news about a year after she lost her Obamacare plan. There was no replacement she could afford. A few good friends said they would help her pay for it, but no insurance company would give her a policy at any price. She’s here under a state hospice program.”

“Bad timing,” Trump said, shaking his head. “Unlucky. Sad, so sad.”

The spirit said nothing but again his eyes blazed.

Turning away from the bed, the President looked thoughtful. “Are the things you’ve shown me things that will happen, or things that could happen?”

“Nothing is set until it happens,” replied the spirit tentatively.

“So, it is possible this girl’s life could be saved?” The spirit nodded and Trump added, “And I could still win re-election?”

The spirit couldn’t suppress a laugh. “Technically, I suppose. But don’t get your hopes up, dude. There’s a lot I haven’t shown you. I mean, Russia alone…whew!”

140 Characters

Back in his room, Trump sat in front of the window looking at the water as the dawn sky lightened. Finally, he raised his phone and began to tap.

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