I just finished hiking the Grand Canyon, North Rim to South Rim, in one day. It is about 24 miles with about 5000 ft elevation drop and gain. This is my third trip. The first was in 2010, and served as a backdrop for the first speech I gave about ObamaCare, which I delivered to the Arizona Rural Health Association annual conference, held in Flagstaff AZ in August 2010. The Az Rural Health Assoc. has place the entire talk on the web (find it here: http://vimeo.com/album/806143). I still think that the Grand Canyon hike can be seen as an analogy for health system reform in the US. And I still find that we Americans are procrastinating the actual work of health system reform, like a hiker who gets the bottom of the Grand Canyon and then can't bring himself to start the upward trail. During my first hike, I met a group of middle aged men exactly in this circumstance at Phantom Ranch, at the bottom of the canyon. They had hiked in, but were not physically up to the upward trail, so they simply kept extending their stay in the bunkhouse day after day. Like that group of out-of-shape hikers, sooner or later we actually must hike the steep trail out of the health care mess we have gotten into.
Leaving the North Rim, there is a four mile plunge from the Ponderosa Pine forest at 8000 ft elevation down to the first bridge over the chasm. Followed by about 10 miles of gradual downhill hiking along Bright Angel Creek. The last several miles is through a deep gouge into the oldest rock formations at the bottom of the canyon--the so-called schist layer. After walking through several miles of schist (or, in the case of our health care system, layers of something that sounds like schist), the hiker arrives at Phantom Ranch. The parallel in our health care reform politics would be the phantoms that we consistently fall prey to: socialism, death panels, rationing, queing up for surgery, etc. Not far past Phantom Ranch is a bridge over the Colorado River. I crossed this bridge in 2010 at about 4 AM and took a picture. It was pitch dark, and the photo looks like a bridge going to nowhere. We Americans rail about the government doing all kinds of nonsense at ridiculous expense, and yet we allow our tax dollars to be spent on corporate welfare for health care corporations without a fuss. What other tax money is misused like that spent on health care. In the US, powered wheelchair companies advertise on TV claiming that they can guarantee that Medicare will pay for their product. How is that possible without someone calling that advertising something as pejorative as the now infamous 'bridge to nowhere'. After crossing the Colorado River, the trail follows the river for about a mile, gradually going up, making the hiker feel like the uphill climb has started. But, just before the real uphill climb does start, the trail drops back down to river level. We Americans have had repeated failures at health system reform, most recently ObamaCare, which make us feel like we are making uphill progress, only to fail us. All of the heavy political lifting of health care reform is still ahead of us. All along the trail are signs about not feeding the wildlife. The ground squirrels and deer are so used to humans that they have become aggressive in begging and/or stealing food from hikers. Not unlike the parasitic lobbyists who steal our legislative process from us.
Ultimately, the truth of the trail must be faced. In the hottest part of a July day, the hiker must buckle on the gear, fill the water bottle, and hike the 10 mile, 10% grade up to the South Rim. It is just plain hard work. But the magnificent view and feeling of accomplishment at the end is worth it. Plus, for those with the foresight to make a reservation, one can indulge in a fabulous meal at El Tovar.
So there is our choice: stay in the bunkhouse at the bottom of the canyon, or get to the top and feast at El Tovar.
Isn't it time that we stopped procrastinating steepness?
Dr. Joe Jarvis