Yesterday, Today and Tomorrow

This California Bull blog post is about the new Affordable Care Act, and how it will affect California. But first, let’s examine this amazing photograph!

This photo was taken in the early 1960’s at a Christmas party for the young staffers at Boston General Hospital. The man is either a medical intern or a resident, and the women are probably nurses or wives, although it’s possible that one of them is an intern or resident as well.

I love this photo because it captures both their world and the world of the early 1960s so well -- the era celebrated in TV shows like Mad Men. We watch, amazed and shocked at how we once were, while also waxing nostalgic for the mid-century style of an expanding and influential America.

Notice the peeling paint and wallpaper on the wall behind them -- this is not some fancy ballroom, this is a student social hall. And the piece of round metal on the right hand side of the photo -- what is that? A water or coffee dispenser?

Nowadays it would be made by Igloo, or Rubbermaid, but that steam-punk cylinder comes from before the age of plastic. There’s probably no plastic anywhere in that room, except maybe some costume jewelry on a few women’s wrists.

But let’s talk about what the photo is really about: the amazing style of the four people posing. Everyone is in their mid-20s, they’re working 80 hours a week and they have no money probably, yet they look fantastic. Granted, it’s one photo at one Christmas party, but if the same party were happening today, everyone would be in scrubs and Ugg boots, and their hair would still be wet from their shower.

They’d still be struggling, only they’d each also have s cell-phone and a massive debt in student loans.

My favorite outfit and hairstyle is on the girl on the left. Her harlequin print dress goes up to her neck and down to wrists so no skin shows, yet it still shows off her figure. Her hair is also pinned perfectly with a little curl on the forehead. I also like the next woman in blue, and how she manages to hold her black clutch in the crook of her right arm while not spilling the drink she’s holding.

The guy is cool and casual -- the girls all have cocktails, but he does not. He saves his hands for cradling two women at the same time, claiming both, yet claiming neither. My dad, who comes from that era, told me that if someone wants to snap your picture, put your drink down first, especially if it’s a beer. It will always make you look smarter in photos. This guy knows my dad’s rules and has a few of his own.

I also love that he’s wearing all grey -- grey suit, grey tie, grey pocket square, and a perfect square haircut to top it all off. He looks crisp and elegant in a simple suit, probably the only one he owns.

Our country was expanding then, all things seemed possible, and these young people have eyes full of promise. Now, 50 years later, young people who are the same age as the young professionals in this photo can’t find jobs that earn enough money to live on their own, so they’re moving back in with their parents.

Forty percent of them, in fact.

They are college educated, the best and the brightest we have, and their futures are nowhere near as promising as they were 50 years ago.

If that Christmas party were happening this year, there would be gender equality among both the doctors and the nurses, and more racial equality.

However, today’s doctors and nurses all face long hours of work to pay off all the debt they have racked up in student loans, some in the hundreds of thousands of dollars. If that were my reality, I’d show up in Ugg boots and scrubs as well.

Being a physician in the 1960s was a ticket to upper middle class freedom, where your training and expertise could make you a stake holder. Now, being a doctor, especially a specialist, means twenty years of school work and debt before you see a payoff.

Over the past fifteen years, smart ambitious people have gone into technology or investment banking and hedge funds, because the pay-off was in five years, not twenty. We need more smart people going into medicine again, but right now it’s an expensive crap shoot for everyone.

As the Affordable Care Act takes effect, I support it, both for the patients and for the doctors. Yes, even the doctors. I know this is coming, because overall costs will go down, for everyone. I look to Western Europe and Singapore, where a hip replacement costs $15,000, not $150,000, health care is less than 10% of GDP, yet the doctors are still well-paid and respected, and there is still an incentive to innovate and create.

Let’s use my family as an example for the patient side. We have some health issues, and we pay 1/4 of what we earn in some kind of health insurance or health care, and 1/4 of our professional time managing that health care, which includes fighting incomprehensible billing or shopping for better deals. On the physician side, most young doctors will spend a 1/4 of their income in the first ten years of practice paying off the debt they incurred. All of us would benefit from cutting our health care costs in half, and then putting the money we saved back into the economy.

That’s what the Affordable Care Act will do for me, and I can spend money on improving my business. Innovation. Research. Improvement. Infrastructure. Education. Taking a risk. Then we will expand and grow again, like we did 50 years ago. I am already planning ways to spend the money I am going to save -- and it’s going to help the whole state.

California will show the way, for we are the new and true bellwether state.

What does this photo mean to you?

Do you know any of the people?

Will you be enjoying the benefits of the new Affordable Care Act?

Ian BullComment