I felt sheepish that day at being introduced as being from Alabama, imagining the entire class of MDs and hospital administrators thinking, “What is that brainless good-ole boy doing in this class?”
So I was delightfully surprised when several doctors surrounded me during break and said, “Dr. Tinsley Harrison from the University of Alabama at Birmingham wrote my basic internal medicine text,” and several others chimed in with respect for him and for UAB.
That was in the fall of 1967 when I learned for the first time that my state, which had been the nationally scorned epicenter of the civil rights struggle, had at least one man and one institution that national leaders in health care looked upon with respect.
From that moment on I regarded with enhanced pride my appointment to the advisory board of UAB by its first president Dr. Joe Volker who, with Tinsley Harrison as first medical director, replaced Birmingham slums with an urban university and, more importantly, built its international reputation.
But those credentials do not make me an all-knowing seer about health policy, a baffling discipline that does not conform to the normal economic rules of supply and demand.
Health care obstinately refuses to react in the market, for instance, like the price of bananas. Health obeys a different rule, the product of Tinsley Harrison’s intellect; he believed health is neither a right or a privilege … It is a necessity!
How does one put a price on a necessity?
If you accept Harrison’s Law, that health is like air, water and food, it must be made available to every citizen and cannot be taken away because then you are compelled to believe that the delivery of health care is a moral law, a law of nature.
Then comes the tricky part, making it affordable to all. That is the province of politicians who since Harry Truman have been trying to make health care available as a normal part of citizenship — a necessity, as Harrison saw it.
How did a small-town doctor from Talladega develop a theory of health care that cut through the liberal insistence that it is a right, like free speech, and the right’s belief that it is a privilege to be bestowed as a king might bestow a title on a commoner.
Perhaps Dr. Harrison saw health as a natural law because he descended from six generations of Harrison doctors, practicing medicine before there were medical schools, when bleeding was a treatment, where payment might be in produce or chickens, advancing to the creation of medical schools as Tinsley did.
He was born in Talladega in 1900, the year before my grandfather, Dr. T.W. Ayers, left Anniston for Hwangshien, China, as a medical missionary, where he developed a patient-centered practice and trained doctors at his medical school using the new clinical tools in place of mere lectures.
Having met and talked with Tinsley Harrison, being associated with his and Joe Volker’s school, and influenced by a grandfather who spent the most productive 25 years of his life — to him, “the most rewarding” — as a gift to poor Chinese and medical teacher to their sons, I can’t imagine being opposed to President Obama’s plan.
I can safely say that were they to descend from their heavenly home, Grandfather and Drs. Harrison and Volker would be stunned to learn that a majority of Americans are opposed to what they derisively call “Obamacare.”
Because a majority of those who oppose the Affordable Care Act approve of many of its provisions, I believe the three doctors being scientific thinkers would dismiss the thought that Americans have become cold and heartless and conclude that opposition rose because the act wasn’t well explained.
They would be correct. I have been dumfounded by the failure of the administration to mount a clear and sustained explanation of the act’s features and the effect on the country. For instance, it would reduce medical costs, according to the Congressional Budget Office.
Not only was there a failure of affirmative salesmanship when the bill was being drafted in the summer of 2009, the Great (Bush) Recession created anxiety and confusion, which GOP candidates shamelessly exploited, seeding town meetings with false tales that the act would create death panels to snuff out Granny if she got too old.
Ever since, Republican candidates for the nomination have lined up like firing squads with the odious Obamacare being riddled with volley after volley of largely ad hominem, factually unsupported criticism.
Much of the criticism has been leveled at the lifeline of the act, the provision that everyone must have a health insurance policy, underwritten by the government for those who can’t afford the coverage.
Why is that mandate any worse than the requirement that everyone who works is mandated to pay into a pension, Social Security? Even a hostile Supreme Court in 1935 approved that mandate, probably in part because it passed by huge majorities in Congress.
Yet, this Court in open hearings drilled bitingly into the mandate provision, a dialogue that smacked suspiciously of partisan Republican politics, which may be one of the reasons that this supposedly apolitical body of wise men has been falling in public approval in recent polls.
My panel of heavenly advisors and kin would not be surprised if a body of learned men making decisions in the sanctity of a scholarly environment far from public excitement and politics would conclude that the health-care act is compatible with the Constitution.
They might have written a more patient-centered act or made other revisions, but they would be stunned by a Court overturning the act, which would plunge millions of citizens from hope to despair and sew bitterness and confusion into the process of electing a president.
From an even more sanctified venue, they would wonder at a collection of scholars who could decide that it is unconstitutional to offer our citizens what is, after all … a necessity.
So, on Thursday morning, my heavenly trio would have been mildly surprised that — despite $235 million spent by opponents — the Court found it constitutional that millions would have to pay a small tax so all Americans can enjoy the necessity of health care.
H. Brandt Ayers is the publisher of The Star and chairman of Consolidated Publishing Co.