A Matter of Degrees

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If you rattle around enough, you strike up some unlikely friendships. One of the most unlikely friends I have, at least unlikely to somebody brought up in the ’50s, is a fairly high muckety-muck in the Chinese government. High enough to have the ear of Hu Jintao, if he wants it. And a good enough friend, I think, that if I ever needed to get a message to Mr. Hu, he could deliver it. Like millions of other people I have, in fact, two degrees of separation from the president of the Peoples’ Republic of China.

Why I bring this up is that there’s another person, a person I’m not so close to – a mysterious Dr. Romeo who, apparently, resides somewhere in the wilds of Virginia. That’s about all I know about him. Google as I may, review the correspondence in my email files as I will, I can’t discover where Dr. Romeo went to med school, how long he has been in practice, or what his specialty might be. I can’t even track down a first name for him. In fact, I’m not even sure that Dr. Romeo is a he. He may very well be a woman. But, whichever restroom he (or she) uses, he is the doctor assigned to me by the State Department to decide whether I am fit enough to live on the government’s dime in out-of-the-way corners of the world.

You might think that, as the physician assigned to my case, Dr. Romeo would want to examine me. But if you do think such a thing, it’s because you don’t have a lot of experience with federal healthcare. All communication with Dr. Romeo is mediated through third parties.

The third party that I have formally dealt with is one Judy A. Sutton, FSHP FNP MPH, and, for all I know, Dame Commander of the Order of the Garter. She is Dr. Romeo’s Medical Clearances Deputy and, in the past, if I needed to find out something medical from Dr. Romeo, I emailed my questions to Ms. Sutton. From time to time, I imagine, Ms. Sutton sits down at her computer, reads through stacks of emails, and trots the questions she thinks worthy of Dr. Romeo’s time down the hall to his office. After a while, Dr. Romeo gives her the answers, she trots back to her computer, paraphrases the answers in return emails, hits the “send” button and, presto!, medicine accomplished.

I say “in the past” because, apparently, this process has proven much too nimble and effective for Federal Medicine to continue to use. From now on, I have been told, I am to send my concerns to a third government person, a person in an entirely different federal agency who, I presume, does not reside within trotting distance of either Judy A. Sutton, FSHP FNP MPH, and potentially DCOG, or Dr. Romeo. As I see it, the job of this Third Federal Person is to repackage my concerns for Ms. Sutton. She, when she reviews her emails, will trot the questions she deems worthy down the hall to Dr. Romeo, get the answers, trot back, and paraphrase Dr. Romeo’s answers in an email to the Third Federal Person, who will, then, email the gist of Ms. Sutton’s response to me. This puts me at three degrees of separation from Dr. Romeo.

At this point it will have occurred to the perceptive reader that Your Correspondent has a more intimate relationship with the emperor of Red China than he does with the government doctor who is supposed to know enough about the current state of his health to decide where he can and cannot live for the next few years.

I don’t want to jump into hasty generalizations here, but this might be the kind of thing that gives federal healthcare a bad name.


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