Harborview

I hope I can convey this, still having the remnants of a couple of valium in me ... I have a story about health care in the U.S.

My back pain having persisted for months to the point where a disinterested primary care physician finally referred me to a specialist who was interested, I found myself routed to Seattle's roughest medical turf for an MRI, a kind of x-ray in the round that allows a physician to see the soft disk tissue between the bony vertebrae.

Harborview is the once county, or public, hospital known as well for its superlative trauma care as it is for its mostly indigent population of the sick who cannot obtain care elsewhere.

It is a teaching hospital affiliated with the University of Washington and the Veterans Administration hospitals ... each hosts a number of research projects that rely heavily on those willing to subject themselves both to student physicians and experimental procedures. Thus the poor become useful in the advancement of science.

The specialist who will care for my spine is known for a particular technique and I am grateful he is willing to treat me. But, apparently because of his affiliation with Harborview, it was that facility in which I found myself waiting for an MRI today.

My procedure was no different -- and perhaps more comfortable -- than the one I experienced some fifteen years ago in a more luxe atmosphere.

But waiting for it was a trip.

Despite an obviously hardworking staff, and lavender paint trimming the walls, and ethnic-leaning art that tries too hard and the mandatory Chihuly glasswork behind glass, there is a aura of deep grime about the place. And dejection.

These are waiting rooms peopled with those who cannot speak English -- almost every cluster of patients in the radiology room was accompanied by a translator, whether Hispanic or Somali.

These are people who must rely on the kindness of strangers when asked "Do you have insurance? Do you have any coverage at all?" When the most positive answer is the translator helping the sick one pull Medicaid coupons out of a purse or a pocket.

And these are sick people. Radiology is not the most grim department in the facility -- I'm pretty sure the hyper-busy ER is -- but even there, you could tell that a lot of these people had waited until they could wait no longer to seek care.

Spend some time in a place like this and then talk to me about market forces in health care.