We read this morning that the administration is considering compromising its public health insurance option. It is feeling the pressure of public sentiment which is running against change or, at least, that particular change. I am reminded of President Julius Nyerere’s comments on his efforts to bring modern development to the Masai, those tall, resilient, culturally distinct people of East Africa known to Europeans and their North American descendents for standing on one leg and drinking a mixture of cattle blood and urine. Modern development was seen by some as a threat to the Masai way of life and President Nyerere was questioned about the potentially destructive impact on the Masai of his modernization efforts. Nyerere responded that there was tremendous pressure on everyone to live in the 20^th Century and “everyone” included the Masai. He noted that it wasn’t a matter of choice. People were either going to live in the 20^th Century with the flow or they were going to live in the 20^th Century against the flow. No one, Nyerere added, gets to choose not to live in the 20^th Century. It was not his doing. He was simply trying to get his people on board the train.

It appears that we have our own Masai problem right here in the U. S. Change is always difficult for humans. People prefer the known and generally fear the unknown. The unknown can be tricky. Watch one of my elderly brethren try to use a debit card to get gasoline and you will see what I mean. What comes easily and naturally to some is strange and inexplicably complicated to others. But the world we live in now requires us to have debit/credit cards and refusing them is not one of the choices.

Eventually we will have national health care. We can start having it now or we can start having it later. But we will have it just as we will have to live in the 21^st Century. In the meantime, we have our Masai and our Masai don’t want to live in the 21^st Century. They want to live in the early 20^th Century. And who can blame them? Those quiet small towns with tree lined streets. The calm, the peace, the people looking out for one another. The doctor making housecalls. Ah, yesteryear. And, as we are seeing, our Masai can be fierce in their opposition to change. And as between logic on the one hand and passion and ferocity the other, well, the outcome is never in doubt. So, although there is still hope for some small inroad, it would appear that we will largely continue to limp along with our expensive, profit heavy, but familiar private health insurance until it simply collapses of its own weight. National health care is not a panacea. It’s simply what the 21^st Century will require of organizations called nations. Meantime, we will continue to live in the land of the fee.