This week the news was filled with stories about the passage of the health care reform bill of 2010, and it occurred to me that it might be an opportune time to look back at what was happening in health care one hundred years ago. Here’s what a glance through the New York Times during 1910 reveals:

In 1910 there were no drugs as powerful as sulfa drugs or antibiotics, but the government and the medical profession were beginning to wrestle with regulation of the medicines that existed. The 1906 Pure Food and Drug Act outlawed the sale of poisonous patent medicines and pushed for the correct labeling of all medicines, but an article on February 2, 1910 discusses testimony of Dr. Henry Kraemer, a member of the Committee on Revision of the United States Pharmacopoeia, that reveals that administrators were still hard at work trying to identify, label, and deem acceptable the medicines that existed. Dr. Kraemer points out that seventy percent of the drugs being used were “vegetable drugs” (herbal drugs) and that there needed to be standards for them. “It is not reasonable to suppose or believe that a good fluid extract or tincture can be made from a poor drug any more than to suppose that a good malt can be prepared from a poor quality of barley grains or a good extract of beef from a poor quality of meat…”

The article speculates that the Committee on Revision of the United States Pharmacopoeia must be coming under pressure from “sinister influences,” based on the fact that Kraemer was finding it necessary to take the stance that he did. While we’ve come a long way on regulation of pharmaceuticals, today’s newspapers regularly feature stories about the regulation of medications, so in many ways, Dr. Kraemer’s committee would likely feel very much at home in the world of today.

The same cannot be said for those who undertook studies of mental health one hundred years ago. A story about criminal tendencies in children indicated they meant well but were still very ignorant about the workings of the body–and the brain. The story focused on the New York Society for the Prevention of Cruelty to Children, the first organization dedicated to safeguarding children (founded in 1875). By 1910 the Society had expanded its mission, and hoped to rid “feeble-minded children” of their criminal tendencies. Based on research provided by Dr. M.G Schlapp of Cornell University, they believed that many of the children who performed criminal acts were often normal children raised in an abnormal environment and the SPCC was undertaking programs to help these children. There were, however, some cases where “the child’s defect was traced to the absence of the thyroid gland,…the absence of this fluid [from the thyroid] eventually leads to dementia and often to crime.” They also were looking for ways to rectify this “absence of the thyroid.”

On a completely different note, medical personnel today would identify with an article that appeared on October 13, 1910. The article concerned the opening of a world-class medical facility on East 66th Street, the Rockefeller Institute for Medical Research. The plan for the Institute was to focus on only three health issues by admitting only those who suffered from poliomyelitis (infantile paralysis), heart disease, or pneumonia. By narrowing their field of study, those at the Rockefeller Institute felt they would be better able to develop effective treatments for each.

But one additional piece of information caught my eye. Today one of the hospital mandates has to do with improving hospital cleanliness, so it was particularly interesting to read this description of one of the modern elements of the new facility in 1910: “….the glass doors leading to the glass-enclosed rooms are opened and shut with the elbows instead of the hands, and the air from the room passing to the outlet in the roof is sterilized before it gets there. After examining his patient in the pavilion the doctor hurries to a small room where he washes his hands, and he turns the water on, not with his hands, but with his feet.” Perhaps today’s hospitals might pick up a pointer or two from the Rockefeller Institute of 1910.

As for health care today, the passage of the reform bill is a big step forward in offering preventive health care–the best type of medicine–to more Americans than ever before. All in all, it’s a good week for the United States.

“I know you would all like to see a really strong health care reform bill go through by the end of the year so that all of you can move on to the next causes that interest you,” said Chuck Bell, program director of Consumers Union, at a meeting sponsored by the Westchester/Putnam Access to Health Care Coalition.

“I want to remind you–social change takes time,” he said at the meeting, which was held Sept. 25, 2009, in Purchase, New York.

As a member of the audience, I was taken by Bell’s words, because I have encountered a good number of people who are feeling burned out and discouraged regarding what the reform bill may actually contain by year’s end.

Bell went on to remind the audience that this is how progress occurs in a democracy.

This made me think of other long-term and hard-fought social changes that Americans have brought about. For woman’s suffrage, the Seneca Falls convention on women’s rights was held in 1848, and few of the attendees would have been alive in 1920 when the 19th Amendment passed, finally giving women the right to vote. Civil rights for African Americans–and voting rights for them as well–have definitely involved one step forward and two steps back. And though we have an African-American president, we cannot look in the mirror and say our country is now color-blind. We still have a long way to go.

In a democracy, change does not come quickly but when it happens it’s because citizens persist in voicing their desires.

A recent New York Times/CBS News poll that was released last week showed that two-thirds of the country favors the proposal for a government-run health insurance plan as an alternative to private insurance companies. That’s a stunning piece of information considering the anti-reform and anti-public option outcries at town hall meetings and the “tea parties” being sponsored by conservative groups.

In attendance at the Westchester/Putnam meeting were representatives from both U.S. Representative Nita Lowey’s and Senator Kirsten E. Gillibrand’s congressional offices, and both staffers said that the anti-health reform mail was heavily outweighing any mail in favor of reform.

Those of us who are in favor of health care reform need to speak up, and if we already have, then maybe we need to encourage others to do so. Last week I attended a group meeting where the purpose was to write letters to the editors of local papers or to our representatives in Congress expressing our feelings about health reform. As a writer, I was particularly struck by the scene. Writing is something I do every day, so I never think of it as difficult, but in this room 15 concerned citizens had gathered. They wanted to talk about what they wanted to say; they wanted time to put their thoughts into written form, and several wanted to read their letters aloud to be sure the meaning was clear. I was impressed by their commitment and seriousness of intent and reminded that putting our thoughts into words on complex issues we care deeply about isn’t easy.

Among the issues that came up that night were these:

America is the only industrialized country that does not offer universal health care of some sort to its citizens.
Those who “like what they have” in the way of health insurance might need to be reminded that the system is broken and cannot last. President Obama has said that in the last 10 years, insurance premiums have gone up 130 percent. At this rate and with no change in our system, more employers will begin to restrict the insurance they offer, and fewer citizens will be able to pay the difference.
More than 25 million Americans have what Kaiser Health News calls “Swiss-cheese health insurance.” They are covered for some things but not all, and the holes in their coverage leave them under-insured.
Most people are “one catastrophic illness away from bankruptcy.” Even if you have insurance, most of us currently have lifetime caps on our policies. One major illness and you could find yourself with uncovered medical bills you cannot afford to pay. The reality is that half of all bankruptcies are caused by expenses resulting from injury or illness.
If you think health care reform is important, write or call your Congress people. If you telephone the regional office you will very likely get a live human being (wow!). All calls are tallied and opinions noted. Or write a letter or send an e-mail.

And while you’re at it, send a letter to the editor of your local paper or online news source. If writing is something you put off, team up with someone and do it together.

As American citizens, we have the obligation to speak up for what we care about. The soldiers in wars from the Revolutionary War to Iraq and Afghanistan have been willing to give their lives for our democracy. For the sake of our children and our children’s children, we need to pass on the legacy of this great country. In this case, it is as simple as picking up the phone or writing an e-mail to say we believe all Americans deserve access to health care.

The only way change is going to happen is by letting our opinions be known.

For more information, visit the Consumer Union website devote to issues involving health care: http://http://www.consumersunion.org/health.html

If there are days when you step away from the news feeling discouraged about this country, I have a solution: Plan a trip to Washington, D.C. and spend a day on Capitol Hill. You will be reminded that it is our capital and our nation; you cannot help but relish the accessibility of the United States government.

Last week I participated in Lupus Advocacy Day in Washington, an event that called for people from different areas of the country to come and discuss with elected officials their hope that more money be devoted to lupus research and education.

Lupus is a chronic, complex, and disabling autoimmune disease that affects more than 1.5 million Americans, 90 percent of them women of child-bearing age. Many of them are minorities.

Lupus is so difficult to diagnose that most people suffer overt and troubling symptoms for 3-5 years before they are diagnosed. Their diagnosis finally occurs when they are in crisis–a hospitalization that need not have happened if the disease had been recognized and treated earlier.

Just as there is government money going to cancer research, there needs to be that sort of investment in difficult-to-diagnose illnesses like lupus because they are the kind of health “puzzles” that keep national health costs high.

The plan for Lupus Advocacy Day involved members of our 40-member group dividing up by Congressional district and visiting the staff person who handled health issues in the offices of our areas’ respective elected officials.

We met the day before and reviewed with the organization what we were asking. (If you’re interested in our specific requests, I list them at the end of the article.) With three other New Yorkers, I visited the offices of U.S. Representative Nita Lowey, and Senators Charles Schumer and Kirsten E. Gillibrand. In each case, we were met promptly by a staff person who listened carefully to our concerns. Jean Doyle, legislative director for Nita Lowey’s office was particularly impressive–not only did she know a lot about lupus, but she knew the health care bill inside and out.

As we worked our way through the day, I was impressed by several elements:

• Washington feels like “the people’s” city. Everyone from those walking along the street to office workers within the Senate and the House office buildings were welcoming and polite. When we needed directions, people would step out of their offices or walk along with us to better show us the way.
• The buildings around the Capitol are accessible to the citizenry. While we went through metal detectors to get into each building, the security was far less than any airport or any office in New York City. You don’t need any ID, and you get to leave your shoes on! Once we were in, we were as much a part of the people who belonged there as those who work there.
• Most of the staff members are quite young, but I found it heartening to see the knowledge and dedication of these young people—proof that there are generations behind my own who are dedicated to keeping this country strong.
• As a side observation, I can’t resist noting that the city is beautiful, and all 19 Smithsonian museums and the zoo are free…you can’t help but feel good being there.

While going with an organized group has its advantages (like someone else making the appointments) what was clear from the day and from the staff people, is that they are there to represent the People. You just need to take the initiative and let them know how you’re feeling.

If you decide to go and would like to visit a Congressional office, call ahead and tell them the one or two things that you would particularly like to discuss (don’t call with a 20-item list). The receptionist can then direct you to the person who is most knowledgeable in your area, and you can work out an appointment with that person. If you arrive without an appointment, a staff person will likely speak to you for a minute but it is not ideal. (Your chances of saying hello to your Congressperson are higher if you are from a low population state, though we were surprised and delighted that Nita Lowey stepped in to our meeting to say hello.)

One Congressional spokesperson noted that a lot of people can’t make the trip to Washington but that all Congresspeople have office staff in their local districts. “Calling the local office and talking to them or even scheduling a meeting there can be just as effective,” notes a spokesperson for Nita Lowey. Your opinions do matter.

The D.C. offices are busy places, and we were told meetings would last from 5-15 minutes. Many of the meetings are held standing in the hallway because of a lack of office space. But who can complain? Citizens in countries throughout the world would give a great deal to have this type of access to those in charge of their governments.

If you’re like me, you’ll leave knowing that despite the shrill tones and heated debates–and lack of civility–in some of our ongoing political discussions, this is still the greatest country in the world.

Now my personal obligation is to do what I can to help keep it great.

Our Requests regarding Lupus:
1. Last year, $1 million was devoted to start a nationwide lupus education program for health professionals. We asked that another $1 million be allocated for this education program to continue, which will help keep down medical costs by getting more cases diagnosed before a patient is in crisis.

2. We asked that the House and the Senate allot as much money as possible for biomedical research for this year. This was not specific to lupus, but just to affirm that we want the government to look for answers to all difficult illnesses.

3. We wanted Congress to know we support health care reform, particularly the aspects that do away with the current practice of not insuring people with pre-existing conditions and capping lifetime benefits. These are two commonly agreed-upon problems that need to be rectified for any person with a chronic illness, including diabetics, people with MS, or any other long-term disease.

For more information on lupus: www.lupusresearchinstitute.org