Health insurance and the paradox of care

‘Care’ began as an emotion but now is an activity accounting for nearly a fifth of the United States economy.

J. Scott Applewhite/AP
House Speaker Paul Ryan, R-Wis., announces that he is abruptly pulling the troubled Republican health care overhaul bill off the House floor on March 24, 2017.

By the time you see this, dear reader, the United States may have an entirely new health-insurance system, one that will gather up both those proverbially lying in the middle of the street and those driving by in their Cadillac plans, and a great chorus of the people will say “amen.” 

Or maybe not.

Meanwhile, I’ve been pondering the evolution of the hardworking English word care. It started out referring to an emotion, a sense of mental burden, but has evolved into an activity – one whose share of the world’s largest economy, according to 2015 data, reached 17.8 percent. 

Care, as a verb, comes from the Old English carian or cearian, meaning to “be anxious, grieve; to feel concern or interest,” according to the Online Etymology Dictionary. The word was rooted in a Proto-Germanic term meaning “to lament.” 

Care as a noun is similarly ancient. But by around 1400, its meaning had evolved to include “charge, oversight, protection,” to cite the Online Etymology Dictionary again. The postal “in care of” – remember that one? – stems from this sense, and goes way back, too.

“To take care of,” in the sense of “to do” or “to take in hand,” goes back to the 1580s. This suggests that a verb usage such as, “Pick up the doughnuts for the meeting in the morning? I can take care of that,” would have been familiar to Elizabethans, even if the doughnuts were not. (Scones, maybe?) 

The astute observer will note the difference between “taking care of” getting the doughnuts and “taking care of,” for example, a ­special-needs child. 

But the Oxford English Dictionary combines both in its usage examples for “take care of.” Thus we have the biblical good Samaritan who brought the man who had fallen among thieves en route from Jerusalem to Jericho “into an Inn, and took care of him.” And in the same usage list, a reference from 1932: “Money ... which would enable him to take care of all arrears on the property.”

Not quite the same, are they?

The Online Etymology Dictionary traces caregiver back to 1974, noting, “It has, in many senses, the same meaning as care-taker, which ought to be its antonym.”

But language isn’t always logical. And so “caretaker” is likely to refer to a government somewhere in northern Europe, or to someone who lives in a little cottage on a grand estate somewhere. Caregiver, meanwhile, is defined straightforwardly by Merriam-Webster, for instance, as “a person who provides direct care (as for children, elderly people, or the chronically ill).” 

It is reported that the White House does not like the term “Trumpcare.” 

“Trump loyalists,” as The Washington Post calls them, seem to prefer “Ryancare” or “RyanCare,” with the “camel-case” interior capitalization. 

What emerges from the legislative sausage mill may indeed be something called TRyanrumpCare – designed to cover someone’s flank, just maybe not yours.

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