"Health care" is an expression today's senior citizens seldom, if ever, heard when they were children. In addition, few people living six to eight decades ago had ever heard of health insurance, and I never knew anyone then who bought or had it. Prevention, home remedies, home treatments and visits to a family doctor provided most of the medical care. Except for a few inoculations by a county nurse, the health care I received as a child was given by my parents.

A significant part of home health care in those days was prevention. For example, at our house we were never allowed to come to the table without first washing our hands. Nose-picking, hair-combing, coughing and sneezing sent any one so doing away from the table. Dogs or cats were never allowed at the table and, in my case, not allowed in the house. In addition, it would have been unthinkable and repulsive to allow cats or dogs to lick one's face or mouth. Food was thoroughly cooked, especially after my father got a tapeworm (24 feet, nine inches long) from occasionally eating a sliver of cured but uncooked ham. That memorable experience caused him to say, "We would all be dead if we didn't cook our food." Fast-food restaurants and others have been forced by law to ensure that their meats are cooked enough to be free of various contaminations.

During those long-past days, there was widespread use of Cardui, 666 tonic, Epsom salts, castor oil, mustard plasters, salves, turpentine and sulphur. Perhaps it was because of blood or skin impurities, but a common problem for people was to have a skin sore or a painful boil ("risin"). Treatment involved the application of salves, either spread on or beneath a bandage. Cuts on the legs and arms were treated the same way, and sometimes a piece of fat meat was applied with a bandage. A medical staple at our house was Antiphlogistine, a medicated ointment or salve in a jar, that seemed to be effective in heading off infection, pacifying wounds and initiating healing. A poultice of water-moistened snuff or tobacco would mollify bee and wasp stings, and a mixture of vinegar and soda was efficacious for easing the sting of simple burns.

Sulphur was sometimes used in combating head and body lice, and a spoonful of turpentine each spring was considered a necessity for children's digestive well-being. Mustard plasters were used to treat chest colds. Heated salt water was used to soak ailing feet and cuts, abrasions and bruises. The crystals of Epsom salts seemed to have healing and soothing properties for some external ailments. My parents, in addition to advocating frequent hand-washing, insisted on the immediate treating of any break in the skin with iodine, mercurochrome or kerosene.

During those earlier days, outside medical attention was sought only after home remedies failed, when disease was too severe, or when some injury necessitated professional care. Family physicians, chiefly the only kind most people knew about, were called upon for all medical needs, including the setting of broken bones, the suturing of cuts, the treatment of most illnesses and the delivering of babies.

Hospitals and clinics were few, and specialists were unknown or unavailable in most cases and very rarely consulted. While family doctors did it all, there were occasional trips to eye, ear, nose and throat doctors and to a dentist, if there was gum disease, a tooth abscess or a tooth needing to be pulled.

Health care and medical insurance are issues that have claimed the attention of politicians and the American public in recent years -- and with accelerated emphasis and considerable acrimony in recent months. Some means for receiving good health care is needed and important to the nation's people. The raucous clamor across the country about health care seems to center on its quality and cost and whether the government, individuals, health-insurance companies or health-maintenance organizations will have the final say in who receives care and how. Considerable debate has centered on whether national health care can be afforded and if the uninsured should receive free coverage.

Health insurance came into vogue after World War II, along with an increasing number and variety of medical specialists. Today's children often receive semiannual dental care and visits to pediatricians, orthodontists, and dermatologists. Women receive gynecological and maternity care. Some men get annual checkups and see specialists as needed.

Patients needing comprehensive care are referred to multiple medical specialists providing care for male and female adults, children and babies. The annual routine of most older adults may include occasional or frequent visits to a cardiologist, dermatologist, neurologist, gynecologist or urologist, orthopedist, radiologist and a dentist. Also, for older adults, having an occasional colonoscopy has become a must.

There are too many specialists to list and so many it's hard to keep up with them. In one of the Blondie cartoons, Dagwood talked with a man about his medical needs. The man told Dagwood he was going to a specialist. "What is his speciality?" Dagwood asked. He answered, "The left nostril!" Now that is carrying specialization too far!

The price tag for care has greatly escalated from the day when the family doctor was either never paid, paid as little as $2 for an office or home visit, or paid with eggs, potatoes or ham. So we are in a national struggle to know how to reduce the costs of medical services and how best to provide health insurance and medical care for more people.

Realistically, there is no cure for old age, but we may prolong life and its quality by proper eating, exercise and good health care.

Concluding in a more cheerful vein, read some physicians' notations on patient records.

Patient has chest pain if she lies on her left side for over a year.

On the second day, the knee was better, and on the third day, it disappeared completely.

The patient has been depressed ever since she began seeing me in 1993.

Discharge status: Alive but without permission.

Healthy-appearing decrepit 69-year-old male, mentally alert but forgetful.

The patient refused an autopsy.

The patient has no past history of suicides.

Patient has left his white blood cells at another hospital.

Patient had waffles for breakfast and anorexia for lunch.

She is numb from her toes down.

While in the ER, she was examined, X-rated and sent home.

The skin was moist and dry.

Occasional, constant, infrequent headaches.

Patient was alert and unresponsive.

The lab test indicated abnormal lover function.

The patient was to have a bowel resection. However, he took a job as a stockbroker instead.

The pelvic examination will be done later on the floor.

Patient was seen in consultation by Dr. Blank, who felt we should sit on the abdomen and I agree.

Patient has two teenage children, but no other abnormalities.