I went on a camping trip with my sons and grandsons deep into the White Mountains of Arizona, into the heart of Apache country. Reservation Lake is a pristine blue pearl at the base of Mount Baldy. It is accessible only by 26 miles of dirt road; you really have to want to get there. “Rez” Lake is surrounded by a dense forest of aspen and ponderosa; wildlife abounds with elk, deer, eagle, osprey, mountain lion, and bear, and the lake always has fish.

This was my eight-year-old Golden Boy’s first camping and fishing trip; bliss can hardly describe the perpetual smile on his face. He caught fish, learned how to clean them, got dirty, ate s’mores, and listened late into the night to stories around the campfire. There is something about a brilliant night sky, the noises of the woods, the wind through the trees, and being alone in a forest that just makes stories more real.

Some of those stories were mysterious and filled with mayhem and dread. Surrounded by dark forest, one can feel the presence of those old Apache warriors whose spirits still roam here. In the wind and forest sounds, one can almost hear their voices lamenting their fate at the hands of the white man. Fierce fighters who would like nothing more than to seek revenge on the descendants of their tormentors. The Apache always had an attraction for the young plump white men, who were always the tastiest . . . (you get the picture of where this story is going).

One night, after dinner, the fire had died down and only coals remained. My 16-year-old, Red Boy, was the fire chief so he collected some kindling to ignite the flames, and then sat in his chair and blew down on the fire. When the fire didn’t burst into flame, he got up to get some paper. I tried to embarrass him saying only a white man would use paper to light those coals. I told him to get down on the ground and blow under those coals not down on it. So he made a couple more cursory attempts until he got short of breath, and then got up to get some paper; the wood blazed in moments.

Sitting around the dancing flames (the devil made me do it), I launched into a soliloquy that this isn’t just about the paper. It is about not always getting what you want when you want it. Some good things take time; you have to work at them which is part of its goodness…yada, yada, yada. Then I closed with a chorus of “You can’t always get what you want.” When I finished, he looked at me and said, “You were born before paper was invented, this is how we do it now”.

We laughed, and I realized every time I go into the woods and sit around that Grandfather Fire, I hear a new ending to an old story. There are many ways to light the fire and to keep it burning before it’s time to be extinguished.

My Babayaga sister in Taos, a loyal reader of The New Yorker, sent me an extraordinary article written by a Harvard surgeon, Dr. Atul Gawande (6/1/09). It’s a story about how a physician culture drove up the cost of health care in a Texas town.

There are some doctors who are diligently proactive in seeking answers to patient complaints and prescribing immediate relief. They order extra tests, services and procedures because the stuff’s all reimbursable and it’s also a defense against potential lawsuits.

Surgeons in McAllen, Texas, are operating a lot more than those in neighboring El Paso. Their justification is the belief that an obese 40-year-old woman in McAllen is not going to change her diet. If she’s in discomfort, why not simply operate and put her out of her misery. McAllen surgeons also do more cardiac procedures, hips, knees, and assorted biopsies than their neighbors (often in hospitals or surgical/diagnostic/and imaging centers in which they have a financial stake).

Healthcare costs are overwhelming us because we have the most wasteful and least sustainable healthcare system in the world. Unless we change this system, even universal coverage will fail because it will not control costs. We can change the system if we reward prevention instead of intervention. Let’s say we pay doctors more if they keep their patients out of hospitals. Reward doctors who spend a little time to develop a relationship with patients and inspire them to believe that they can become the principal agents in their own healing.

If we reimbursed on such a system, we would reduce by at least half the staggering cost to treat chronic diseases in America (85% of the healthcare budget).

Don’t knock the docs in McAllen; they are, like the overwhelming majority physicians in this nation, a knowledgeable, committed, caring group of professionals. And most of us would like to return to a profession we chose not because it was an industry, but because it was a ministry. For doctors to do that, patients (and lawyers) need to step up if we are going to get beyond finger-pointing blame reactions. Stop all the lawsuits, and stop settling malpractice cases because it’s cheaper than a trial. It perpetuates litigation, makes doctors order more tests, practice more defensively, and rack up the costs.

Universal coverage is possible if we can control costs. And we can if, as a nation, we step up and appreciate that the work of healing is a sacred profession based on mutual trust.