Thursday, November 22, 2012

Why I am Thankful......for MEDICARE

Seniors marching on behalf of Medicare in the early 1960s. At that time, adult children had to declare mortgages, assets etc. to pay any extra money for medical care for their elder parents the state wouldn’t cover. Many seniors, rather than burdening their charges, simply died alone.

The pre-Medicare era was nasty, brutish and saw most elderly either dying in an impecunious state, or simply alone.....of some disease or infection.

By 1960, the then Democratic contender for the presidency - John Fitzgerald Kennedy - had seen enough and as documented in a period issue of LIFE magazine (December 19, 1960, page 31) proposed for the first time a program of elderly medical care and insurance operating under the Social Security System.

Now, as I glance at the recently tabulated bill (from UCSF Hellen Diller Cancer Center)  for my treatment of prostate cancer, I thank JFK and my lucky stars (my 'lucky stars' in the sense of detecting the cancer this year and not when I was scrounging for a private plan prior to Medicare) that Medicare was available and still essentially intact.

That bill tabulation, for those who might be interested, came to $42, 776 and this encompassed a breakdown of different contributors, from anesthesia ($4,124) to radiology services ($16,768) to recovery room ($2, 090) to operating room services ($14,994).   The bill, after Medicare Part B kicked in, came down to $1,299 of which most will be paid by my Medicare Supplement Plan (F).

Now, flash back to when I was 62 and the best insurance on offer to me was an AARP plan with $15,000 deductible and only  limited coverage. Had I been detected with prostate cancer back then, I'd have had to come up with virtually all of the $42,000.  At most, the private AARP plan might have covered $11,000 or so. (And this is assuming the cancer was detected after enrollment and not before - else I'd have been denied based on having a "pre-existing condition".)

In that case, having been given the diagnosis, I'd have had little choice but to skip any immediate treatments and hence, the cancer would plausibly have metastasized until - by the time I finally did qualify for Medicare (last year) - the costs of treating advanced prostate cancer would've been drastically more expensive. (In that case I'd have likely required multiple treatments, including external beam radiotherapy, androgen suppression in addition to high dose brachytherapy)

I point this out because one of the alleged "solutions" to the "fiscal cliff" - grabbing so many hysterical headlines right now - is to extend the age to 67, to qualify for Medicare. To say this is monumentally STUPID, is putting it mildly! In fact, rather than limiting Medicare costs it will explode them - which doesn't require Mensa-level intellect to figure out!

If Dems yield on this to the Ryan-led "fiscal cliff" wheeling and dealing Repukes, then all hell will break loose on the Left flank. The Left understands that those 65-67 yr. old seniors caught in the proposed 'donut' coverage wait, will be like I might have been - and postpone essential medical care rather than go broke. Then, when they do finally qualify for Medicare, their problems will be much worse and require far more resources, medical costs to fix. This ain't rocket science!

As it is, Medicare is NO freebie! This needs to be repeated over and over again! The supplemental Part F insurance that paid the balance of my prostate cancer treatment bill comes to $139 a month alone. This is in addition to the regular Medicare premium (Part B)  of $99 a month. In addition, no dental coverage exists, so my wife and I had to cough up over $2,700 recently to cover the costs of new crowns, fillings and dental cleanings. This isn't any kind of luxury because most people know that once your dental health goes, the rest of your health generally follows. Healthy teeth, after all, are critical to good nutrition and avoidance of chronic inflammation! We aren't talking 'cosmetic" dentistry here!  And I won't even add the $1, 500 or so every other year or so for new glasses.

Another BIG Thankfulness acknowledgement here - that Ryan and Romney LOST the election! Imagine the path we'd now be on if the Ryanesque "vouchers" were the new Medicare? Hell, I'd have exhausted my $10,000 voucher in a heartbeat then have had to pay the balance of the $42,776 bill and that isn't even looking at any other health problems that I've had the past six months (inlcuding ear infection, strained back muscle).  

Under Ryan's plan and with no government mandate for providing care, why should the profit -oriented insurance companies put themselves on a downward treadmill or "losing wicket" as we call it in Barbados? They wouldn't if they had any grain of sense. Without a mandate or order from the government, you can also bet your sweet bippy they'd reject any elderly person with a pre-existing condition. This would be the proverbial no-brainer for them!

Thus, by the time JFK proposed a government health plan linked to Social Security, in 1960, America's seniors were more than ready. More than ready to stop being parasitized by commercial outfits, or humiliated by the likes of states under the odious Kerr-Mills plan (which required adult kids to cover costs). The only main opponents were the AMA which (One Nation Uninsured, p. 68):  "ran newspaper ads and TV spots declaring Medicare was socialized medicine and a threat to freedom" while blowhards like Ronnie Reagan made idiotic recorded talks trying to scare people by asserting (ibid.): "One of the traditional methods of imposing statism on a people has been by way of medicine".  (Reagan also suggested Medicare was a means of "communist intervention in a free nation.")

Fortunately, most seniors who'd actually experienced the dregs of capitalist medical bestiality didn't buy this hog swill. They organized under groups like the National Council of Senior Citizens (see image) and turned the tables by imposing relentless pressure on representatives (the most intransigent of whom were Southern Democrats, who LBJ had to finally confront and read the 'riot act'). Eventually, the opposing voices were muted and Medicare was passed in 1966.

For those interested in what elder health care was like before Medicare get the Oxford University Press monograph, entitled: One Nation Uninsured, by Jill Quadagno, which also gets to the bottom of why there is such massive political aversion to any kind of genuine health care coverage in this country which doesn't drag in the profit motive.

As for the "fiscal cliff" - let's not let our reps toss us over it for the sake of bankster slime (like Lloyd Blankfein) and return us to an era where seniors had to sink or swim medically!



Julie Anderson said...

Medicare policy is to get advantage between the health insurance company and the people!Most of the people are falling under this category where they get many advantages by using this!

Copernicus said...

What you say is true up to a point, but much more advantage (or 'leverage' via the health insurance companies that help shape Medicare) could be attained by simple changes. Many of these would save billions each year. They include:

1) Allowing Medicare to bargain for the lowest cost prscription drugs like the VA does.

2) Transferring those currently on "Medicare Advantage" (based on more expensive private plans for which standard beneficiaries must subsidize) to standard, gov't run Medicare.

(2) also makes tons of sense given the admin costs for standard Medicare are barely 3% of total budget while most private plans run to 20% ore more - hence more waste.

Finally, we need to adopt the model currently used in Japan, whereby each procedure has its own rate or cost. As opposed to widely varying costs for the same procedure across the country. There's no sane reason why an appendectomy should cost $18,000 ni Florida, say and only $4,000 in Colo.