Wednesday, April 27, 2011


You're a senior citizen under Republican health care vouchers.  The price of medical care has continued to escalate at a rate higher than inflation, but the buying power of your voucher is capped by law, so you're losing ground.  For a while you can scrape together enough to buy private insurance, but your needs are greater every year.

Insurance companies are not there to be anyone's friend.  Patients?  They exist to care for their shareholders, and the mutual companies can't afford your annual costs.

At age 70, you have to choose between cancer treatment and heart treatment.  You know your PSA level has increased thanks to the home analysis kit you bought at Walgreen's.  At least you think you know; those things have a 30% false positive rate.  But most prostate cancers are slow, so you pick the cardiovascular insurance.  It only costs you $50,000 a year, which means you need a reverse mortgage and the entire annual payment from the privatized account that replaces less and less of Social Security with each passing year.  (And just try to get what you have left invested in a no-load index fund.  No one makes any fees off that, and your dwindling nest egg is too small to interest anyone anyway.)

A year or two later, still feeling pretty hale but in need of several medications, you can no longer afford any insurance without a low-dollar lifetime cap.  Basically, the only use you get out of your insurance company is to negotiate volume discounts on routine care.  Surgery beyond office procedures is out of the question, and even those mean a lean year at the kitchen table and skimping on your maintenance medications.  Arthritis?  Suck it up and suffer so you can keep taking your blood pressure meds.

With the level of care you're getting - minimal - your life expectancy drops.  The closer you get to that last year when the bills really pile up and your ability to promise to repay your debts slides off in the five stages of grief, the less willing any reputable insurer is to cover you.  Sure, there are companies that will take your premiums, but their policies have huge on-line PDFs filled with pretexts for denying your claims.  It seems as if all they care about is your voucher.

At a time when your life expectancy under the old Medicare program would still have been ten years, the private insurers all expect you to die soon in a way that's very unprofitable for them.  You can't get insurance coverage at any price.  You're a pay as you go customer.  With no money left.

With a touch of pneumonia, you get a friend to drive you to the ER.  A course of azithromycin would only cost $200, but the physician on duty won't prescribe it without $1000 in fees for the ER and the exam, so you leave untreated.

You should have planned better. 

Instead, the free market is so efficient that it doesn't need a death panel to end your useless, uneconomic life.  Those last 10 years you could live that you don't?  All profit for America.

The America of deserving titans of business, anyway, not unproductive freeloaders like you.

That's Republican health care for the aged.  If you're a teabagger who buys into Paul Ryan's bullshit, there's a certain harsh justice there.  You thought that harsh justice was for other people, and it catches you too.

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