Sunday, Jul 20, 2008
My mother is 65 and has always had health insurance. But since President Bush announced his plans to overhaul Medicare, she's worried she may never be able to retire.
Sep 12, 2005 | A couple of months ago, as I sat at my mother's hospital bed staring at the 4-inch gash left across her throat from parathyroid surgery, I couldn't help but feel both stunned and grateful. Stunned that a person can survive an operation that appears identical to the act of a crazed serial killer, and grateful that my mother has the health insurance that allowed her to get such high-quality surgical care and the prescription coverage that maintained her health until the surgery could be scheduled.
That both these are true does not go without saying, not even for my mother, who has always been insured, and who is a public health administrator and thus would rather walk the streets of our hometown stark naked than be uninsured for even a day. It does not go without saying, because my mother is turning 65 in August, and she hopes to retire in the next few years.
My mother has been working steadily for the past 45 years, and she not in the best health. She has high blood pressure, diabetes and arthritis, and I know she would like to stop working before ill health prevents her from enjoying the activities -- traveling, gardening -- she has been putting off until retirement.
She cannot retire, however, because as soon as she does she will lose her health insurance. Even with the vaunted Medicare prescription coverage passed by Congress in 2003 and signed with much fanfare by President Bush, my mother's medication costs will quintuple. Under the new plan, even if my mother develops no new ailments, even if her physicians never change her medications, even if she never, ever gets sick again, 15 percent of her gross retirement income will go to medications.
Much has been written about the mendacity behind Bush's plan to privatize Social Security, about the fact that the "crisis" about which the president shrills is trumped up to scare voters. Medicare, however, is facing a true crisis, one that could lead to a catastrophe for people like my mother.
There are currently 40 million Medicare beneficiaries. By 2030, when the baby boom generation joins the rolls, that number will double. There is simply no way we are going to have the resources to pay for 80 million Medicare beneficiaries at our current tax rates. And yet, instead of dealing with this looming fiscal crisis, debate and "reform" have been entirely focused on the prescription plan.
Now, don't get me wrong, I'm all for a prescription plan. The actual cost of my mother's medications is $1,500 a month. My father's are also nearly that high. Without prescription coverage my parents could not afford medications and also pay for luxuries like, well, food. But Bush's prescription plan, slated to cost $400 billion over the next decade, will actually cost at least $700 billion, according to Jonathan Oberlander, a professor of social medicine at the University of North Carolina-Chapel Hill and the author of "The Political Life of Medicare." For a program already facing tremendous cost increases, this would be a disaster.
The Medicare prescription plan's worst crime is that it is a huge financial boon to the drug companies. It guarantees that they will be able to set whatever prices they want for the drugs they produce, and it bars the U.S. government, one of the largest purchasers of prescriptions in the world, from negotiating for discounts. Medicare must simply pay the prices set by the pharmaceutical companies.
The other problem with the new Medicare prescription plan lies in its baroque design. Oberlander says that "virtually no one who voted on this legislation understood these benefits, and certainly no one who is going to use them understands them."
My mother has a master's degree in public health. I went to law school. And still it took us hours to come up with an estimate of what her prescription costs would be under the new prescription plan. I would feel worse about this, and about not being sure if our calculations are even accurate, if it weren't for all the misinformation and errors in the government's own 2006 Medicare Handbook. Hell, if they can't understand their own law, how can they possibly expect us to?
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