I try to drop a column in this space monthly. When I go silent for more than a month, you can safely assume it’s health-related. At 80, only a lucky few of us escape the indignities of a deteriorating chassis.
For some of us, health maintenance can become a full-time job, at least in stretches. Often, my week seems to be nothing but medical appointments. I mark my months less by the flipping of pages on the fridge calendar than the ritualistic filling of pill boxes. Not cool, and I make sure my adult kids don’t catch me at it.
But so far, I mostly bounce back, thanks to a phalanx of dedicated doctors here in south Tampa, and their praetorian guards, the powers behind the throne — nurse practitioners, who hold up the pillars of our shaky medical empire.
I’ve been a regular visitor to most of the local clinics and ERs. It sounds like a tall tale, but I’ve edited at least a couple of columns lying on gurneys. Kind of proud of that, actually. The clanking of MRI machines and the snapping of X-rays are familiar and reassuring sounds to me.
Hanging out with the medical crowd has had other benefits — being around people who spend their lives actually thinking about patients and their health, rather than their next financial gambit. Oh, they think about money, but as a rule, they don’t spend their lives in pursuit of it. A relief to the soul in this money-mad, yacht-buying, ballroom-building gilded era.
What I’ve stopped doing is looking at the costs of my tests, labs and procedures. It’s genuinely shocking, shocking to see the stated prices of an MRI or PET scan. They charged Medicare what?
Or, for a real jump scare, the cost of my heart ablation. Medicare, of course, covers most of it, paying out a portion of what hospitals and doctors charge, in the familiar kabuki of make-believe pricing and reimbursement that both sides dance to.
But the thing is, Medicare works.
I was among those who had to scramble for health insurance at different times in my working life, pre-Obamacare. I had glamorous jobs, but journalism can be a bumpy road. When a couple of the publications I started or worked for folded, I had to face the notorious “pre-existing condition” bugaboo — and the bugaboo won. We were without protection for a scary period of time before I tap-tapped my way to another salaried editorial job. Can I tell you how much fun that is when you’re in your 50s?
So yes, I have a keen appreciation for Medicare (plain vanilla Medicare; not tempted by the Advantages). I never take it for granted. At 65, Medicare finally took financial medical stress out of my life and made health care as natural as tap water.
I don’t know that I’d be here without the protective net President Lyndon Johnson — and Democratic POTUSs after him — put up for us in 1965. (God, how I hated LBJ for Vietnam.) It’s hard to remember how our parents coped. Or whether I’d have made it this far if I’d had to pay retail to keep myself alive these last few years.
To say nothing of fighting the insurance companies. Or paying for insanely priced medications. Those of us with interesting diseases pay astronomically interesting prices for certain life-saving drugs, notably cancer, even with Medicare. But just last year, President Joe Biden — currently being skinned alive even by our side — capped out-of-pocket pharma costs to make those drugs affordable.
Yes, another Democratic president. And I haven’t even gotten to Obamacare.
If you detect a slide toward politics, take a pill and stay with me. It’s just that I think often about you, older fellows and gals, aging like me, who voted the other way. And if you’re among the loudest and angriest, does it ever strike you that you owe your free or affordable health care solely to the radical leftist lunatics you want to, you know, own and crush?
Is it deplorable of me to point out that it’s the legislators you vote for who’ve tried over 70 times to kill Obamacare? The same lawmakers who chip away at Medicare, and especially Medicaid, burrowing into them relentlessly like termites, promising there’s a “better” health system they have “concepts” for?
Politics to the side, many of you may be comfortable enough not to sweat the Medicare premiums — and can pay for the rapidly rising supplemental costs. And can find ways to pay for your drugs.
If so, you may feel as I do. Despite the whack-a-mole depredations of age and its costs, I consider myself lucky to be living in this time.
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And then, and then … I think of those who aren’t as lucky. Those who are way, way far from comfortable, who can’t afford premiums, supplemental fees and those lovely pharma costs, especially those on Medicaid, the fallback to Medicare for all ages who didn’t get the breaks, who struggle financially.
One in five Americans depends on Medicaid. And Medicaid is where the termites really like to dig in. Softer wood, less resistance, second jobs or sick kids mean less time for complaints and pushback. Chomp chomp!
The government shutdown was in part about health care subsidies for those who need them most. Here in Florida, the situation is so dire that The New York Times ran an in-depth story about us, which should prompt at least a few of you to hit the brakes on your golf carts.
The pandemic-era boost to federal premium tax credits for Obamacare plans is set to expire this year. In Florida, about 4.7 million people are enrolled in these plans. And Florida, for no discernible reason, is one of only 10 states that chose not to expand Medicaid eligibility even though it was free to the states. What’s that phrase we’ve heard so often — cruelty is the point?
This is happening simultaneously with SNAP food benefits being suspended in this meaningless government shutdown. The Marie Antoinette of it all, as Trump holds a Gatsby-themed party and builds his gilded ballroom, is almost too on the nose. Dunking food and health benefits in the same month! The tumbrels should be rolling.
Florida’s original decision not to expand Medicaid — this means you, Gov. DeSantis — is essentially inexplicable. Losing those subsidies bites hardest here. Twenty-four percent of Florida’s under-65 marketplace enrollees use the enhanced subsidies, the highest share in the nation. Nationally, the figure is about 8%.
Semi-older folk, those behind me, in their early 60s — who earn just over the eligibility thresholds for Medicaid or Medicare — are especially at risk. For example, someone earning around $65,000 might see premiums jump from several hundred dollars a month to $1,000+ as subsidies vanish.
I won’t use this space to list the health-care horror stories that national media and our own regional press have recorded. We’ve all heard the tales of the heartbreak — and the heart disease — assailing those without insurance.
And I’m afraid I have no numbers for you to call, or to get put on hold. Wish I could suggest someone to dial if you’re under 65, or struggling with Medicaid cuts.
What I fervently hope is that Medicare’s pillars are strong enough, established enough, that even an ox-cart full of anti-science vandals will leave at least this one program alone. Or we can start hoarding our heart pills.
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The coverage crisis, alas, will worsen.
Estimates are that 10 to 15 million Americans may lose health insurance. About 50,000 more people may die needlessly.
Who does that?
America, that’s who.
And at a cost three times higher than the rest of the world pays for health care.
Come to think of it — and stay with me here, readers — why are we older citizens, one-fifth of the American public, the only large group with free, mostly efficient health care? What about the other quintiles? The other age groups and everyone else without job insurance? If a 40-year-old pricks his finger, does he not bleed?
This is not sane.
It’s time for those of us who’ve had the gift of well-run, sensible government health care to speak up before we depart the stage.
WE SHOULD HAVE MEDICARE FOR ALL!
A recent The Economist/YouGov poll shows 59% support for nationalized health care, with 27% opposed. A survey quoted by Reuters/Ipsos reported that about 70% of adults supported Medicare for all (and even a slight majority of Republicans: 52%) in one sample.
Every Western country at our level of prosperity provides health care as a national human right, just like clean tap water. Bernie Sanders was right about Medicare for all, and still is. I wasn’t a Bernie Bro. I thought the socialist label would sink him. Better, I thought, to stick with Hillary and Joe and Kamala.
On mature reflection, I was wrong. Bernie was always right, especially about health care. Bless him, he’s 84, a lot more vigorous than I am, still killing himself to travel, to speak out from every platform, to make TikToks that would wear out a younger man.
Bernie’s aged out now as a presidentialcandidate, but I think he’ll be considered a moral hero, not only for calling out our growing autocracy, but for speaking, stubbornly and endlessly, about the only thing that matters in the end — our health. As our mothers said, when you’ve got your health … .
Bernie never got the respect of the centrist liberals and moderates. We liked him; he was a character, but he was the Ringo Starr of electable politicians. It turns out he’s been the Lennon and McCartney. His voice, his Brooklyn refrain — often lonely — has been the one I think will be remembered when looking back at this blighted era.
Look, friends. At my advanced age, strictly speaking, I no longer have a dog in this fight. I have my Medicare, my free care, my survival kit.
So this one’s for the rest of our countrymen and countrywomen.
Medicare for all! Even in Florida.
For a pleasant change, I’m not writing this from a gurney. I’m feeling pretty well this week and — maybe preposterously — hopeful.
Guest columnist Barry Golson covers the Tampa Bay senior scene. His writing has appeared in The New York Times, The Washington Post, the Los Angeles Times, Playboy, Forbes and AARP. He is the author of “Gringos in Paradise” (Scribner). Contact him at gbarrygolson@gmail.com.