Friday, July 08, 2005

Michael: My Mom's Health Care Insurance

Sometimes issues of great national importance and complexity can seem just too daunting and complex to comprehend, and too abstract to care much about. A personal story can often make the values at stake in a dry policy debate much more concrete. Health care policy is one such topic.

Meet my Mom. She 72 years old. She has mild diabetes and high colesterol. She has an arthritic knee, which doesn’t work so well, so she often uses a cane. She recently had eye surgery for cataracts, so at least she doesn’t have to wear glasses anymore. But she’s at a stage in life where bits of your body are always going wonky, or just plain conking out. She takes it in stride and with good humor. My Mom is probably one of the most stoical and good-natured people you’d ever meet. She was raised in the Great Depression and fought WWII on the home front as my Dad fought it in the Pacific. She’s not the sort to ask for handout, but is the sort to expect a fair deal and an honest word.

My Dad’s employer for most of his working life was JC Penney. My Dad’s passed, but my mom still receives a small pension and a Social Security check. These make up the entirety of her income. It’s not much, in fact, it is less than most people live on. But the house is paid for, as is her car, so her expenses are mainly utilities, food, gas, car and house insurance, maintenance costs, and health care costs. Those costs eat all of her income and more, forcing her to frequently dip into her ever dwindling, and not large to begin with savings.

My Mom’s insurance is through a group plan provided by JC Penney, The cost of that plan has grown by leaps and bounds since my Dad’s retirement. JC Penney’s has passed on more and more of the premium costs to retirees and employees. Back when he retired, in the early 90’s, the premium was less than $20 a month. Now that premium is over $140. That cost does not include growing co-pays for visits, and procedures, and tests, and drugs - though these costs are sometimes picked up by Medicare part A if over the deductible. The result is that much of my Mom’s income and savings goes to medical expenses. She really doesn’t have much room to wiggle or kick up her heels in her budget.

Imagine yourself in my Mom’s position, on a fixed income with no room to maneuver, and then you get a notice from the JC Penney corporation that they are ending retiree health care benefits as of the end of this year. You’re going to be cut off.

That’s not entirely accurate – in 2006 you are eligible to get an individual policy through AARP with no health check and no limits on pre-existing conditions (thanks to HIPPA) and Penney’s will apply 55% of their 2005 expenditure toward your new premiums. Great! But in 2007 and beyond, Penney’s will make no further contribution. And Penney’s part of the premium has already shrunk immensely since Dad’s retirement; 55% of chump change is, well, chumpier change. And they can’t say how much the new premiums will be. They could be – read ‘will be’ – much higher (HIPPA plans generally are). Basically, JC Penney’s is dumping her into health care limbo so that they can report another penny (groan…) per share earnings for the quarter.

Great for JC Penney. Don’t they have any legal obligation under US law to provide retirees or their spouses with access to heath care? No. Not unless the employment contract or a collective bargaining agreement specifies it. JC Penney has always carefully disclaimed any obligation regarding health insurance. Penneys is golden, and rid of annoying and expensive liability.

Not so great for my Mom - or anyone other than Penneys, for that matter. What of the cost this imposes on my Mom, whose husband gave JC Penney 27 years of service? What of the hit to the economy as I, and lots of people like me, divert their earnings to care for Mom instead of buying another SUVs and Armani suits? What of the cost this imposes on the public as my Mom will likely come to rely more and more on Medicare part A for regular care, and likely on part D for drugs, and maybe even Part B for hospitalization? Medicare is already a looming fiscal crisis that this Administration is studiously ignoring, such new burdens are only going to make things more dire.

But let’s keep focus on my Mom. She’s facing the prospect of possibly disrupting all her relationships with her doctors as she moves to a new insurance company, which raises quality of care issues and heightens the likelihood of malpractice or mistake. She faces the prospect of much higher premiums, and lower benefits. This means that she could be facing the proverbial choice between feeding herself and buying her meds. Of course, myself and my siblings won’t let that happen, but she’s already taking about dieting to get her weight down in hopes of saving money on her diabetes meds. This isn’t the sort of thing I want my mother contemplating at 72. Would you?

I would be happy to put her on my healthcare plan if I could. But there is no option for putting an elderly parent on your policy. Kids, spouses, domestic partners? Sure. Parents being booted from their former employer’s retiree plan? Forget it.

Why should we as a society allow corporations to clean their slates at the expense of others like this? They are being allowed to pass off elderly people as if they were bad debts to be written off. Worse, their actions impose greater costs and insecurity on the retirees and upon all of us through the Medicare system. What social good justifies so much social ill, much of which we don’t have the policy tools or social structures to mitigate?

So that’s what the health care debate is really about: millions of stories like my Mom’s. Some are far more dire. Many involve issues of life and death. But they are all issues of fairness and responsibility to someone’s Mom, or Dad, or child. They all confront us with a fundamental moral choice of whether health and life are just commodities, or if it is immoral to let indifferent markets decide who lives, who dies, who suffers, and who receives care.


At 7:47 AM, Anonymous Gail Davis said...

It all fits in with the BushCo plan. Work for the dregs and then die. What could be better for a world in which Corporations rule? We're not completely there yet, but implementation of the plan is proceding quite nicely.

Just in case you think I don't sympathise, I am 63 and expect to have much less in the way of MediCare and possibly SS by the time I am your mother's age if the corporatist plan continues to play out. So as 'our' government transfers my taxes to the very,very wealthy at the same time they take a loan in the name of future generations to pay for killing people in Iraq I, along with your mother and all the rest, can expect to be squeezed until we have the good sense to die off.

Not what I expected back when I thought I was working hard and playing by the rules for a secure future. But then someone like Bush is not what I expected 51% of my fellow countrymen and women could stomach voting for nor did I expect the Supreme Court of the land to override the voters and install a president and a crooked one at that.

To be fair this process started before Bush though BushCo has successfuly escalated the decline. My father and his fellows in the Navy and other services were promised lifetime medical care for making a career of service to their country. I'm sure you know how that played out. The government betrayed them. When promises and guarantees of future benefits no longer have any meaning, then people will no longer trust in the institutions that hold the country together.

At 10:39 AM, Blogger shrimplate said...

Hillary Clinton tried to address such problems years ago and she got crucified for that.

We in this country do not want healthcare for all. We want war.

At 6:48 PM, Blogger Jack Benway said...

Explain to me the morality that requires my tax dollars to be used to care for your mother.

She owns a house. She can borrow against it. You've got a good job -- help her out.

At 6:51 PM, Anonymous Anonymous said...

Why is it thought to be greedy to desire to keep the wealth one has properly earned but selfless and caring to demand that others reliquish it for somone else's sake?

Is the honest act of earning wealth so meaningless to you?

I understand that having suffering loved ones is extremely difficult, but as we are all free humans with active minds, I think it is up to the individual to acquire what he needs in life without the force from the State. That is what seems to be the only honest and just option (for all sides).

We can try to lay blame with all kinds of entities, but in the end our lives are our own responsiblity. Expecting others to take responsiblity for your needs )or an elderly mother's even) is dishonest & lacks integrity.

Id be happy to take on a second job to help my family in times of need. But I would never expect my neighbors to take second jobs or give up their own wealth to help me or my family, which is exactly what welfare of all the government kinds comes down to isnt it?



At 11:36 PM, Blogger Michael said...

I find the theme of 'bootstraps' which conservatives play when faced with a government program promoting the general welfare through collective coordination to be 1) facile and/or ignorant, 2) driven by intellectual and moral vanity, and 3) for these reasons, ironic.

The great American fortunes, and most of the medium ones, were gotten by governmental preference and/or assistance in one form or another. The great ideal of the independent success is a myth, as anyone who has actually studied the subject of wealth in America would know. I suggest Wealth and Democracy by Kevin Phillips to begin your education.

Benway: What I'm talking about here is the obligation of a promise, the harming of anothers vital interests solely for pecuniary gain, both of which I believe to be acute ethical dilemmas. If you don't see that ethics, and indeed Christian charity and agape, are not implicated by this story about my mother, I'd like to know just what your definition of ethics is.

The conservative impulse to 'leave everything to the market' grates on common sense and ignores the very signals that the market is sending us. Common sense is that every major industrial nation besides us has a not-for-profit medical insurance system. That is not 'socialized medicine'. It only means that providing insurance for medical care would no longer be a for-profit industry. Other countries save enormous amounts of money on health care for this one simple reason. The market is failing to deliver health care to those who need it, when they need it, at the level and time they need it. The system works fine for those who are lucky enough or wealthy enough to be well-insured, but not for anyone else. That's a market failure which indicates that the market is poorly structured. I believe in markets, but they are tools, not religious doctrines. There is no such thing a free market, only more or less functioning ones with greater or lesser degrees of self-regulation.

Briget: I find your comment both churlish and insulting. As far as the obligation to care for the elderly in our society being the sole burden of their progeny, we abolished such primitive social models in order to achieve the widespread mobility and productivity we have enjoyed since Social Security was ennacted. Expecting society to provide a basic level of dignity and sustenance to the elderly even if there is no relative able or willing to so is not 'dishonest & lacks integrity'. That idea is one of the lynchpins that enables the modern American lifestyle without the horror of elderly people starving and homeless in the gutters.

This nonsense about not expecting your neighbors to provide for you is utterly absurd. You expect just that, and get it, every day. You drive on roads you could not purchase yourself. Your water is delivered and purified through a corporation owned by the city government which you could not replace. Your 'property' is the result of, and protected by, laws and courts and sheriffs you could not afford to replace with a private option if they didn't exist. If you have kids, your neighbors without kids finance their education. In a million ways your neighbors make your life possible through a web of interdependencies you can't live without. Your quaint notion that you don't expect anything from your neighbors is rot and pure insipidity.

At 1:00 AM, Blogger Jack Benway said...

Wow, "pecuniary" and "agape" in a single paragraph. Surely, you're much smarter than me.

My definition of ethics is rather simple, logical, and reality based. Pardon my folksy common sense. That which benefits me without unfairly inhibiting the ability of others to benifit themselves is right and proper. Stealing my money to care for others unfairly inhibits by ability to prosper. It is immoral.

A good many industrial and advanced countries have socialized medicine. Those who can afford it flee their country to obtain advanced medical care in the US. TANSTAAFL.

I prefer to buy my own lunch rather than steal it from others. I guess that demonstrates a lack of enlightenment on my part.

I empathize with your situation with your mother. My family is faced with a similar situation with my grandmother. Medical science has developed ways that allow for people to live longer. Unfortunately they aren't affordable to everyone. When you try to level the playing field, making these developments available to everyone prematurely, you undermine that which allowed the scientific breakthroughs to occur in the first place. We all die. We aren't all going to have access to the Pope's life support. Get over it. Life ends.


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