Michael: My Mom's Health Care InsuranceSometimes 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.