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| panda-like calm through fiction | |||||||||
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Unwarrantied
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I never banked I’d live forever. Given the option, I don’t know that I’d want it. Life is a long-distance run, with stops and starts along the way, and even to this point, there have been times when I’ve been tired, and would have liked to stop. But now, I know, I was just tired, waiting for another wind to blow me along, because I know I’m not done running yet.
And I’m old enough, now, that I remember what it used to be like before. I worked my way through school, doing whatever low-paying job I could that didn’t interfere with classes. But while I complained about the pay, at least I had insurance- since in those days, not being insured was playing a game of Russian roulette- where if you played long enough, there was basically a guarantee you were going to find that loaded chamber. But I remember the furor, back then. People were worried about health care. I think, mostly, people were concerned about change- America was still the superpower, then, so most of us could still see a doctor if we needed to. I think folks were worried that was changing, and even a reasoned response from the Congress sounded as likely to muck things up as not. And that fear, understandable if unreasonable (but then again, how often is fear ever reasonable?), led to a lot of silly things. Some complained about exchanging a government bureaucrat for a corporate one, or the government coming in the middle of the night to take away grandma. In the end, an incremental health bill passed. And through the years, it proved to be a good plan, and became as popular as Medicare, and expanded to eventually encompass both Medicare and Medicaid. It eventually ended up covering nearly 80% of Americans, as the continuing rise in costs (at a rate of about $700 per year) priced most Americans out of the private market. And because it functioned similarly to Medicare, it had lower administrative overhead- accounting for less than 2%, versus the private market average of 7%. It was at that point that the American Warranty Entitlement act was created; in committee the bill had been ridiculed as a “warranty for human beings,” which proponents picked up and carried as a badge of honor. Basically, as passed, every U.S. citizen was guaranteed their medical expenses up to age 72 for men, and 76 for women (though there was a grandfather clause, so that people over 55 would not be affected by the change, and those from 42-55 could open tax-free Health Savings Accounts- since that was how long it would take to save up to compensate for the change in health services). The only caveat the act introduced was that Government Medical (as the new program was jokingly named) would not cover “new and untested” medical equipment, basically anything costing more than 150% of baseline treatments already in use for that ailment. Of course, virtually no private insurance was covering these procedures anyway, and as a result, nobody was buying the equipment, but with the new artificially created market, private insurers rushed to fill in the gap. NU insurance was costly and prohibitive, but for people who thought it worthwhile to pay the equivalent of a house payment a month on extra medical care, it was there. Of course, the insurers also rushed to offer Extended Life care (which everyone of course referred to as End of Life care) plans at a high premium; AWE followed suit with an amendment creating its own EL care the following year as a fee-based optional service. The AWE act even had a provision dealing with tort reform, though not in the way its proponents originally sought (which according to anyone fond of facts had always been a strawman anyway). Congress mandated limits on physician malpractice awards, but mandated a “cost of care” increase to the physician’s premiums any time they lost a suit. Physicians were also allowed to buy malpractice insurance directly from GM at the then market-average cost (pegged to inflation) or 80% of outlays, with a guarantee that the average cost of premiums would not increase unless payouts did (and again, anyone familiar with the industry could have guessed they never have). The added bonus was extra money from premiums went directly into the general health fund. Now, compared to me, you’re young, but I was young, once, too. And I had a bad back when I was young. I had to get chiropracted once a month, and since it wasn’t covered by the insurance I had through my job, that cost me $50 bucks a pop (no pun intended), instead of my $10 copay (and, you know, this was back when $50 bucks was something- most of a day’s take-home pay for me). I suppose, to think of it, I still do have a bad back, but between physical therapy and my covered chiropractic visits, it never gets to where I’m in pain enough to fret over it. And I’m actually lucky. I turn 76 next week. The fact I’ve gone my life without needing major medical anything means I’ve probably saved a life or two through sheer good luck- and I’m trying not to spoil that getting bitter about no longer being guaranteed care for myself. After all I’ve lived a full life, a fuller life, really, than I’d have imagined, since most of the men in my family had a tendency to drop in their sixties (of course, most of the men in my family had a history of alcoholism, lousy diet, and smoking, too). But I don’t think I’ll make it to 77. I have lung cancer. I didn’t smoke (unless you count a dozen or so cigars when I was in my early twenties, and maybe three packs of cigarettes during a lousy break-up). But some people just get lung cancer the old fashioned way. And even in this day and age, people still die of cancer, which is not something I thought about when I was young- I thought we’d cure cancer and AIDS and everything else under the sun- but that was the arrogance of youth and a poor understanding of the costs of medicine on display: every promising rat-based study had petered out- every last miracle cure was proven for the tonic water it was. But what’s most lousy about this is there’s no one to blame. The private insurers stopped covering late-life cancers fifteen years ago; and I’ve seen the numbers, and frankly, even the government plan can only afford to offer 65% coverage, otherwise they’d have to raise their EL premiums, pricing some folks out of the market. Which I suppose is fine. I could fight like a bastard, and maybe get another year like my grandmother did way back, but the cancer’s around my heart, strangling my blood supply from the inside- too close for radiation, too big and weird and wrapped to cut out. So even if I could afford it, my “life” would be in a bed, poison in my veins, with the occasional blast of radiation to stave off the cancer metastasizing. And there’s a nagging little part of me that wants to live, and says that no matter what the cost, it’s worth it- I’m worth it. But my brother had a son, and that son had two daughters, and now they have kids, too, and seeing them play, knowing they’ve got good long lives and that they’ll need every penny to keep them healthy, I understand the sacrifice we’ve all agreed to make for their future. That nagging little part, the lizard brain that wants to keep moving another moment to pass on whatever’s left in my withered old genes, still screams that I’m worth it- but weighed to that, goddamnit, I’m not. |
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