I once had a boss, who, over coffee, said “John, I just thought I would lie down and die one day.  I had no idea it would take many difficult years.”  (She did pass away).  As I age I often think of that conversation.

This is not a political statement about Obamacare though I think that is the most awful legislation ever foisted on the citizens and I will not resist a few snipes.

When I was younger, my insurance premiums more than paid for my care and the care of others with medical issues. I had no issues so I used the system rarely.  I jogged; I was physically active (still am) and ate moderately well.  At 55 I had a cardiac stent and at 61 I had another but in neither case was damage done.  Each of those approached $100,000.  Now, at 70, I have a urologist (one time I hope) a dermatologist, a general practitioner and a cardiologist.  And my “routine” visits are more frequent. Now I am taking much more from the medical system than I am paying for insurance.  I feel bad about that; not because I have done anything irresponsible (as, for instance an O.D. druggie is doing) but I am fastidiously efficient in my personal life; I conserve everything from gasoline to household utilities, to food.  I use an urgent care center rather than going to a hospital. I like to think that should have been enough.  It is not.  

I had a $10,000 procedure (non life altering) a few months ago...helped pay for college for my urologists kids.  I have a hunch, with pending medical diagnosis, that I may be in for another stent...another $100,000, maybe more on Long Island.  Remember, this is from a guy who has earned everything he receives and is not a leech on the system, to whom nothing has any value because s/he paid nothing for it.

Rising costs and inflated medicaid benefits will hurt in the long run.  Our population is aging, less (fortunately) some of the folks who are more successful at overdosing on illegal drugs.  Obamacare is going to cost more exponentially over time but even if we had a wholesome private system it is going to cost more as well so forever the Republicans and Democrats can blame each other for the rising cost of health care and it will be the Republicans’ responsibility to avoid caving and raise taxes and to stave off the crying mothers who bemoan the “uncompassionate” Republicans. Let Obamacare fail and start over again and block grant Medicaid.

There is another angle if one is a survivalist, and I have just a hint of that in my character.  If society ever breaks down, without medical care and medicines, I might have two years left on earth...at least that would enable me to take some politicians with me. When one is dying he has very little left to lose. Since I prefer to live and anarchy does not seem imminent I remain an expensive draw on the medical system.

My dad, when I was much younger, spoke of rationing health care for the elderly.  I bristled at what I saw as fascism or “cleansing the earth” of older people.  I don’t like his idea any more now - Sarah Palin pointed out to the loathing of Democrats that there are such provisions in Obamacare -  but I see his point now that I am becoming a serious customer of the medical profession.  Other than birth defects, developmental disabilities, serious accidents and druggies, it is the old people who are going to drain the system, more so as time goes on and our population lives longer.

I have a few weakly fleshed out ideas to stave off bankruptcy.  One is that the medical community ought to be able to share more information.  I am with a group of various specialists who are all linked - great - but every time I see one of them I have to get yet another blood draw.  Small cost in the big picture but every little bit helps. Besides, I don’t like to be poked. Could they not share the information?  As an aside, these are great doctors and the information sharing does shorten visits.

As a senior, who paid into medicare my whole life and even when unemployed, made sure my family and I had health insurance, I don’t want Medicare compromised.  I want less money spent on Medicaid. I pre-paid medicare; medicaid recipients did not pre-pay for medicaid.  Some medicaid recipients were, no doubt, productive, health insurance-carrying adults at one time but if ten years later they are still not working, except to get down to the welfare office...that does not work for me. Serious medicaid reforms can save a great deal.

Social Security Disability is a rip.  There are many on disability who simply prefer to be permanently “handicapped,” have made sure through law that they cannot be forced to work at alternative jobs for which they are qualified.  Many of these people have paid very little into the system.  I digress from medicare but this is money that can be used to prop up medicare, or social security...a pyramid scheme to which most of us are forced to contribute. Therefore I feel entitled (I did try to get out of SS once but of course was not allowed, government wanted the money to spend on other programs.)

A conservative Republican idea which makes eminent sense is to block grant medicaid.  Those states who opted for expanded medicaid...okay they knew fully what that meant (I worked for the Washington State welfare agency for 25 years) and now they have to face an entitlement public as they cut benefits since block grants are not likely to support the expanded programs. Should have thought that one through a bit better.  They can start with at least one woman who had EIGHT state of Washington medicaid funded abortions.

This country has painful choices to make; medicare/medicaid is going to turn into a feeding frenzy when the inevitable lack of supply develops and but cost-cutting is worth the effort. At least the effort to cut costs will begin to change the horrid tax-and-spend culture in D.C.  After 50 years of “you were born so we owe you” mentality, pushed by the democrats and to which the Republicans dared not push back, my opinion is we have moved beyond turning back. I do not think we will come out “on top.” We passed the point of no return 30 years ago.

*&*&*&*&*&