Tomorrow is the 15th day of April. If that is news to you, I uncharacteristically suggest that you PANIC, because our red, white and blue Uncle has an ever-diminishing sense of humor when it comes to individuals not paying their taxes, as opposed to corporations not paying taxes, which he finds infinitely more endearing.
If your situation is such that you are not required to pay taxes due to the fact that you are (a) a corporation, or (b) “low income,” this may be the one time of the year when you can unabashedly celebrate your circumstances - We, who are about to pay, salute you.
Speaking of large, governmental undertakings, a couple of weeks ago, to our unanimous relief, I finished up a three-week medley on “The Medicare Machine from 30,000 Feet”; since that happy ending, however, a rather considerable number of you have expressed various and sundry opinions on the matter of Medicare, with a few miscellaneous questions thrown in, about the state and the origin of said Machine – The phrase “conspiracy theory” pathetically understates the gist of most submissions.
Nonetheless (or, less-the-none), being the true blue journalist that I am, I feel compelled to share a distillation of these observations, courageously dismissing “fact,” “history” and even political persuasion, in my usual swashbuckling, journalistic style; thus, near as I can tell, the civilian view of Medicare (which flies in the face of conventional political wisdom, a phrase that defines “oxymoron”) goes something like this:
In the early days of our national odyssey toward confusing the term “healthCARE” with the phrase, “health INSURANCE,” people who made decisions for people who were considered incapable of making decisions, noted two distinct facts: (1) There was getting to be a lot of old, and relatively poor, people, and (2) should the number of old, poor people continue to grow, there appeared to be an entrepreneurial niche’ in which to develop a lucrative industry that accomplished virtually nothing, except to add dollars to pockets that were chuck-full of dollars – Dismiss “value-added,” and think, “opportunity!”
Thus was born “health insurance” and, in there somewhere (because we are steadfastly avoiding being confused by facts), Medicare, and the approach is elegant in its simplicity:
If healthCARE could continue to escalate its cost to the level of being unaffordable, people could probably be convinced that it made sense to send money to people who would, ostensibly, send back that money to people who were providing healthcare to people who needed healthcare, because the people who needed the healthcare didn’t have enough money to pay the people who provided it.
And if, again, the costs of healthcare could be driven upward to point of orbital, people could probably be convinced that it made sense to pay some money out-of-pocket before the people you sent money to would send money to the people who provided you with healthcare, on the off-chance you needed healthcare, or – Better yet! – Drive UP the costs of this thing called “health insurance” to the point where people were afraid to use it, because using it would increase the costs of their health insurance, so they would die without using healthcare; thus, the money they paid for health insurance would stay squarely where it belonged, which was in the pockets of the people that people sent money to, so they would pay that money for something that, as it turns out, people were afraid to use.
WHEW!
But that’s not all, because here’s the most conspiratorial piece of the Conspiracy Theory: As a subset (or, “fringe benefit”) of the above: IF this health insurance/Medicare “thing” could adequately confuse, frustrate and intimidate (think, STRESSED-OUT!) unrich, old people to the point of medical capitulation, they would, likely, die sooner, providing the ever-elusive answer to reducing the number of poor people – Population control! – Which is why Medicare has never paid for “long-term care.”
And the latter could be most effectively achieved by inventing concepts like “deductible,” “co-pay,” “benefit limits,” “managed care,” “benefits coordination,” et cetera ad infinitum, which would, eventually, replace the old cliché “…it isn’t ‘rocket science’” with “Well, it isn’t health insurance!”
OK, maybe not, but it does make you stop and think – Or, think – Or, stop – Or stop thinking…BUT! As is often the case on this fascinating planet where God is considered to have no sense of humor, there is an unintended, and somewhat contradictory, side-effect to all of this; Consider:
As our national life expectance has continued to increase in spite of health insurance, various forms of dementia (think, Alzheimer’s) have emerged as a leading means of retiring retirees; Now, how does one attempt to prevent dementia? Right! By developing new neuronal pathways.
And how does one develop new neuronal pathways? Right! By learning new things and attempting to master the unmasterable.
And what is the most unmasterable thing you can imagine? Right: Medicare!
So, belay the Sudoku, cancel the crossword, relegate the quantum physics text to the doorstop and simply perseverate on your Medicare “Explanation of Benefits!”
…and try to remember that tomorrow is April 15th.
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