HEALTH CARE ESSAYS: When I listed links to everyone's health care reform essays on 20 August, somehow Pete Sampson's got lost. His topic, in a very personal story, is end-of-life consultation. You can read it at his blog, As I Was Saying.
It has been around no more than a month and already it's a tired, old joke: “No socialized medicine and keep your hands off my Medicare.” Except that it is all too true. In every poll, people 65 and older – those who have Medicare – oppose similar health care for everyone else by about two to one. What could the reason be?
The “death panel” explanation has been pretty well put to bed now, and if anyone still believes Medicare benefits will be cut, they are operating on mental fumes.
In major stories on Sunday, two journalists addressed the question - Matt Bai in the magazine of The New York Times and Ezra Klein on the Opinion page of the Washington Post. I hoped, when I dived into the newspapers yesterday, that these two journalists might have an answer for me. Both disappointed.
Mr. Bai attributes elders' disinclination to support health care reform to political ideology:
“[A] 70-year-old American today, born in 1939, probably has no personal memory of F.D.R., but he would have lived through the pain of disappearing manufacturing jobs and family farms, and the rapid deterioration of urban neighborhoods and schools, conditions unabated by government experiments in welfare and public housing.
“For these new senior citizens, even the Social Security and Medicare on which they often rely may be viewed less as instruments of beneficent government than as a partial repayment for decades of taxes.”
Mr. Klein, noting the “incoherence” of elders on this issue, agreed with Bai that today's elders are Reagan conservatives, not FDR liberals, but disagrees with me that everyone, by now, should be disabused of the propaganda that Medicare benefits will be cut to pay for health care reform:
“From the beginning, Medicare has been named as one of the potential sources of savings that would fund subsidies for the uninsured. That sounds like service cuts, even if the specific changes don't involve anything of the kind (most of the savings would come from reducing overpayments to the private insurers that participate in the Medicare Advantage program).
“So the fear is not of a welfare state but of changes in their welfare state.”
From placards and yelps at August's town hall meetings, that last statement appears to be so, but Messrs. Bai and Klein have no more hard information as to elders' reasons than I do. We're all three guessing.
One of my guesses is that the Reagan conservative argument is suspect. I'm only 18 months shy of Mr. Bai's mythical 70-year-old and like the majority of people I've known in my age group, my mother, who came of age during the Depression, put the fear of god into me about it. Even if, like my mother, they didn't like FDR or his policies, they grudgingly respected his efforts.
Elders are the only age demographic that President Obama did not win in the 2008 election. Mr. Bai in the Times (and others elsewhere) suggest that racial prejudice is in play with the generation who grew up in a still segregated U.S. It pains me to think that a majority (27 or 28 million of the 35 million 65 and older population) of old people haven't come around in the 45 years since the Civil Rights Act of 1964.
Even if they have not, wouldn't the fact that some reasonably large number of those elders have adult children - and a grandchild or two without health coverage - change their minds? Wouldn't they set aside their less charitable leanings for the betterment of their families' health?
Or, more greedily, wouldn't they support reform to guarantee the continued existence of their own health care program?
Projections tell us that if nothing is done to reform the health care system in the U.S., Medicare will run out of money in just eight years. Within a decade, it is said, health care costs will be three or four times what they are today if nothing is done. Congress knows that elders vote in much larger numbers than young people. All of the House and one-third of the Senate are up for re-election next year so they will pander to the old-age crowd, and if elders hang on to their fear or dislike of reform, that scares the hell out of me.
The only reasons on the table for so many elders' opposition to reform are political doctrine, greed and bigotry. Is it really that or are we missing something? What do you think? And what can be done to change elders' minds?
At The Elder Storytelling Place today, Lyn Burnstine: The Bird Parade