My Parents are older Americans. People who both dearly depend on Social Security to get by and Medicare to get well when the worst happens and one of them gets sick or injured.
My father is 85, and my mother is 75.
Recently, my elderly father got sick. He had a fever at first, then chills, but even after staying off of his feet and taking the usual over-the-counter remedies for fever and aches he didn't feel any better. In fact, he kept getting more and more ill over the course of several days. Usually, like many other men in my father's generation, he has to be convinced to go to a doctor. Sometimes by a combination of concerned voices that don't stop as well as the circumstances at hand. You have to make a good case to him that he cannot simply gut through this-or-that annoying or nagging health problem this time. After all, this is the same man who solemnly told me that he had to walk to school, in the snow, at 4am, up hill, both ways. Even when it wasn't Winter.
He didn't have to be convinced of anything, not this time.
He was scared.
Visibly scared.
When macho old men get scared and implore medical attention instead of defiantly dismissing needing it, you notice.
So. Like millions of other working class retired Americans, he recognized that he wasn't going to 'just get better on his own' and went to the Hospital to see a doctor and get the word on what was wrong with him.
Because he has Medicare, he didn't have to hestitate. He didn't have to be afraid to go and get help. He never had to consider staying in bed getting sicker and sicker because he was terrified of the massive debts he would be facing if he sought care as an American without means and health insurance facing a grave illness.
He feared he had an impacted kidney stone. It has happened before. A massive infection caused by such a stone almost killed him a decade ago.
He spend two hours in the emergency room, for an initial diagnosis and was eventually admitted for an overnight stay in what he refers to as "the real Hospital" beyond it. He didn't spend six or seven hours in the emergency room because it was his only option for care as I have as an unemployed person without health insurance. Turns out, he had a serious urinary tract infection. He was given an antibiotic schedule and watched overnight, and a painkiller perscription to go with his other meds the next afternoon, and then he was discharged and sent on his way.
Oh.
The bill for the hours, consultations, and tests in the emergency room would have been 2K without Medicare.
The bill for the room and the overnight stay and the expanded treatment and oversight would have been 8K without Medicare.
The bill for the drugs, the stupid little paper skirt he can't stop fiddling with and getting angry about, the jello he ate and loved like a little kid, all of that would have been about a grand without Medicare.
Eleven. Thousand. Dollars.
Without Medicare, the 11K that was generated by only his first, and, God willing, his as well as her last trip to the hospital for a problem this year, is all on my elderly dad and mom. That means letters and calls from collection agencies in this economy and on their income. It also means that my dad and mom both live in fear, that one or both doesn't speak up when he or she gets sick, even if he or she is in agony, because neither of them "wants to be a burden" or doesn't want to ruin the family with any of their hypothetical deep future medical debt.
With Medicare?
My parents payed several hundred dollars with all things considered on their end. Painful. Not a hit to be dismissed lightly on a fixed income. But they aren't forced to choose between their health and their viability as a household.
They don't live in uncertainty and in fear because Medicare allows them the confidence to seek care when they need it as soon as they need it. That security means they don't wait to seek care until problems are catastrophic, and far more expensive to treat. They don't tie up emergency rooms because they are forced to use the emergency room as a primary care physician, rather than for emergencies.
But Paul Ryan's plan to privatize Medicare and turn it into a voucher/coupon based scheme would do more than merely screw my elderly parents. A 2.5K vouncher? Gone with this one trip. A 5K vouncher? Gone with this one trip. A 7.5 voucher? Gone. 10K? Gone. In one trip to the hospital. In one family emergency. They and I both know all that, awful enough as it is on it's own.
But. Worse than that reality that they would be on the hook for the rest. Far worse.
It would create a climate in their household, and in countless others, where older Americans would start to make existential decisions based on the ability to pay and their want to avoid being a burden. Medicare helps older Americans live with dignity and with a sense of personal security that Paul Ryan would rob them of by replacing it with uncertainty and fear of breaching a cap. Not just not going to the hospital to avoid debt, but maybe even ending one's life to "spare" his or her family the "burden" that Paul Ryan's plan would make of them if they got too sick or their illness or injury was more expensive than their coupons would allow.
My diary title isn't hyperbole. It wasn't thrown up there lightly.
"I'd kill myself before I'd put your mother twenty or thirty grand in the hole."
That's what my world-weary and still sickly old man said on the ride back to his modest home. I can't forget it, and not just because it's been keeping me up at night ever since.