I keep not hearing it in the debates, and in the general discussions in the media (except for here, of course; Kossacks are brilliant). Occasionally, including last night, there is a passing reference to the idea, but it is almost never actually discussed in living color detail.
I am 54 years old. After a half-century of not taking care of myself but being healthy anyway, the piper has started demanding his payment. In the past couple of years, I've
~been hospitalized twice,
~ had a heart attack,
~ discovered that I might have COPD but it's more likely asthma (and in either case it's treated with daily inhaled steroids),
~ been diagnosed with sleep apnea and had to start using a CPAP machine at night,
~ had blood sugar readings that put me just barely into the prediabetes range, and most recently
~ had a routine colonoscopy that indicates a possibility of Crohn's disease.
I am a teacher, used to be a lawyer, and have scored in the 99th percentile on every standardized test I've ever taken in my life. When I was married, I was the one who handled the family finances. I know how to read insurance policies and medical procedure disclaimers, do online research regarding my medical conditions and medications, and do comparison shopping for products in the financial, medical and insurance markets. I've been in sales, and I've taught communications, so I know what to listen for in sales pitches and how to wade through the BS during sales negotiations to get to the bottom line.
And I am frankly scared shitless at the idea of having to shop around for health insurance 20 or 25 years from now, when my health problems are worse and my mental faculties are in decline and I'm living on whatever meager resources the Republicans decide to let me retire on as a public employee.
Just the task of looking through the materials that I get through my employment every year during open enrollment is enough to exhaust me even now, in my relatively vigorous "youth." There are only 3 or 4 choices, and either the full cost will be covered or at most I'll have to pay about $50/month, depending on which plan i choose. And my current plan, which I've had for about 5 years, is serving me very well, so the default position of sticking with that plan is really easy.
And yet, even the thought of looking at that paperwork stresses me out so much that this year I didn't even bother. I just stuck with what I've got. Maybe I could have improved my position slightly by switching to the new plan they added to the menu this year, but honestly it wasn't worth it to me to find out.
I wish the Democrats would emphasize this as much as they emphasize the $6400 per year that the original Ryan plan would add to medical costs. The problem with vouchers is not just that they won't keep up with rising medical costs, it's that they will throw seniors into the lion's den of having to negotiate their way through the insurance market, with commission-hungry salespeople lurking around every corner -- and for those who are less computer-literate, those salespeople will be the primary source of available information.
Of all the hundreds of millions of people in this country, I am among the elite: the ones whose education, background, and inclination best suit them to be able to make good healthcare choices for themselves in their golden years.
And I am scared to death at the prospect of having to do it.
The next time Paul Ryan extols the virtues of "choice" for seniors in their healthcare, I hope some cute little gray-haired granny walks up to him and slaps him in the face.
And the next time there is a presidential debate, I really need to hear the President ridicule the idea of choice in Medicare for the bilgewater that it is.