Americans who are lucky enough to earn the kind of money to even think about “retirement planning” had better think again. If they live up to the American life expectancy of 79, and beyond, retirement won’t be what they’re planning for at all. If they are not rich, they will find themselves old and more or less helpless compared to their salad days fighting for their dignity and their health in a predatory economy in which they and those they love have become the harried geese that lay the golden eggs.
Their plight will be what some refer to as “senior care,” a spectrum of service and expense that goes from excellent and expensive to perfunctory and expensive. And heaven help them if they are too poor or stove up or mentally compromised to fend for ourselves. They become useless baggage in an economy like ours, almost an “externality,” a person who did not choose to be superfluous but who is considered a “cost,” almost as bad as a tax or salary that has to be paid, an expense rather than a “profit” center.
What’s waiting ahead for all of us when we’re old — all except perhaps the one percent — is probably not the cozy life we had been induced to imagine, even if we have long-term care insurance, a costly bundle of incomplete coverage. In America, what awaits us as we age is not a national health system that honors the accomplishment of living a long time and contributing our strengths and ideas and values and efforts to our culture. What awaits us is a safety net with so many holes in it most of us will hit the ground so hard we’ll break ourselves apart. If you’re poor and live on social security, but have never made enough money to have monthly payments that are enough to live on, you can apply for supplemental social security. But it takes a year to get, and you have to hide whatever money you manage to scrape up to keep body and soul together while you’re waiting, because if the government finds the paltry sum, it’ll toss you over the railing, leaving you without any support in a pool of sharks. So what are you supposed to eat for a year on an inadequate income with no “right” to earn a pittance more, lint and paper clips?
And what if some moron in D.C. who’s a Tea Party true believer decides that if you need food stamps, you better find a job before you can get them, as if children, the aged, the infirm and those suffering from dementia are all freeloaders scamming the system. Isn’t the point of food stamps to hold your family over until you find a job? Work requirements for food stamps see the poor as grifters. This is what awaits us when we’re old, if we’re not rich — a draconian prejudice against us that’s woven throughout our society. And that “us” turns out to be an immense number of people. Over 25 million elder Americans, 60+, are economically insecure. And nearly 20 percent of New Mexico seniors live below the poverty line. Living to be a ripe old age for many of them and their families is an ordeal close to torture.
That’s why it was so important last week that New Mexico Governor Lujan Grisham resolved to do away with Martinez administration co-pay requirements for the some 645,000
New Mexicans who depend on Medicaid. The governor said that the Martinez policies “would limit access to emergency services, prescriptions services, and disrupt continuity of coverage for hundreds of thousands of New Mexicans…. I have no intention of implementing policies that put a financial strain on low-income New Mexicans as well as administrative hardship on our health care provider network.” Medicaid is designed to help people with “very low” incomes, people who literally cannot afford co-pays. Trying to fathom the differences between Medicare and Medicaid, and all the regulatory ins and outs, is beyond many seniors who have serious and debilitating health issues, not because they are “poor and stupid,” but because they are weakened and confused by sickness or by the general trauma of poverty and aging.
With a third of Americans living close to such circumstances, this is the best reason why we need “Medicare for all,” and a national living income to help create an economy that doesn’t prey on the elderly poor, baiting and switching long life with ruinous costs and profound disadvantage if you can’t afford them. Being old and broke, old and enfeebled, old and alone, old and swamped in grief and fear and depression — being old in America is being caught in what psychologists call a “double bind,” a crazy-making set of contradictions that are even more debilitating than the one revealed in the old saw, “damned if you do, damned if you don’t.”
Our commercial culture sells us relentlessly on living long lives, knowing full well that we will reach a point where, like cattle being herded into a killing pen, we will become, poor or not, part of a vast income river for the health care industry, insurance companies, pill makers and “senior” providers. Of course, we all want to live a long time. Dying young is a tragedy, but living beyond your health or beyond your means or beyond your community and family, that’s for many not only a tragedy but a living hell, a double bind no one could see coming.
Who could have guessed, as a young person, that being old costs witheringly more than being young, relative to savings, earning power, and physical capacity? Old age, as a cultural actuality, hardly exists in a culture that glorifies youth.
And woe to you if you’re a an impoverished caregiver, a person with no family, no connections, a meager income and a loved one to care for with absolutely no help coming from anywhere reliable, and no possibility of new income earned out of the house, and no hope at all of earning anything near the costs of “home care” and “keeping mom at home,” which can run conservatively up to a quarter of a million dollars a year, at $22.50 to $24.50 an hour, 24/7. So- called “respite care” for the caregiver is beyond the range of all those but the very well-off, and even they, the savvy financial planners, can see their savings wiped out in a bat of an eye at such prices.
The double bind of old age can literally drive you to despair. One aspect of this “catch 22” of being old is wrapped up in what elderly caregivers hear all the time from their well-meaning friends and family. “Take care of yourself.” Well swell, how do I do that? Who takes care of the person I’m caring for when I’m taking care of myself? It’s estimated that 40 percent of the caregivers of Alzheimer’s patients die from a stress-related disorder before the patient with Alzheimer dies.
Is there a realistic solution to these double binds? How do you plan a social safety net for a fast-growing part of the population when large swaths of the electorate, under the sway of Limbaugh, McConnell, the Tea Party and Trump, consider old people not as “seniors” who’ve earned some peace and rest, but as parasites and welfare queens?
Talk about a double bind — the health care and insurance industries embrace preventive care and “wellness” to keep us alive a long time, swelling the ranks of the aged, so some old folks can fill the coffers of the “ health industries” that see us all as a revenue source, while the rest of us, our impoverished brethren, are left to fend for ourselves and die relatively quickly after achieving old age, if we’re lucky and don’t linger on in destitution.
What’s to be done in a culture like ours where people are “data,” or “expenses,” or “profit centers”? How do we address the double bind of a youth-adoring culture that sees death as a defeat working feverishly to help people live long lives so that they can reach an age where they are more than likely to run out of money with their youth vanishing, an age where they find themselves in the social role of the elderly — once revered for its association with wisdom — but now stigmatized as a burden, a “cost,” possibly as an unwilling resource of wealth for others, or maybe seen as a loafer and a freeloader, a person who represents the exact opposite of the illusion and allure of youth? A national health system that is simple and across the boards — with no age distinction — would be a first step to turn old people from being victims into being citizens first and foremost like everyone else once again.
*Nullius in verba: take nobody’s word for it
(Image by Hernán Piñera)
Right on! Once again, nail on the head. Thank you VB.
Walking into a medical facility these days is like walking into a shooting gallery and becoming the target. It’s all buyer beware and caveat emptor. My wife recently went for physical therapy and they told her it would be $845 for one hour of evaluation, not therapy. This was after two hand x-rays that they charged $456 for. The medical system is out of control. We receive better Medical Care in Guatemala. Medical facility should have to post a menu just like a restaurant does listing their prices.
Perfect, V.B. The day will come when this country joins the civilized world. What sort of system is it that puts its future generations in crippling debt, profits from social dysfunction (private prison industry), and uses illness and suffering as a way to reap obscene amounts of money? Answer: runaway predatory capitalism. We are in the belly of the beast.