She never intended to be there… in a shared room, in a wheelchair; in a skilled nursing home, in the grip of Alzheimer’s.
In a Medicaid facility.
Her plan was to grow old in her cozy mobile home community in Leesburg, Florida, surrounded by friends, accompanied by her husband, visited by her kids; hopefully healthy enough to live out her days in relative ease; to slip away at life’s end without fuss or bother.
But that didn’t happen; what she intended got stymied by the vagaries of life, the unpredictability of human existence, and the randomness of fate. Her husband, abundantly healthy throughout his first seventy-one years, was struck with a terminal illness that killed him within six months of diagnosis. And though he’d worked hard all his life (three jobs at one point) to sufficiently provide for his family, money was always a challenge. They were able to purchase the little mobile home they loved with proceeds from the little home they sold, but there were no flourishes, no extravagances; their kids paid for their own college and were on their own early; there was just enough to get by.
Or so my father thought.
In his somewhat shortsighted assessment of what life would be for my mother once he was gone; in his lack of financial acumen related to the staggering rise in not only the cost of living but the cost of growing old, he miscalculated what it would take for my mother to exist beyond his death, in even the most minimal of fashions.
The sale of their mobile home netted little; his annuity was pocket change; his pension and Social Security were minimal, and there was no portfolio, no nest egg; no savings account. Upon his death, we, his children, managed the money he did leave to get my mother into a series of retirement facilities in both Illinois and Washington state, even housing her in a sib’s private home for a year. But as her physical and mental state diminished to the point where 24/7 care became non-negotiable, we moved her to Los Angeles ― where my brother and I could manage her care ― to an Alzheimer’s facility that fortunately accepted the long-term insurance some in my family had wisely purchased.
Three years. That’s all her policy afforded. We assumed that would be sufficient, given her rapidly declining health. But in a confluence of unexpected events, she outlived that term, while continuing to decline to the point that she had to be admitted to the skilled nursing unit on the same campus where she remains today.
Do you know the monthly fees for a skilled nursing facility in Los Angeles, California, in the year 2017? Even in a moderate-to-mid level facility? More than anyone in my family is paying for their rent, more than anyone in my family is paying for their monthly mortgage; more than anyone in my family could possibly afford.
More than my father, in his most far-reaching of estimates, could ever have imagined. So what’s a family to do?
We live in a world where medical costs, hospital costs, doctor costs, any healthcare costs, come with staggering, unfathomable, bloated numbers that we have no control over yet are obligated to pay. Those numbers are based on arcane formulas extracted from the interminable battle between the insurance, medical, and pharmaceutical industries, and while that triumvirate annually rumbles in unseemly justification for the exploding cost of healthcare, we, the people, are at their mercy.
Insurance companies gouge us with insanely high premiums, huge deductibles, and indecipherable limitations. Any doctor or hospital visit comes with myriad fees, unexpected add-ons, and often exorbitant numbers for shots, tests, exams, and treatments. Prescription drugs can be so cost-prohibitive that people suffer for lack of ability to pay.
And while this chaotic drama plays out in ways that affect real people ― real children, real families, real seniors ― the Republican party is, once again, out to repeal the Affordable Care Act with its latest punitive pretense at policy: the Graham-Cassidy Bill. Rather than do the people’s work of reaching across the aisle to refine and improve the system that’s there, that’s in place, that’s already working, this latest round of partisan cynicism will see to it that millions lose their insurance coverage and Medicaid is gutted.
My mother is not a freeloader looking for a handout. She’s not “working the system.” She’s not unwilling to take a “better job” to pay her way (thank you, Kellyanne Conway). She’s an 88-year-old women with Alzheimer’s who’s living out her life as best she can, at the mercy of a healthcare system that is priced beyond what any average American could afford even with a “better job.”
So I applied for MediCal for my mother. With no assets, minimal income, and inarguable need, she was deemed eligible, leaving her to rely on a compassionate “government insurance program for persons of all ages whose income and resources are insufficient to pay for health care.” A program that Republicans now want to slash, depriving millions of needy families, children, and seniors – like my mother – of basic survival resources.
They say politics is local; I say it’s closer than that.
Politics is personal.
If any of the Republican senators and congresspeople pushing for this bill had mothers, children, family members dependent on Medicaid for their survival, we would not be having this conversation. But most Republican senators and congresspeople are far wealthier than the average American, and that, really, is the crux of the matter.
When politics dismisses, demeans, and damages the lives and well-being of everyday Americans in the name of tax cuts for the rich, capitulation to fundamentalists, bragging rights for party loyalists, and acquiescence to a pernicious, shortsighted leader, it is very, very personal.
I don’t know what will happen to my mother if Graham-Cassidy passes. I don’t know if we will suddenly have to pull her out of her bed to move her somewhere less expensive; I don’t know if somewhere less expensive — that can still provide the care she needs — exists.
I don’t know what will happen to millions of Americans who will suddenly be at the mercy of the vagaries of life, the unpredictability of human existence, the randomness of fate… and the greed and indifference of the Republican party.
I don’t know if any Republican pushing for this bill can possibly imagine the realities of life for people who aren’t wealthy, who aren’t privileged, who are dealing with hardships and happenstances that are beyond their means.
I don’t know if any Republicans have a heart.
I can only hope enough do to listen to their conscience, to the countless organizations and leaders in the field who have denounced this bill; to their own inner voices of compassion and integrity... to vote NO on Graham-Cassidy.
There is no other spin on this that has a heart. And yes, that’s personal.