August 2000: Old Geezers Are Worth Listening To
[Note: No, Conrad Meier hasn't replaced Joseph Bast as President of The Heartland Institute, though he might if response to this column is positive enough. Conrad is Heartland's health policy analyst. Joe thought so highly of this essay that we are running it in lieu of his usual President's Letter. Joe will be back next month . . . probably.]
In response to one of my columns on health care, a reader wrote and called me an "old geezer" ranting in opposition to universal health care. On the chance that the Heartlander might be read by the young and innocent, I left out the best parts of my response to that reader. I confess to having a healthy discontent for the way things are, but I draw the line at being called an "old geezer."
Having just turned the corner on 65 got me to thinking about ageism: an ignorant practice of judging people on the basis of age rather than their ability to perform.
Putting this in Perspective
Those of us with birth dates before 1940 were born before long-term care, guaranteed-issue, gatekeepers, managed care, PPOs, IPAs, MCOs, ERISA, COBRA, CHIPs, MSAs, and HIPAA. Medicare was an unheard of public policy initiative we are living long enough to see bankrupt the nation's health care system. Social Security legislation, passed the year I was born, was meant to be a supplement, not the sole means of financial support.
We did not have CAT scans, heart transplants, bypass surgery, contact lenses, the pill, split genes, group therapy, pacemakers, proctoscopic exams, or WebMD. We came before Viagra, Prozac, Ritalin, Zoloft, Tylenol, Celebrex, Ibuprofen, and generic drugs.
We did not come before weekly life insurance premiums, but we did precede employee benefits, group health insurance, pension plans, annuities, IRAs, ISEPs, 401ks, viatical settlements, patients rights issues, and multi-million-dollar medical malpractice settlements.
That, of course, was not the whole fabric of our lives. To paraphrase the unknown author(s) of "We Are Survivors," we were also born before television, videos, cell phones, pagers, fax machines, credit cards, panty hose, dishwashers, clothes dryers, air conditioners, frozen food, and ballpoint pens. We came before the computer, the computer economy, the computer virus, and the dreaded computer crash. Software wasn't even a word, and Yahoo! was an expression I used when Cindy said she would be my date to the prom.
We got married first, then lived together. Rock music was a Mother's lullaby, and wisdom was bestowed by a Father's firm hand.
Been There, Done That!
Over many years we said goodbye to our relatives and friends who died in hell-holes around the world defending freedom of speech, liberty, individual responsibility, the right to privately contract for goods and services, and the right to own property.
And we've lived long enough to see some of those freedoms and rights taken for granted, and then taken away. Don't think we haven't noticed.
In spite of all we did not know and everything we did not have, we managed to invent penicillin, cure polio, advance medical technology, put a man on the Moon, and write music with lyrics people understood. We managed to raise large families and watch them start their own. It's no accident we're a powerful social influence: We earned that right.
We can make or break a company's bottom line, we can repeal laws that don't serve us well, we can vote politicians in and out of office, and we can influence the passage or failure of legislation.
Having said all this about my generation, let me say as well that one cannot view the aged, as my critic does, as a homogenous group of old geezers on a mindless rant. Nor can social policy be designed as if one size fits all. From experience in insurance markets we know that huge economic and societal distortions arise when all the aged are grouped together and policies assume a uniformity about our financial, physical, and mental well being.
As politicians and activists try yet again to develop one statist health care policy, we who are greying have learned such attempts always create havoc and eventually fail when dealing with diverse groups. There is no such thing as the collective aged.
Health Care Dysfunction
Because many aspects of government-controlled health care are based on collective logic, it is out of step with reality and the emerging problems attending the aging. This dysfunction is, for the most part, the result of political pandering and a liberal desire to treat everyone the same in a universal health care system.
For example, we know from research by the National Center for Health Statistics that Medicare funding has ballooned to over $7,000 per senior adult per annum. But the true cost of age-related health care goes way beyond what government pays. Medicare covers less than half of a typical senior's health care costs and does not reimburse many expenses related to disease prevention. Medicare will pay for a quadruple bypass, but it will not pay for preventive services like smoking cessation.
To further expand this government dysfunction, Rep. John Tierney (D-Massachusetts) recently introduced a new health care bill: the State's Rights to Innovate in Health Care Act of 2000 (SRIHC H.R. 4412). SRIHC would provide $3.75 million to each of 10 states to fund the planning phase of universal health coverage. Of the 10 states, five would be granted $10 million plus $3.00 per capita to fund a demonstration project of universal health care. Incredibly, the bill allows use of taxpayer dollars currently directed to Medicare, already financially shaky.
From Age-ing to Sage-ing
While I confess to discontent with the ways things are, I also hold out hope for the future, a future where tens of millions of outspoken, wise, and healthy long-lived men and women will redefine government in general and health care in particular.
We are witnessing market-based alternatives in long-term care insurance, in the repeal of earning caps for working seniors, in the collapse of Medicare-MC Plus, in the failure of centralized health care wherever tried, in the growth of Medical Savings Accounts, and in the almost invisible trend back to fee-for-service health care.
Contrary to what my critic may believe, there is significant evidence indicating seniors continue to grow, at least intellectually, and some bloom late in their years. The best measure of this is in the way aging people process and express complex ideas in argument or discussion, and how they courageously exercise the right to speak out.
Given this point of view, the elderly now and the age wave of baby-boomers right behind me must be seen not as a collective group of old geezers, but as living historians who have been to yesterday, are here today, and are headed towards tomorrow with their eyes wide open.
Conrad F. Meier is health policy advisor for The Heartland Institute, author and retired health insurance consultant.