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Been to a Nursing Home Lately?

The Republican attack on Medicare and the broken promise of our safety net

With Republicans in the Senate and Congress almost unanimous about wanting to terminate Medicare and Medicaid, I think it’s time we all pay a visit to a nursing home and see the greedy senior citizens whose stubborn longevity threatens the very idea of a luxury tax break on yachts and second homes.

I’m serious. This is what it’s come down to. During my lifetime, the richest five percent of the American population saw their tax rates drop by almost two thirds while their income outpaced the rest of the nation by similar numbers. Despite the revenue shortfalls caused by these cuts, the Republican Bush administration started two wars, one of which is now the longest war in US history, saddling us with what is ballooning into a multi-trillion dollar war debt. But unlike their predecessors, they never instituted a war tax to cover these costs. The result was predictable to anyone who ever balanced a checkbook. The math is simple. Wild military spending coupled with irresponsible tax giveaways to the rich equals structural deficits as sure as the sun will rise.

Add to this the mayhem that resulted from the deregulation of the financial industry, where banks were allowed to make insanely bad loans, then bundle them together, wrap them in shiny cellophane, and dump them on an unsuspecting global securities market, and you have the financial collapse of 2008. Not allowing a good crisis to go to waste, the same politicians whose policies created this perfect storm of a fiscal collapse and a bankrupt government have used it to push “austerity,” not in the way of a responsible tax plan or the curtailment of military spending and corporate welfare but in the form of pushing the agenda they’ve been pushing for more than four decades—the wholesale looting of our national wealth through the annihilation of the public sector.

The logic, sold to us daily by the most sophisticated propaganda system the world has ever known, goes like this: Don’t blame the greedy rich, who psychotically want to reap unimaginable benefits from society while essentially putting nothing back into the pot. And don’t blame the hawks in government or the war profiteers who swell their campaign coffers and fund their propaganda with our tax dollars. And certainly don’t blame the multinational companies that often own both our energy and defense sectors, and our media. No. They have nothing to do with our current fiscal problems. Instead blame old people, greedily clinging to life, taking the Jell-O right out of our mouths.

The deal we all signed onto went like this: We pay Social Security and Medicaid taxes all of our productive lives. In exchange, we gain the peace of mind that when we eventually grow old and fall ill, we will have some baseline of medical support. We pay when we’re strong and we collect when we’re weak. In the interim, the knowledge that we can grow old with some modicum of dignity and a decent chance of survival cuts down on our stress for the five decades or so between youth and old age. It’s not a bad deal, which is why the American people overwhelmingly support these programs.

The new math, arriving in the form of what’s become known as the Ryan Budget, or the Republican Kill Medicare Budget, breaks this promise of security to the American people. Put simply, under the GOP plan, we work for decades paying into a system that is supposed to give us some sense of social security, hence the name, only to be told, perhaps in 2012, that we’re fucked. Those years or decades of payments are being looted to underwrite the continuation of wars and tax cuts for the rich. What we get instead is a coupon which we can use toward the cost of a private insurance policy, if we can somehow afford one, and if one is miraculously available. Picture this conversation: “My mother (or uncle, or brother, or fill-in-the-blank) has Alzheimer’s (or MS, or ALS, or terminal cancer, or had a stroke, or an aneurism, or fill-in-the-blank) and needs 24-hour medical care. How much will it cost to insure them? We have a $1,500-per-month government coupon. Hello, are you still there?”

I’ve recently been to a nursing home, visiting a relative. Almost all the patients there have the bulk of their bills paid by a combination of Medicaid and Medicare, though it’s safe to say that a good number of them have no idea who pays their bills, or where exactly they are, for that matter. The common route into a decent nursing home involves the patient showing evidence of some sizable life savings that is still intact and hasn’t been lost in any medical bankruptcy or junk bond investment scheme. As a price of admittance, this sum would be doled out to the nursing home until it runs out, which is usually within a year, at which time the formerly middle-class senior, now pauperized, has Medicaid take over the bulk of their nursing home bills. This is the real “death tax,” a 100 percent inheritance tax on the middle class, brought on by a mean, stingy, and terribly inadequate social safety net.

If you’re poor, however, it gets worse. Your choice of nursing homes is limited to those that will accept your loved one without the prerequisite dowry. This can mean moving them into a renovated junior high school staffed by exploited, exhausted and terribly underpaid and inevitably impatient and miserable workers. Still, this Medicaid sponsored purgatory beats what the Republicans are now proposing—which is to take even this away from infirm seniors.

I can hear the responses to this column already. “No, we don’t want to kill Medicare, we want to reform Medicare, we want to save Medicare, we want the magic of the market, the gods of free enterprise and the goodness of greed to…”

And so “war is peace.” None of this nonsense, no matter how many times Fox and Rush Limbaugh repeat it, holds water if you actually read the Medicare-terminating budget that every Republican in the House of Representatives voted for. Don’t believe me. Read it.

In the crazy zone, no Medicaid means no more Jell-O for those freeloading seniors. Once we show them the door, no doubt they’ll forget all about those lazy years spent as wards of the state and get out there and get jobs, start businesses, and get the economy moving again. On the ground here on earth, however, the result of this sadism are unthinkable. Seniors overwhelmed by declining health issues, no matter how much they may have saved, can never hope to pay the medical bills a free market will throw at them.

I have no doubt that many middle-aged children of declining seniors will bankrupt themselves throwing their meager life savings at their parents health bills, only to buy a few more months of health care. Without money for long-term nursing home care, at best, they’ll see their parents die before their eyes holed up in their basements and living rooms. And no, this is not an exaggeration. Think about it. Think about the role Medicare and Medicaid play in our society. Then think about what America would be without this minimal social safety net—no matter what type of coupon the crooks in Washington give you. Go to a nursing home and imagine what a life under a Republican government would look like.

Dr. Michael I. Niman is a professor of journalism and media studies at Buffalo State College. His previous columns are at artvoice.com, archived at www.mediastudy.com, and available globally through syndication.


Reader Comments (posting new comments is closed!)

Heronimous
16 Jun 2011, 11:11
"Dying is not a crime." --Jacob Kavorkian (1928-2011)

Social security was supposed to stabilize our society and it did. The poverty of the 30s and 40s were replaced by the prosperity of the 50s and 60s. Then when healthy stable people looked beyond their individual concerns, they protested injustices. The important social advances of the 50s and 60s have NOT been seriously challenged morally but they have been attacked by social instability, ever since Nixon/Reagan. . . The people have an induced insecurity.

Robert Finney PhD
16 Jun 2011, 11:45
End Health Greed As We Know It, Not Medicare
Medicare does not need to be cut, much less ended. Eradication of fraud, waste, abuse, and mismanagement by politicians, health plans, medical groups, and special interests would fund medically necessary health care for all Americans. Special interests have hijacked Medicare by rationing healthcare of the taxpayers who fund it.
President Obama believes that the privileged have more health care rights than plain folks Americans. He used Kaiser Permanente as the model for health reform, because the HMO has scammed non-privileged patients for 60+ years. Politicians, bureaucrats, and Dr. Strangelove physicians are “bending the cost curve,” but breaking the patients and destroying the doctor- patient relationship.
Kaiser Permanente’s Managing Director of Investments supervises the HMO’s $40 billion non-profit slush fund, all income from which is non-taxable. CEO George Halvorson’s annual compensation is $6.7 million. All Permanente Medical Groups are for-profit.
Kaiser Permanente rents its patients to researchers to secretly test drugs and medical devices, in which for-profit, Kaiser Ventures, invests.
Original investigations are posted on YouTube and HMO Hardball.
Robert Finney PhD

Jim
17 Jun 2011, 06:15
Mr. Niman is terribly wrong about one thing. The distinction between nusing homes for rich and poor people, particularly in New York, is not accurate. There are no such things as nursing homes that are "renovated junior high schools.". All nursing homes must meet the same federal and state Standards for everyone regardless of payor source. Nursing homes are not allowed to offer different service levels by payor source and you will find many Mediciad recipients in private rooms. Although I agree with many of Mr. Niman's points, his characterization of nursing home care for the so called rich and poor is completely off the mark and unfair to nursing homes who provide excellent quality of life and care to Mediciaid recipients.










Nick
19 Jun 2011, 09:55
Jim: Visit the Utica Free Academy in Utica, NY. It's a former High School, now converted into death house for poor seniors. Many more examples from around teh US on the active truthout discussion board for this article -->
http://www.truth-out.org/been-nursing-home-lately/1308409031

Frank G
21 Jun 2011, 13:22
Mr. Niman was accurate about several nursing home issues. It was a nightmare trying to place my father into a nursing home. After several placements into nursing homes, I was left to admit him into the Erie County Nursing Home in Alden. I have mix feelings about the Erie County Nursing home but I am very glade they are building a new one next to ECMC. Unless you have long term care insurance or are rich enough to pay for the best care. The nursing homes available are very limited and the staff is usually horrible. Unless, you visited your familiy memeber on a daily bases you can expect them to be neglected and in some cases abused. I've seen the neglect first hand in all the nursing home my father was placed. This will only get worse as the need for nursing homes increase.

Kunst
29 Jun 2011, 13:17
You obviously haven't been reading your Ayn Rand enough. (Ayn Rand -- remarkably similar to Paul Ryan or Rand Paul, or for that matter John Boehner or Glenn Beck). How about that Ayn Rand:

“What I am fighting is the idea that charity is a moral duty”
“You love only those who deserve it”
“Nobody has ever given a reason why man should be his brothers’ keeper”

If you aren't one of the Productive Few (architects, inventors, corporate leaders, financial engineers, wealthy heirs, politicians...) then you are by definition a parasite (aka looter or moocher), an unworthy being who just wants to steal the hard-earned wealth of the Productive Few. If you can't afford medical care when you get old, it's obviously because you didn't succeed very well during your working life – after all, it's an equal-opportunity world where only individual talent and effort matter. Bill Gates doesn't have a problem paying; what's wrong with you?

The real Republican philosophy: if you can't afford to live, please have the common courtesy to go away and die.

Linda Dezenski
01 Jul 2011, 14:11
Hi:

I agree with you. The only thing I would add is that the gutting of Medicare and Medicaid Services also reduces funding for the cost effective alternative to nursing home care which is called Home and Community Based Services. Disabled and older persons can live effectively at home with an attendant/home health aid for 1/3 the cost of a nursing home bed. Recent attacks on all of these supports are actually going to cost tax payers more in the long run.