September 23, 2019

Why Charity Isn’t Enough

“I’ve been knockin’ on the door that holds the throne
I’ve been lookin’ for the map that leads me home
I’ve been stumblin’ on good hearts turned to stone
The road of good intentions has gone dry as bone
We take care of our own.”

—Bruce Springsteen

During this political season, we are hearing a lot about how big government should or shouldn’t be, and its appropriate role in our individual lives. For those most vulnerable among us, including the poor, the disabled and the frail elderly, the real question is: will the government be there for me when I need it the most?

As important as private charity donations are, the simple fact is that even when donors are generous as they often are in the Jewish community and other faith-based groups, the collective efforts of all that fundraising can’t come close to the real costs of taking care of people in need, especially so if there are long-term needs. According to the International Federation of Health Plans, the average cost per hospital stay in the United States was $15,734—would your synagogue or church want to foot that bill for every congregate who didn’t have health insurance or Medicare/Medicaid?

And those numbers are chicken feed when we start looking at long-term care.
My almost 90-year-old Dad took a bad fall last week, fractured his hip, had surgery and is now in rehab care for the next month or so at a skilled nursing facility.  That service would cost around$230 a day out of pocket without his Medicare and supplemental coverage. He’s getting high-quality physical therapy five times a week, but with less coverage, he would be receiving far less sessions, even if the doctor recommended it for optimal recovery.

A lot of disability advocates are very worried about the Ryan (and now Romney) proposal to turn Medicare into a voucher system. Although Medicare is widely known as health insurance for those over age 65, federal law was changed in 1972 to include those with permanent disabilities. As David Lazarus reported in the LA Times last week on how the Ryan plan would work:

“People under 55 would receive a federal subsidy — a voucher — to buy health insurance once they reach the eligibility age, which Ryan would raise to 67.
That voucher would be used to buy either conventional Medicare coverage or a similar plan from, say, one of half a dozen private insurers. The amount of the voucher would be determined by the cost of the second-least-expensive plan available, which experts say would likely be private coverage that would not be as comprehensive as Medicare.”

The bottom line is that we are facing a potential situation of a lot less care for those who need it the most.