Medicare, health care reform and happy birthday


Well, I am getting ready to celebrate a milestone. On July 18th I celebrate my 60th birthday. First of all, I just don't feel old enough to be 60. When I gave birth to my daughter Kirtley at 36, I kept thinking I would be older than this when she was finished with college and working, but, you guessed it, she is a year out of college and working in New York City at Harry Walker Agency, the country's top speaker's bureau for political speakers (sorry for the plug, but it's a mother's prerogative to brag). Anyway, next week she will be home and we will be going to Austin to celebrate my birthday with her older siblings from her dad's first marriage and their children, my step-grandchildren. I have one of those modern families that takes a computer program to figure out. I can't wait to spend time with family and just enjoy getting older. Yep, I am one of those that can't wait for her next birthday. It's what happens to you when you have had cancer. Overnight you stop hating birthdays and start looking forward to them. Right now, I am hoping to make it to 65 when I can spend lots more time being Gran to Dani, Max, Miles, Lilly, Zadie, Tobias, and Terra Belle. But there is something scary about getting older, and that's health care. Right now we are in the midst of health care reform and, like most of America, I am trying valiantly to keep up with the complexities of an increasingly complex situation. Our health care system is flawed, no one doubts that when we know that even with health care, many people going through cancer come out the other side in financial ruin. And what about the studies that show that many people with cancer don't seek care because they know they can't pay for it. That is something that should not happen in the greatest country on earth. Then there is Medicare. When I hit 65, that's what I'll have. I haven't paid much attention to Medicare issues before, but with a 6 now in my age, I have stopped to read a few of the e-mails I get. I got one today that really scared me. It came from, a nonprofit with offices in New York and Washington D.C. whose mission is to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs and public policy initiatives. Here is the question of the week. Will health reform help these people?My husband is 62 years old and has been on Social Security Disability for seven years due to heart disease, arthritis and diabetes. He takes 13 prescription drugs daily, plus aspirin to manage his health, including two injectable insulins. I worked in an office and covered us with health insurance for years. When Medicare Part D came into effect I was told by BlueCross/BlueShield that since he was eligible for Medicare Part D, they would no longer pay for his prescriptions. I subsequently lost that job and the coverage. We are not "insurable" on a private policy.By the first week of March each year, he is in the "donut hole" and his medications cost between $800 and $1,000 per month until approximately the middle of June, when he has spent enough to move to the catastrophic category. We have used credit cards to do this and now the credit card companies are reducing our available credit and/or closing our credit card accounts because of the economy. Our house is now worth less than we owe on it, so there is no equity to tap to consolidate debt. We have not yet paid off last year's donut hole expense and are now adding $4,000 to it. My husband's $21,000/year social security disability puts him over the financial limitations to be eligible for additional help through the State of Georgia or any of the prescription help programs out there, including the manufacturers of the insulin he needs to keep him alive. How are we supposed to pay for this? I can't make enough money to keep my husband alive and we do not qualify for any help.I am terrified. I don't know how to do this. I applied for Partnership for Prescription Assistance; I applied online for help through the State of Georgia; I talked to our doctor; I have searched the internet for help. We don't qualify. >--Kimberly Z, GeorgiaThere was no answer to the question by the folks at medicarerights, because there isn't an answer. There is only another question. What is health care reform going to do for this family and the others like it? This man could just as easily have been taking one of the new targeted therapies for cancer that keep it in remission. What then? Or what about women on hormone therapy as part of their treatment for cancer? If you want to read more about the challenges, and get involved in the national dialogue on health care reform, this website is a good place to start. Go to

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