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No good deed goes unpunished: Your health care system in peace and war

My health care Catch-22

3 minute read
Do I look like someone with Alzheimer's?
Do I look like someone with Alzheimer's?
Like a Good Wife, I worried that I might have inherited my poor mother's Alzheimer's. She was a nasty handful in her last ten years— angry, impulsive, paranoid and sometimes violent. If that happened to me it would destroy Husband's golden years and ruin him financially. I don't want to stick him with that. But how to spare him? Plan ahead.

"70% of over 65-ers will need long-term care," some government figures show. How much and for how long? Who knows? Better to hear the bad news now while I could prepare to cut him loose from having to take care of me. I made an appointment with a neurologist.

"No, Alzheimer's Disease is not hereditary," Dr. Arthur Deauville of Los Gatos, California, told us. "But there are no conclusive tests to show if you have incipient Alzheimer's, either. It could occur anytime. We don't know enough about it yet. Let's just have a look at you."

The doctor tapped my kneecaps, asked a few cognitive questions and made me walk a straight line. Then he patiently inquired of Dear Husband whether I got lost going to the store or rambled incoherently. Husband and I had the distinct impression we were wasting his time and Medicare money.

"'Quite normal'


He offered a detailed explanation of how the brain works or fails to work. Finally, the good doctor, a well-preserved 60, sat back in his chair and chuckled. "No one has ever walked into my office to ask if she has Alzheimer's. All you have is a little age-related memory disorder. Quite normal."

That was slightly irritating. I can play a hand of bridge after 45 years of no-bridge. I know exactly what's in the refrigerator and I write books and columns such as this and I can damn well do the crossword puzzle every day. Well, almost all of them every day. How is this a disorder?

But who cares? I didn't have the dreaded A! I was good to go.

Off to the insurance broker


Moving along on the Good Wife's planning track, I asked long-term health care broker Barbara Hansen how much it would cost to insure us. Jim's mother lived her last two years in a nursing home. My mother had home care. Both are pricey.

When Barbara heard I had visited a neurologist, she practically fainted.

"That's a deal-breaker right there," she said. "Underwriters won't touch anything to do with cognitive disorders because it sounds like Alzheimer's. Insurers don't care about your arthritis or high blood pressure. Insurers don't care about your husband's recent heart surgery. It's merely the possibility of Alzheimer's. That you visited a neurologist means I can't write you a policy. And there's no changing this because the insurance industry has already collected your diagnosis in its central file," the Medical Information Bureau.

Next, Plan B.

Now, I know the MIB could not possibly be compared to the faceless and powerful agencies such as the CIA that secretly collect information about us. MIB is simply an insurance industry tool to select out unprofitable insurance risks. Wellness inquiries, for example, are like bankruptcies or felony convictions, only they never drop off the file.

How annoying— how possibly ruinous— to be excluded from the Healthy Club. Just when I was congratulating myself on having doctors looking after each and every organ, feeling coddled while millions of our citizens are going broke and missing medical care, now I'm 70% likely to join them.

Next, Plan B. What the hell is Plan B?

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