As a senior, she was covered by Medicare, and the couple also has AARP Medicare supplementary insurance. "I walked out of there owing virtually nothing," says Jackson. "I think it was maybe $400 for the whole mess out of my pocket.... I figure I've got one heck of a deal."
But only 42.4 million people qualify for Medicare, all either 65 and older or disabled.
Now, with the baby boom generation heading for retirement beginning in 2011 -- and the new prescription drug benefit projected to cost $558 billion through 2013 (according to the Congressional Budget Office) -- many are debating when, not if, the program will be bankrupt.
Like so many Americans, Johnston doesn't know how the system can continue working as well for future generations as it has for him and his wife. He's particularly stumped by the medical cost demands at the very end of life. Between 27% and 31% of Medicare spending goes for care during the last year -- often costly treatments that can add days, weeks or months to a dying patient's life, according to a December 2005 article in the journal Health Affairs.
"The ungodly cost of the last years of life ... ," he says. "I don't know how you deal with that."
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CYNTHIA La MORGESE
CYNTHIA La MORGESE is a nearly perfect health specimen: 29 years old, works out at least three times a week, eats vegetarian, practices Pilates.
"I answer 'no' to pretty much everything on the [health insurance] application," says the West L.A. woman. That is, no diabetes, no high blood pressure, no high cholesterol, no history of kidney disease. Surgeries, yes, one knee laparoscopy after an injury following a workout a few years ago. Smoking, no, not anymore; not after treatment with Wellbutrin, an anti-anxiety drug shown to help people kick the tobacco habit.
She works two jobs, one as a tutor for high school students, the other as a part-time clerk at the Venice Health Clinic. They add up to more than full-time hours, but neither job provides health insurance.
"I can't get insurance," she says. Her knee injury is noted as a preexisting condition when she applies. Her seven-year history of smoking and use of Wellbutrin are cited as reasons for a cost that's more than she can afford.
The best she could do was a plan that would cost $120 a month, but it came with a $1,500 deductible. She'd have to pay a monthly premium, plus every penny of every appointment, medical test or prescription drug she could anticipate needing, since her yearly medical expenses would probably fall below $1,500 a year. She paid for a couple of months, then dropped it because of the expense.
