Medicare For All. Be Careful What You Wish For.

John's facial tick reminds me of a shark. His upper lip curls behind his teeth and he makes a hissing sound. He does this every time we talk about health care reform. He smiles and teases, but he's only half joking.

You doctors have it coming! Boy do you have it coming!

We banter back and forth as I examine him. John's muscular limbs are surprising for a ninety year old. His opinions offend, but only slightly. He belongs to the far left. He is most comfortable discussing universal health care and the public option. To him, medicare is the final answer.

Medicare for all!

He looks at me with both sincerity and pity. He realizes that my colleagues and I think this will be the death knell of modern medicine. But he doesn't care. He's fairly certain that we are wrong.

*

Although John's emphysema is much improved, his ankle is now swollen and painful. It's bruised and barely able to support his weight. He hobbles through the door with a cane. He is finished with the prednisone and levaquin, but now is suffering the consequences. His tendon has ruptured.

A week later his orthopaedist performs a short surgical procedure. He is discharged home hours later with detailed instructions. His only support is his eighty five year old spouse.

The next morning John's wife calls. Her voice trembles with panic.

John's too weak. He can't even get out of bed. We're bringing him to the nursing home.

I pause a moment. While I definitely think a skilled facility is a good idea, I'm doubtful that medicare will pay or it. I begin to verbalize my concerns, but John, who has now joined the line, interrupts.

Oh don't you worry. Medicare will take care of me.

*

Weeks later John is recovering at home. His physical therapy is going well. As he stoops to lower himself down on the chair in my office, he slams a stack of papers on the desk. I look up quizzically.

Five thousand dollars! Can you believe five thousand dollars of nursing home bills? And medicare won't pay a cent.

It is now I who looks at him with pity.

Medicare for all.

Be careful what you wish for!