"We have literally fallen from the middle-class to potentially having nothing," says Kate Michelman. But she's lying. Michelman, the former president of NARAL, was not middle class. You don't run one of the largest advocacy organizations in the country and make $42,000 a year. Similarly, her husband was a retired college professor. Between the two of them, they were almost certainly wealthy. Which makes her story all the worse. In 2001, Michelman's daughter was horseback riding. The horse spooked and fell backward, crushing her spine and paralyzing her. She had no health insurance. The bills neared a million dollars. Michelman cashed out her 401(k) and her IRA. The next year, her husband was diagnosed with Parkinson's disease. In theory, this should have been less of a problem. Her husband was covered by Medicare and backed by supplementary long-term care insurance. And that worked. For awhile. But walking to a doctors appointment one day, his balance gave and he cracked his femur and fractured his hip. He was moved to an assisted living facility. Even that was mostly covered by health insurance, but as Michelman says, "when 'most' comes to be reality, you're left with thousands of dollars of bills that are not covered for one reason or another." There are those who believe insurance a perversion of the market. It may be true, they sadly admit, that low-income Americans need subsidies and help. But there's no reason such distortions need to reach into higher income brackets. But this misunderstands the nature of health care costs. They are not on the scale of individual incomes. Even the rich find themselves rapidly impoverished by the staccato procession of treatments and medicines and daily care required in the aftermath of a health calamity. It is only aggregate incomes that can afford insurance protecting unlucky individuals against the full costs of catastrophe. Health care isn't about purchasing. It's about pooling. The problem for Michelman was not her husband but her daughter. Her daughter didn't have insurance. And that meant that it didn't really matter that Michelman had money. Medical technology is not priced to be bought by individuals. it is priced to be bought by large groups and used on those individuals that eventually need it. Even then, it is not really affordable. But it is, at least, survivable.
