Out of the Woods

Inequality

Anyone but the most fanatical conservative acknowledges that economic inequality is growing, not only in the United States. They are also willing to admit that growing inequality is undesirable.

One may admit that inequality is real without fully understanding what it means for its victims.

A friend, who does some sort of social work, told me this story as an illustration of what inequality means for people at the bottom of the scale.

This story is about a mother and her son. The mother is 92. She looks her age but she still hears and sees perfectly well and her mind is in excellent shape. She does not miss much. She had three children. One daughter died of cancer at age 50 a number of years ago. One wonders about the medical care she received. There are two sons. The one I know, said my friend, is in his 50s. He earns about $440 a week.

A while ago the mother had a bad fall. She injured her pelvis and needed skilled nursing care for several weeks. Medicare paid for a large portion of the nursing home cost. But the mother had to pay a $16 co-payment for each day she spent in the nursing home. That bill mounted up to more than $2000.

When the mother entered the nursing home, her son, concerned about the co-payment, talked to the nursing home management. They assured him that some way would be found to pay that $2000 bill. He was told not to worry.
The plan had been to get Medicaid to pay the co-payments. But when the bill was submitted to Medicaid, the nursing home was told that the mother had some "assets" and Medicaid could not cover the co-payments.

What were those "assets"? For the last 50 years the mother had owned a life insurance policy worth $3000. She also had a joint bank account with her daughter where her daughter kept her life’s savings – $1500. Medicaid mistakenly assumed that those $1500 belonged to the mother.

It turned out that Medicaid refused to pay the co-payment at the nursing home because the mother had a $3000 life insurance policy. After living for 92 years, most of them years of hard work, her $3000 policy disqualified her for having her nursing home costs paid for. She lived on Social Security and barely got by on that. Her son, who earned barely more than $20,000 a year, was barely in a position to contribute even marginally to her income.

As a consequence the nursing home took the mother to court to collect the $2000 owed. The mother readily admitted that she owed this sum but pointed out that she was in no position to pay.

The son said he was willing to pay $10 a month. At that rate, it would have taken more than 10 years to pay off the nursing home debt.

Had they cashed in the life insurance policy, there would have been no money to bury the mother once her day had come. She faced the choice of a pauper's grave or not paying her bills as she had done all my life.

The folks at the nursing home, who seemed to be well-meaning enough – but were not willing to leave a $2000 debt uncollected – had no suggestions. Neither did my friend who was familiar with problems of this sort. Mother and son, both  hard-working and responsible, were caught in a hopeless dilemma from which there is no escape.They cannot pay their bills and act as responsible and trustworthy citizens. In old age, the mother suffered a serious injury to her self-esteem.

Victims of inequality over and over again are faced with situations in which they have no way out. Their fellow citizens are not willing to make sure that at age 92 their financial needs are met, that they will receive the health care they require and will have a roof over their head, enough food, and money for transportation.

In our very unequal society it is not enough to be hard-working and responsible. You may nevertheless end up unable to pay your bills. However much you deserve to do so, it is difficult to hold your head up high if you cannot pay your bills or have no money for a decent funeral. 

We need to do more than deplore inequality. We need to put an end to it.