"Ma'am," she said, clearing her throat. "Do you have supplemental insurance?"
"What's that?" the old woman said, smiling pleasantly. She was hard of hearing, apparently, and must have thought the clerk was offering some jocular pleasantry.
The clerk repeated her query, this time to the daughter, as if the old lady was a doddering old fool.
"There's something you should know. This medicine costs $170."
"Oh, lord," the daughter responded. "Why is it so expensive?"
"Your mother is in the donut hole," said the clerk, as if this infantile expression was perfectly clear. "She's maxed out. Medicare won't cover this prescription."
A quiet conversation took place as the daughter tried to explain this to her mother.
"Donut hole?" the old woman repeated, baffled by the sudden change of topics to breakfast pastries. "Oh, dear." She snapped her change purse shut, pushed the bagged pills back toward the clerk and announced, "I can't afford my medicine."
The pharmacist, overhearing the exchange, chimed in.
"Here, let me write down the 800-number you can call so that someone can explain this to you."
The mother and daughter blinked and took the slip of paper with the 800-number proffered by the pharmacist. They shuffled away without a word.
Another jolly old soul falls into the donut hole, and another wound is inflicted on the English language. The "donut hole" is a simple way to bypass explaining how the Medicare Part D beneficiary is S.O.L. if the costs of their prescriptions annually exceed $900 (and whose don't?). They must pay out of pocket for all prescriptions up to $4,350, at which point a "catastrophic coverage threshold" is reached and Medicare covers the costs. Though phrases like "donut holes" obscure the "debate" over health care reform, the biggest wound to language has been to refer to any form of government intervention as "socialism." Medicare, then, is socialism, in these people's view. And so is road building, bridge maintenance, public education, state universities, etc.
The "donut hole" shows, of course, that all is not perfect with government-run health initiatives. The chronically ill can fall through the cracks. But if left up to the private sector there would not even be a donut, much less a hole, to fall through. The elderly would just die in their hovels after they ran out of dog food to eat.
The privatization of health care, touted by its fans as more efficient because of the purity of the profit motive, has proven a failure. Paradoxically, the same folks screaming loudest about "socialism" will be first in line for government help when their corporation outsources their jobs to India and they find themselves, like the 86.7 million (or one in three) other Americans under age 65, who've been uninsured in the past two years.
That "privatization of health care" dynamic was on display recently when the government's H1N1 vaccines were scarfed up by Wall Street firms like Goldman Sachs and Citigroup long before even hospitals had them — and ahead of anyone who may have been most at risk. I can think of a lot of terms for that behavior but, I will concede the point: It wasn't "socialism."