True to my commitment that I'd not enroll in Medicare until all people of all ages have access to proper care, I persisted in my un-covered state until this week, seven years after becoming eligible and ten years after the spouse's retirement from employment by the state of Florida. It wasn't hard to stay un-covered. Although the Social Security Administration had been sending me helpful notices over the years, reminding me that I still hadn't accumulated enough "quarters" to qualify for a pension, nobody bothered to take note of my 65th birthday and, presumably in the interest of saving paper and postage or the realization that it was now hopeless, the annual reminders of my dereliction stopped being delivered by the postman.
I will admit that, at first, I was a bit curious to see that happens to people who don't speak up and demand to be served. The answer turned out to be nothing. It is possible to remain anonymous even in this day and age. It took the election of 2004, when Howard Dean made a big issue of the derth of medical care for thirty million people, that I decided not to participate in the inequity. Indeed, I came to perceive the supposed privilege of having lived long enough to "deserve" health care as insulting--an attitude which subsequently soured me on the third Clinton candidacy. That Hillary was reluctant to admit that the years of aggression against Iraq, culminating in the invasion, had been a mistake was understandable. That health has to be deserved, along with "lunch," strikes me as evidence of an authoritarian streak not welcome in the Presidency.
Anyway, the launching of the sign-up period of the ACA struck me as a good time to test the system. So, heeding the frequent prompts to go ahead and use the internet, I logged on last Friday, filled out a form and within about a half hour had received an email with a case number, as well as a notification that I would have to provide original documentary evidence of birth, marriage and citizenship at a Social Security office in person--a reasonable suggestion since I already knew from personal experience that the federal government is not good at keeping track of paper. While the Germans, despite having their cities bombed to smithereens, managed to preserve vital records, when I went to request a copy of my certificate of citizenship in 1989 (the original having disappeared when our house burnt down), it turned out that the Federal copy was "lost" and I had to be photographed and certfified anew by taking an oath to be faithful and true. People are presumed to be telling the truth, unless someone can prove otherwise.
At 8:15 the following Monday morning I took a phone call from a clerk in the Medicare office to tell me the documents would have to be brought in and telling me that, because I'd waited long after turning 65 there'd be some penalty attached to the Part B premiums I'd agreed to pay. It will be interesting to see how that's collected, since I don't have any income from which they might collect. Presumably, the spouse's pension will be tapped, but we'll see how that works. I agreed I would present myself and the documents that very day, but did not set up an appointment. How long could it take?
I put money for 45 minutes in the parking meter and really irritated the spouse, since he was sure it would take much longer than that. It did, a couple of minutes, but that was mostly because I hadn't counted on the security rigamarole in the lobby where I ended up leaving a 2.5 inch pocket knife and a nail file and the spouse ended up being wanded, rather than take off his belt and suspenders. It was quite a production--make-work for a couple of old geezers and a reminder that the security apparatus is a grand waste of time.
The Social Security waiting room at the end of a long hall, in which no loitering is allowed, had about 20 citizens in waiting but, of course, they are now referred to as "customers," rather than consumers or, even more correctly, patrons. An electronic sign-in station, where the card seekers are separated from those with "other" business, is complemented by an electronic sign-board announcing the number being "served," as well as enumerating a variety of prohibitions (no recording, no loud talking, no objecting, etc). One wonders if the U.S. electronics industry could even survive without this constant subsidy for their continually evolving gadgetry.
Perhaps all this preliminary delay is designed to highlight the efficiency of the staff. Because, once my number was called, records were consulted and documents duplicated in no more than ten minutes and we were on our way. How would we appreciate the agency's workload, if we weren't made to wait?