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Koch: Spend what's needed for healthcare

Clamps, scissors and other surgical instruments are seen

Clamps, scissors and other surgical instruments are seen in the operating room during a kidney transplant at Johns Hopkins Hospital in Baltimore, Md. Photo Credit: Getty Images

Former Mayor Ed Koch wrote a weekly column for New York Newsday from 1999-2000. This column first appeared in January 2000.

THE TWILIGHT Zone of life starts at 65. People entering this zone quickly realize the key to enjoying life is good health. Without good health, regardless of all else, a meaningful life is much more difficult.

According to the U.S. Department of Health and Hu- man Services, life expectancy at birth increased by eight years over the past half century. It is now 80 years for white women, 74 years for white men, 74 years for black women and 67 years for black men. The elderly population is growing at a faster rate than other sectors. Within the next 30 years, there will be 70 million people in the United States 65 years of age or older - about 20 percent of the total population.

In order to provide comprehensive medical care for this large and ever increasing cohort, we must enact appropriate legislation immediately. Yes, we have had Medicare since 1965, but it does not provide prescription drugs, nursing home care or home health care for those who require those services.

It is true that some people receive assistance when they become eligible for Medicaid after exhausting their life savings. To qualify for Medicaid in New York State, elderly couples can have a maximum income of $ 875 a month, singles $ 600 a month. The amount of total savings is also limited: $ 5,200 for couples; $ 3,600 for singles (house and car are exempt).

Does it really make sense to require heretofore middle income folks to become part of our below-the-poverty-line population just so they can obtain adequate medical assistance? Why does Congress, which is responsible for deciding what Medicare covers, exclude not only life-saving prescription drugs, but dental care as well? Enormous medical ills affecting the entire body can flow from unattended tooth problems. Anyone who has suffered the experience knows that tooth pain can rival the worst of any pain in the human body.

Shorter and less frequent hospital care - paid for by Medicare - has resulted from the use of effective prescription drugs, paid for by the individual senior citizen.

These changes should require a re-examination of Medicare's coverage and expenditures.

A question debated by Vice President Al Gore and former U.S. Sen. Bill Bradley in the Democratic presidential campaign is how much it will cost to provide universal health insurance for every resident of the United States. They agree: It would cost a fortune.

But how can we fail to make this investment? For years, almost every western democracy has provided health care for its entire population. No conservative government subsequently elected in those countries after adoption of universal health care coverage has dared rescind those programs. They are well aware that the sense of security that flows from knowing your basic health care needs are covered remains one of the voters' highest priorities.

I am a fiscal conservative and supported a balanced budget when it was not fashionable among Democrats. I am personally financially secure, and have the best medical insurance available. That coverage became important in 1987, when I suffered from a stroke, and in 1999 when I had a heart attack. I fully recovered from both medical incidents.

I also have long-term care insurance that costs $ 14,000 a year. This would enable me to enter a nursing home of my choice or to receive home health care.

Nevertheless, I cannot accept or understand why this great country refuses to provide adequately for senior citizens who are not so fortunate. Why do we force the elderly to sink below the poverty line before properly taking care of them? Why do we refuse to deal with the larger problem of health care for the total population, even though there are more than 45 million Americans, most of them employed, who do not have health insurance? Over the past few years, $ 100 billion has been spent tackling the Y2K computer problem in the United States, a problem that should never have existed.

Apparently, countries that spent little or nothing on the problem have had the same successes we have had. Why are we reluctant to spend the additional amount needed to keep our people healthy and productive longer before they pass on? All voters, particularly senior citizens, should make comprehensive health care coverage their No. 1 priority and state that their votes will be cast against the candidates who fail to respond to that need. Younger voters should take the same action.

With the passage of time, and without the sounding of trumpets, almost everyone will face the need for major medical care. Why shouldn't that care be available?