Surely at one time or another, you have heard the expression, “Noblesse Oblige,” usually bandied about by some liberal as justification for yet another entitlement program. The meaning of the phrase has been bastardized by the Kennedy clan to read, “To whom much is given, much is expected,” which is taken from the Gospel of Luke. Translated from the French, “Noblesse Oblige,” is closer to “Rank has its obligations.” Perhaps there is no real difference.

But, if the wealthy were obliged to provide care for the poor, the poor, although lower in rank, had an obligation to “give something back” to those on whom they depended to pay their bills. Nowadays, there are very few expectations placed on those who belly up to the public trough like the proverbial pigs at feeding time.

You know, much of my income is given away to others in the form of government programs that are rife with waste, fraud and abuse. I’m tired of being told to lower my expectations.

The latest entitlement foisted on the taxpayer will be an across the board prescription drug plan for senior citizens.

Exorbitant drug prices, old age and sickness are nothing new. Over four centuries ago, William Bullein, an English physician, and gentleman of noble birth observed: “Surfeit, age and sickness are enemies all to health, Medicines to mend the body, excelleth worldly wealth.”

Bullein and his Renaissance contemporaries would render care, give advice and provide free medicines to their very poorest patients and “charge the rich more.” In exchange, the poor who managed to survive the medical regimen might perform work for the nobility, or at least feign respect towards those who had interceded and provided for their upkeep.

Show me de monee!

Today, taxpayers and those who pay insurance premiums have taken the place of the nobility in terms of financially supporting those who cannot or will not pay their own medical bills. Only we, like Rodney Dangerfield, get no respect. I echo the words of the 16th century queen who complained, “I see far too many caps on heads, and hear far too few ‘God save Yous’, for my liking.” Oh, wait; I forgot, as a simple taxpaying fool who foots the bill for these programs, I’m not “entitled” to any respect.

I don’t really expect sick patients to show deep gratitude, I’ve been a nurse far too long for that. However, before I left bedside nursing for good, I would have really appreciated not being kicked, bitten, cursed, spit on, hit and scratched while trying to perform my duties. A “thank you” now and then wouldn’t have hurt. As a nurse’s aide many years ago, one of the first “frail elderly” male patients I was assigned to in a nursing home tried to choke me. Fortunately, I was with another aide, and she managed to subdue the attack. Instead of asking myself, “Hey, what’s wrong with this picture?” I continued working as an aide while attending nursing school. It was an omen.

Politicians frequently say that America’s elderly often make the “hard choices” between food and medicine. Perhaps a very few find themselves in such dire circumstances, and they deserve some help. However, my suspicion, based on more than two decades of observation as a nurse, is that the “hard choices” for a substantial majority of seniors involve which Beanie Baby to buy, or when to book that trip to Disneyland. Ever walk into a casino? What with all the “frail elderly” in the place; I’ve come to think of gambling as a “social security check redistribution program.”

This is not to say that I believe that people should not buy impulse items, or treat themselves to various amusements. What I’m saying is that most seniors are, in fact, rather well off, and that the majority does not need yet another across the board entitlement.

Between 1960, five years before Medicare was enacted, and 2000, U.S. life expectancy has increased almost 10 percent, from 69.7 to 77 years. Supporters of entitlement schemes point to an increasing lifespan as proof those programs should proliferate. The fact of the matter is that longevity has much more to do with lifestyle choices and good genes than government spending programs. And, as Sue Blevins, RN, MPH points out in her latest book, “Medicare’s Midlife Crisis,” life expectancy for Americans was on the rise well before Medicare arrived on the scene. The average life span of Americans increased from 47.3 years in 1900 to 69.7 years in 1960, without the benefit of Medicare.

Along with the number of years one can be expected to live, the overall “worldly wealth” of seniors has risen as well; according to the government’s numbers. In 1995, the most recent figure available, The Public Information Office of the Census Bureau estimated the median net worth for householders age 65 and over at $92,399, compared with $40,200 for all householders.

According to data from the department of Health and Human Services (HHS), approximately 73 percent of Medicare beneficiaries have drug coverage at any given time. Asked whether another program was necessary when 3 of 4 seniors already have coverage, HHS Secretary Tommy Thompson countered that not all seniors have consistent coverage, and that many do not have access to substantial discounts.

If individuals are having problems affording their prescriptions, a full and frank discussion should take place between the patient and provider, to see whether there are any medications that can be stopped, or the dosage reduced. Hey, senior citizens, here’s a novel idea, get a part time job so that you can pay for your drugs. This is America; the notion of living on a “fixed income” is absurd. Besides, we need all the productive taxpayers we can muster right now. Be a greeter at Wal-Mart’s or something.

Well, Government entitlement programs without regard to need are not new. After all, the first person to be given a Medicare card was none other than a former President of the United States, Harry S. Truman. In 1965, President Lyndon Baines Johnson (LBJ) traveled to Missouri to present Truman with the card. In case you are too young to know this, the name of Truman’s hometown in Missouri was “Independence.” Now, there’s some irony.

LBJ should have listened to his Vice President. It was Hubert H. Humphrey who said, “The impersonal hand of government can never replace the helping hand of a neighbor.”

Be healthy. Institute for Health Freedom. Sue Blevins is a Registered Nurse, and is founder and president of this organization. She is the author of “Medicare’s Midlife Crisis.”

CBO Budget 2001 revised estimates of the cost of the Rx program. Don’t forget, the expected outlays are in billions, with a “B.” Remember, too, that government cost projections tend to be underestimated. People always spend more on something when someone else pays.

Currently, there are more than 100 pharmaceutical manufacturers’ patient assistance programs. These programs usually offer a limited supply of free prescription medication to eligible patients.

Written by Maggie Boleyn, RN for the SierraTimes.com, and published on DrKelley.info, February 9, 2002. Embedded links (if any) may no longer be active. (Ed. 01.01.11)

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