Ageing & pooling risk

I lost my mother last year, long enough to not keep writing about it. But far worse than grief, her death revealed how much, without realising it, her ageing had become the fulcrum of my domestic routine—how incredibly harder my search for meaning and purpose became with the freedom from responsibility and the breadth of possibility that the passing of a second parent brings.

I must now turn to the business of my own ageing. Unlike her, I do so childlessly. It’s a cost of not parenting I had absolutely never taken account of. I shared this recognition at a joint National Insurance Board/Equal Opportunity Commission forum I attended on how as a country we plan for the costs of ageing. I hadn’t realised my comments were televised [skip to 28:42] until neighbours shared in the supermarket how they had resonated with them.

A law degree was to be my insurance against poverty as an ageing activist. So I’d taken the mic to whine that I was one of the actual people over 50 denied GATE this year.

14322752_10209682435555167_7702661197543670548_nExclusion of 50+-year-olds starting new programmes is one of two or three GATE reforms implemented immediately, without notice, in August. It seems to apply only to those unlucky enough to have had some clerk’s inattention tie up our admission letter so it was dated after the Cabinet note.

ar-160729969-jpgmaxw730imageversionarticleA means test that kicks in next year will disqualify all students with higher incomes or savings—whether through age or other reasons—from GATE’s tuition subsidies. But to reinforce that investing in old people’s potential isn’t this government’s priority, its 67-year-old Education Minister (the oldest Cabinet member) ensured the handful of students over 50 who cannot afford tuition still won’t get GATE.

A PNM government paid for my education before. But denying GATE-funded education to others my age committed to non-profit work that is not highly rewarded seems fundamentally unfair. Seniors are much more likely than young people to apply their education at home, and not be lured by foreign markets and life opportunities they promise.

Perhaps PNM’s vision is to push seniors who can migrate to do so. That would be a smart move for someone in my shoes. As we fall out of the productive economy, supporting my “Baby Boom” generation is a challenge for the smaller ones that follow, moreso in T&T where overall population growth is almost flat. Pushing us out and abroad creates opportunities for younger workers, as well as relieving the burden of our eventual dependency.

My GATE lament might not be the chord that struck my TV-watching neighbours. National insurance contributions are formal ways states invest for old age. But we all know, I noted, that children are the real mechanism for supporting ageing’s costs. Investing in offspring ensures parents’ socioeconomic mobility. This process, however, is breaking down in “hotspot” communities, where the Education minister’s head-in-the-sand-style thinking on school-based sex education fuels early pregnancies that push girls into a cycle of dependency and out of economic advancement. The school curriculum and ideas of masculinity are also failing boys, who will not outlive their parents.

Screen Shot 2016-12-24 at 7.12.18 AM.pngI had eye surgery last week. A Diabetes Awareness Month morning-show guest put fear in me that imaginary mosquitoes and roaches floating by my left eye risked sudden blindness. I showed up, all entitled, to be seen at Mt. Hope Hospital’s eye clinic. Get a referral letter; register; you’ll get an appointment in order of urgency. I found $600 and saw a private ophthalmologist the same day. It wasn’t diabetes; but it was $30,000 surgery (around the same price as the GATE-denied tuition I couldn’t afford): “If you go in the hospital, you would go blind.”

I went. They offered an External Patient Programme referral, a fund the Partnership government established for privately-available procedures (probably performed by GATE-trained doctors) not provided in public care, and others like cataract surgery, where public waitlists could mean blindness. But approval takes seven months, the current government hasn’t allocated any funding, there’s already a backlog, and if you’ve paid for your procedure, then you don’t need help. Even by using privilege to skip lines, or folks doing principled advocacy, I’d indeed “go blind.”

Like NIS, insurance is the formal approach civilised states take to health financing. Through risk-pooling (the basic concept underlying insurance), everyone makes small contributions into the same pool, which then covers the few chance chooses some ill(ness) to befall. But not here. Our health risk pools are currycues and GoFundMe campaigns, where many make small contributions to support others’ catastrophic health needs.

Being an activist helped. Funds came in in less than two days. CTV asked me on air. I may have raised enough to contribute to someone else’s surgery.

Screen Shot 2016-12-24 at 10.49.54 AM.pngI didn’t say this at the mic, but while we wring our hands over Shannon Banfield’s murder, we should remember that investment in the humanity of duncy-headed boys and force-ripe girls is as much about our own risks and future as it is their grandmothers’. I’ve never taken up gay parenting as a cause; I thought gays were naturally selected to be aunties and godfathers. Social democracy requires sacrifice for a common good; citizenship cannot be about what one can exact from the state. This includes doctors avoiding taxation by taking only cash.

The point is we all have to find ways to pool risk.


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