The Decline of Health Care in America
The Washington Post is swirling in the john. (Yeah, I know. This doesn’t sound like much of a Christmas letter😊) Yesterday the Post published an apt case about what is happening in America. Metaphorically, the article epitomizes the Post’s own centrifugal descent. Given my seasonal custom to write a little something about the year’s contemporary catastrophes, here’s a riff on it.
The Post reported on the cancelation of healthcare subsidies under Trump’s One Big Beautiful Bill, which became the law of the land last summer. The article highlighted the law’s impact on a family of four in Wyoming. Their annual health care premium will increase in 2026 to $43,000.00. Plus, they’ll have to pay a $10,000.00 deductible and extra for prescription medicine.
I can still remember the days when $43,000.00 was a lot of money. In 1979, you could buy a house in my hometown for money like that. Not the nicest house, but more than a hut.
When my dad retired in 1979, he was earning a salary of $700.00 a month. He retired at age 62 because his Social Security benefits would nearly equal that salary. He stopped working when he realized that he would be laboring for pennies a month.
My mother was a nurse. When Dad retired, she continued to work for a few more years. Her employer was the Vacaville Medical Facility. The name was (is) a euphemism for a state correctional institution to house criminals who are ill and/or insane (sorry about the redundancy but it’s for clarity). She looked after people like Charles Manson, including Charles Manson. But as an employee of the State of California, my mom had a good pension with health insurance that covered both of my parents throughout their retirement. So, they lived a pretty good life in their old age.
Here in Spain, we’re not doing so bad in our retirement. We have pensions and Social Security. We have a little put by for rainy days. We have a home. The roof doesn’t leak. It’s insulated to keep warm in winter and cool in summer. Our home is in a picturesque village where a pleasant walk is available right outside our front door. We have a variety of fruit trees that render nourishment of one sort of another nearly every day of the year. Oranges and tangerines are presently in season.
Here’s what we don’t have. We don’t have any medical bills. None. It is not that we don’t have any need for medical care. We do. Stuff happens. I slipped off a ladder last year and needed an MRI. (Unlike the President, I know what images of my body the hospital scanned and why.) I also have arthritis. Ten years ago, with medical insurance, my medication in the US cost me $200/month. Without insurance, it would have cost me $2,000.00/month. Here? Spain pays for it.
My family has several other medical needs. Spain’s Social Security provides coverage. Period. End of memo. And I cannot say that the doctors here are worse than the ones we experienced in California. As a rule, I’d say Spaniards are about as intelligent and competent as Americans.
If this sounds like I am boasting, I might be. These days, I feel very fortunate to avoid facing the kind of problem a family of four faces in Wyoming or any other state in the US when it comes to healthcare. I have plenty of worries, but apt medical attention for our ailments is not one of them. As the song goes, I count my blessings.
We do pay taxes here. (As a US citizen, I also pay income taxes in the US.) Just about everything we buy has a VAT. It is twenty-one percent for most things, including services. Wow! That sounds like a lot, doesn’t it? Even food is taxed at ten percent. OMG!
But here’s the thing. The sticker price of almost everything already includes the tax, so I don’t notice it at the cash register. Am I a fool? I don’t think so. I fill the grocery shopping cart to the brim, and often I pay less than 100 euros ($115.00). A kilo of broccoli went up during the pandemic to 1.80 euros. A kilo of giant red peppers costs about the same too. That’s about $1.00 a pound.
When I visited California three years ago, broccoli at Safeway was nearly $3.00 a pound. I mention broccoli because we eat a lot of it. Not because we like it especially, but because it is good for us. With the right condiments, broccoli ain’t so bad.
In short, we pay more taxes, but we have fewer worries and more money in our pockets. That’s not just luck.
* * *
2025 has been a tough year for a lot of families. We have not suffered so much as many other people. But we have felt a little of their pain and anxiety, and we have prayed for a change for the better for them. In this letter, I would like to share a message of hope, and I refuse to discourage it. But for these times and those ahead, I recommend fortitude and courage.
If Spain can afford to look after the health of its residents, why couldn’t America manage to do the same? Why is half of the American population now being vilified as “the enemy within?” Why are America’s billionaires getting what they want and spending and borrowing like there’s no tomorrow in order to build data centers and artificial intelligence? Why are the Zukerbergs building bunkers on tropical islands?
Whether we like it or not, ordinary people will have to do extraordinary things in the coming years if we wish to live in a world where there is hope for liberty and justice for all.
I wish you peace and bravery.
Mind how you go.
Feliz Navidad y Próspero Año Nuevo
Don Hergumino