Ageism and Social Insecurity

Right after this New Year, when we all became a year older, a headline in the January 3rd Chicago Tribune grabbed my attention.

“Congress problem? Aging America. Budget debate is really about the needs of baby boomers vs. younger generations: Safety needs for seniors vs. jobs, education.” Continue reading…

Comments are off for this post

Struggling With One’s Age

I see now the problems I experience confronting old age. Of all things, the words of literary critics, and more generally, the function of literary criticism, clarify the struggle I face practically every morning in one manner or another, as I feel the culture slipping away from me like a dock finally unleashed from its always precarious moorings. Continue reading…


Forgiveness and Aging

I’ve been thinking lately about the act of forgiving.

When I was about 10 years old, my father was in business in San Francisco. Like many immigrants at the time, he was not an educated man, having left school after the sixth grade, but he worked hard, and he accumulated a little money running an arcade during World War II. After the war, he invested his money in starting a new business as a wholesale distributor of electrical appliances. The timing was good, and he did reasonably well. Then he met someone whom he decided to take in as a partner, a sophisticated salesman with big ideas about how to expand the enterprise. My father was a bit in awe of him. For a while, things went very well, and the business was riding high. Then, his partner convinced him to engage in a business deal that turned out to be disaster. The losses piled up, and when the company that my father had built was about to collapse, the partner disappeared with the remaining assets of the company. Continue reading…


Medicare and the Physician Shortage

Still vivid in my mind is a visit I paid to the director of Center for Medicare and Medicaid Services in Washington, D.C. in 1990 in the company of the president and second vice president of the American Academy of Orthopaedic Surgeons. I was then its first vice president. The president spoke on behalf of the organization emphasizing that further reductions of reimbursement for services provided to Medicare patients would easily create a scenario where there would not be orthopedists available to treat those patients. The director smiled and said, “Doctors, don’t try to scare us, because we know how you operate: every time we reduce reimbursements you increase volume.” She then proceeded to remind us that orthopedic surgeons were the physicians in the United States with the second highest mean annual income of $250.000. Continue reading…

1 comment

On Turning 65

The first thing I learned about my new Medicare card is that it’s hard to fit in my wallet. Made of paper, not laminated, it’s a tad bigger than the slots perfectly-sized for a credit card, a driver’s license, or my Blue Cross-Blue Shield card, which until Sept. 1, the start of the month of my 65th birthday, had been my ticket to health care. Continue reading…

Comments are off for this post

Job Loss and Mortality

In my clinical practice some years back I saw “Mr. A,” a man in his early 50’s who had become profoundly depressed after losing his job. We had a good relationship and he was very cooperative in his treatment, which involved medications, different forms of psychotherapy, and environmental manipulations. Despite all our efforts, nothing worked. He remained depressed for close to two years, at which point a friend found a job for him. Continue reading…

Comments are off for this post

Becoming the “It’s Not All About Me” Generation

Some months ago my colleague, dear friend, and mentor, Gordon Moore, showed me the draft of a proposal he had written for Medicare reform. Gordon and I have worked together and exchanged ideas regularly for more than 30 years, so it’s not surprising that we agree that we in the over 65 generation are key for reforming Medicare in a clinically and ethically informed manner. He gave me permission to print what he’d written and to tweak it for length. – James Sabin, M.D.

To my fellow Medicare recipients,

I am a retired general practitioner, now on Medicare. Like many of you, I am feeling guilty and at the same time defensive about the claim that Medicare expenditures threaten the economic well-being of America. Defensive because I feel I have earned the right to have good medical insurance as I get older. But guilty because I know that the growth rate of Medicare does, indeed, threaten the future of our children and grand children. Continue reading…


Suing Your Children

During a recent teaching trip to Singapore I learned about the country’s fascinating Maintenance of Parents Act, which went into effect in 1996.  The law allows Singapore residents over 60 who are unable to maintain themselves adequately to claim maintenance from their children, either in a lump-sum payment or in the form of monthly allowances. Cases are heard by a special tribunal that decides whether payment should be made and how much it should be, based on criteria including the parent’s financial needs and the child’s earning capacity and other financial obligations. Continue reading…


Amour or Love Among the Ruins

Nominated for five Academy Awards, Amour is a film about love and death. (Read no further if you haven’t seen the film and don’t want to know who dies and how.) The setting is Paris, the language French, but any resemblance to a conventional French film about light-hearted romance or a ménage a trois ends there. Continue reading…