Member-only story
The $900 Penalty
A Saturday in a safety net medical clinic
A standard Saturday
“How do they expect me to come up with $900?”
It was a Saturday morning in our safety net clinic, and I was seeing David, a 76-year-old man with bilateral shoulder pain, high blood pressure, and diabetes. My student had already seen him and reported good news: David was keeping to his diabetic diet, taking his iron pills, and sleeping better, his restless legs finally quieter at night. When I walked in, he looked well — lean and weathered in the way of a man who had spent more than 50 years as a farmer and woodworker, almost all of it working for himself.
I asked if he had any questions. That is when he brought up the $900.
“How are we supposed to know we have to apply for Medicare? And why should we have to pay a fine?” he followed. It was not rhetorical. He genuinely wanted to know.
He had a point. As someone who had worked for himself his entire life — an entrepreneur, whether or not he would ever have used the word — David had paid for his own private insurance, and his family’s, for decades. No benefits office had ever sat him down to explain what happens at 65. No one told him that Medicare does not simply arrive; that unless you are already drawing Social Security, you have to go and ask for it within a…
