I'm 57. I will be 58 in April. I am getting thisclose to retiring, or at least contemplating it. One thing I was looking forward to was continuing to have a great health plan when I turned 65. But this Medicare (Dis)Advantage that might be awaiting be is making me nervous.

I have two concerns how Medicare (Dis)Advantage can affect me if and when it comes into effect.

The photo on the right is my right shoulder. Actually, my new right shoulder. 

In 1987 I fell hard on it and tore the labrum. Bad. My shoulder was unstable for years. Arthritis set in. Pain. It was bad. I didn't have insurance when I hurt it and I suffered the consequences. In 2002 I had it scoped out but all it did was put off the inevitable.

In 2019 the pain was the worse it had ever been. I was popping Aleve like M&M's. I went to a shoulder surgeon. He said I needed a new shoulder but want to give physical therapy I try. I had bone on bone. How the hell was PT going to help?

I went to a second doctor. He said PT was a waste of time, but agreed I needed a new shoulder. However, I just didn't feel right with him.

I went to a third doctor, Dr Young Kwon at NYU (Yes, a shameless plug, but he is the best shoulder surgeon!). He saved me. He made me feel whole. 

Here's my issue. Artificial shoulders last from 10-15 years. I'm lucky, I'm a lefty. The artificial joint is in my non dominant arm, but you never know. Dr Kwon even told me that I was a bit too young for shoulder replacement.

What happens when I am between 65 and 70, on Medicare (Dis)Advantage and need another shoulder? I will need to get pre-approval? Will I be considered too old to get a replacement? I might be told since it is my right shoulder and that being left handed, a new joint is not a priority. Heck, will I be allowed to see Dr Kwon again? 

My dad had his hip replaced at Special Surgery at the age of 74 in 2005. My step mom was retired from DOE and everything copacetic. No fuss, no muss. 

Will Medicare (Dis)Advantage let me visit three doctors? I doubt it. 

My other concern is I am Type 2 diabetic. My numbers are great. My A1C is very close to where it should be. My weight is the best since high school. I go to the gym three times a week. I eat better than I have, but of course I can do better. But I am on several medications. I'm not on insulin and don't plan on it. I see the eye doctor every year. I don't want anything chopped off or to go blind.

But what happens if  insulin is needed? Will I be sufficiently covered? Will my medications be covered? Even if I am covered what out of pocket charges will I face? I see my endocrinologist every three months. Will I be able to continue this? Like Dr Kwon, my diabetes doctor is one of the top in her field. Under Medicare (Dis)Advantage will I still be able to see my doctors or still be able to choose from the best physicians? Or will I be left to choose between Dr Nick and Dr Hartman?

I don't like what I have read or heard of Medicare (Dis)Advantage. Someone, somewhere is getting rich over this being forced upon us and it's not someone at Emblem/Blue Cross or Joe Namath. 

I have a fantasy of moving to Corning NY, for a year after I retire. How many providers will I find there? One? None? Or maybe Hudson NY. There might be three providers in Hudson.

I don't need nor want a Fitbit. I don't need or want rides to and fro. I don't want meals sent to me. There is one thing I want with my health insurance when I am 65. 

I want certainty. And I want myself and my health professional to make the decisions what is best .

Myself, I am a "left of center libertarian". I believe there is a place for liberalism, I believe there is a place for government in our lives, I do believe government can make things better, but I hate overreach, both in politics and government.

Our, mine and my brother's, grandfather was a neighborhood captain for Tammany Hall back in the day. He would register voters in the cemeteries, vote several times on election day, leave turkeys at the doorsteps of the poor (With a note "Happy Thanksgiving from the Democrats") and somehow got my parents to the top of the waiting list in 1962 for Peter Cooper Village.

Reality is my great-uncle Jack was a Communist. He went to Cal-Berkley in the late 1920's and was met there by a distant cousin, actor Howard DaSilva. Jack went on to work for the State Department and after WWII got caught up in the Alger Hiss crap and moved to China. When Mao took over he was kicked out, along with other Americans, of the country and lived the rest of his live in Rome never to return to the US.

Every month or so Jack used to write my dad and for the first page or so inquire how we were doing, how I had gotten big, etc... and then for the next how many pages or whatever discuss how Marxism, or Leninism, or Communism, or whatever was going to take over the world and all that stuff. When he died he had about $1 million in stocks. Go figure.

So I guess that is why I am the way I am. But as I have grown older, and more so being a father, things change. I still believe in the core of what Jack and my grandfather believed in. Both Jack and my grandfather believed in the same thing but from opposite ends of the spectrum. But without some of the rough edges. To me extremism on either the left or the right is anathema to me.

I look at the Democrats and see why they lost in 2016. Not just because of a shitty candidate in Hilary, but the Democrats were concentrating more on voters like Jack than voters like my grandfather.

I came to this epiphany when my son and I traveled to Ithaca College in February. Driving through the small towns of Broome and Tompkins Counties, driving though the desolation in Owego NY, stopping on the way home in Hancock NY thinking of all the small towns that I love visiting upstate got me thinking. As I was driving I said to a friend of mine who came along that in these small towns that I believe the vast majority of the people in these forgotten corners of New York have have the same needs and wants, hurt, as well as anger, as those in the inner cities. They do want justice, they do want health care, a safety net, jobs, an opportunity, but they are constantly being talked down to. They are taken for granted and see the Democrats ignoring and bypassing them. The want the social justice but want to go about it differently.

What they want, and care mot about is where and how is that next pay check coming from. What will happen to me if I or my family get sick? What about my farm? My business? What about the opioids?? But these issues are either ignored or just brushed over. They see the Democrats not talking about or attempting to solve bread and butter issues. They see Democrats getting into bed with every crackpot who cries, "SAFE SPACE!!" "TRIGGER!!!" Being told that there concerns are not the Democrats concerns.

Drive through Hancock, drive through Owego, the towns are dead. Closed up storefronts with plywood. Dollar stores. Instead of Crack Dens there are Meth Labs. Where and when do the people of these communities get heard? The want safe streets, they want responsible policing, They want good schools. Well financed schools. They want the same thing as those in the South Bronx but want to take a different path.

My wife and I love to visit Hudson NY. There are many art galleries along the main drag Warren St. which runs east-west from the Hudson River. A block in either direction of Warren St you see the poverty which the weekenders ignore or try to turn away from.

You can not have a party, a group, a class and claim you are are are for change, claim you are there to help without opening your eyes and not just listening to the other half, but embracing the other half's different ways of seeing the same thing as you.

This is what the Democrats need to embrace. This is what the people of the Democratic party need to be party of.