On a brilliantly sunny afternoon last October, twenty-eight New Yorkers — some clutching walkers, others in wheelchairs — crammed into a tiny space at the back of Manhattan’s East Side Cafe. While waiters set down blueberry coffee cake, grape jelly, coffee, and orange juice, Maxine Davis, a Medicare account representative from Empire BlueCross BlueShield, raced through the first several pages of the company’s sales booklet. She was promoting MediBlue Plus (HMO), a private plan that Empire offers as an alternative to traditional Medicare. “The maximum amount you pay out of pocket for major medical expenses is sixty-seven hundred dollars. This makes it a predictable health-care cost. We never make you pay more,” Davis promised.
One senior asked, What if someone had cancer? — a diagnosis whose costs could quickly escalate. The patient’s share of such costs was “written in black and white,” Davis answered, vaguely referring him to page 6 of the booklet while noting that “a lot of people would be excited about a twenty-dollar copay for chiropractors.” Page 6 didn’t actually address his question, but pages 7 and 12 did. There he could have read that beneficiaries were on the hook for 20 percent of the cost for radiation treatment and 20 percent of the cost for chemotherapy, up to the $6,700.