Topic: Pure Satire
The military, law firms, and other competitive organizations have long had as a slogan describing one of their key personnel policies the phrase "Up or Out." This means, of course, that for people at the bottom and middle ranks of the organization, it isn't enough to simply be competent at the job you're doing. You have to be more than competent, make the right political connections, and GET THAT NEXT PROMOTION. Those who don't move UP the organization fast enough--to the next rank, to the next management level, or to partner--are OUT, even though they do their current job very well.
However, as an aging baby boomer who is stuck in a job I do very well, but with no way to move UP, I'm beginning to believe that UP OR OUT has been made the slogan of the healthcare delivery system for my generation. Since I haven't been ablen to move UP in my profession (for reasons described elsewhere), I am being priced out of the healthcare delivery system. If I had made all of the moves UP that others in my law school class of 27 years ago have made, I'd be able to afford the extortionate health insurance premiums I must pay (since I'm now an older worker with health problems), and I'd be able to save the amount of my $2,500/$5,000 annual deductible on top of paying premiums. (Or, possibly, I'd be in a larger firm, corporate law office or government agency that has cheaper coverage with lower deductibles?) But because I have failed to move UP as I was supposed to, I am now expected to tamely move OUT--out of this life, that is. Economic "responsibility" is going to force me to ration myself out of some necessary appointments and prescriptions within the next few months, so that I'll have income to pay for some deductibles I already owe, so obviously I'm supposed to get OUT of this life, since I can no longer afford it!
"UP OR OUT," appears to be the slogan of the current employment-based health care delivery system. It looks like the President's reforms may not get here in time to help me.
