What a trashy article. A lot of elderly Americans, including in the upper middle class, never retire due to Medicare being inadequate. You can quite literally save millions for retirement as an individual, and have coverage for drugs and treatment under Medicare, and still run out of money due to having to pay extortionate prices for covered drugs.

This line in the article is quite revealing and strange, contextually: "Maybe not. Though the literature on this question is sparse, giftedness and achievements early in life do not appear to provide an /insurance policy/ against suffering later on. "

I personally have 2 rare neurological diseases affecting my peripheral nervous system and I require an orphan drug, a blood product, that was covered under Medicare Part D when I lived in America. If I only had traditional Medicare in America, I would be liable for Medicare Part D Catastrophic Coverage Limits, and I would be forced to pay $50,000+/year total for all of my medical care under Medicare.

Technically, yes, I can get a Medicare Advantage plan, which has an out-of-pocket limit. The problem is that the vast majority of these plans are HMOs, and that does not go well with rare disease. Also, one of the rare diseases that I have is very rare, with case reports and cohorts at best in the medical literature. So, if I want to stay alive (like it is a choice?), I really cannot be on an HMO.

By the way, 7-8% of the general population collectively has some sort of a rare disease. There are about 8,000 or so rare diseases. So, it is not uncommon to have a rare disease.

Also, if you have cancer, or are likely to get cancer (elderly, perhaps?) having an HMO via a Medicare Advantage plan is not a good idea if you likewise want to stay alive.

The problem is that once you are on a Medicare Advantage plan, you basically cannot go back to traditional Medicare. This is because Medigap plans (Medicare Part B Supplemental plans) allow medical underwriting even after the Affordable Care Act went into effect, unless you live in 4 US states! So, you basically can never get a Medigap plan again after switching to a Medicare Advantage plan. It is, quite literally, a deadly, but not well known error that Americans make when they are on Medicare.

This is one of the top reasons why I left the US and never plan on living there ever again, even if I have to file and pay taxes as a US citizen. I naturalized and acquired another citizenship over the US healthcare system.