Your citation of Dr Calver’s precepts in “The 5 Percent Solution” in the AARP January-February 2012 Bulletin was both inspiring and pertinent for several reasons. My father’s life has also been guided mostly by those health commandments; and, moreover, my father is also from Argentina. Nevertheless, such principles may not be enough to safeguard the wellbeing of today’s aging population, and I respectfully suggest that you give further consideration to additional factors that may be of strong interest to your readers.

  As a child, my father would take me out on summer nights to look at the stars and talk about the Universe. We read encyclopedias on weekend mornings and discussed scholastic articles on several  topics. That is how both my sister’s and my interest for science flourished from early on, and that is how we grew up to become scientists. Both my sister and I received higher education degrees in Argentina and migrated to the US soon after we graduated with our Doctorates. My dad had always instilled in us the admiration for the US, because he shared the ideals of freedom, justice, responsibility, integrity, progress, and fair reward. Thus, both my sister and I, having grown up with these principles, immediately felt at home in this country and we proudly became US citizens. We are very grateful to this country for having welcomed us here.

  I have worked for many years in biomedical research, and currently, in the aerospace field. My sister is a Faculty member at a renowned university. We have daughters that equally promise to be good contributors to society. The oldest is already a Harvard graduate. We are proud of our accomplishments; yet humble enough to think we still have a lot to learn, improve, and give back.

  As the years went by, my sister and I continued to think about our parents back in Argentina and how they were going to grow old. Being both the only children of European immigrants to Argentina (in the early 1900s, boats were simultaneously arriving in New York and in Buenos Aires), with their two daughters now in the US, there is no family left to watch after them in Argentina.  Therefore, my sister and I always planned to eventually bring them to be with us to the US, where they could age in the company and care of their close (and only) relatives.

  I diligently worked towards obtaining the status of Legal Permanent Residents (LRP) for them, which they acquired more than 6 years ago, under the support of policies like “Family Reunification”.  Given our limited resources, I researched and conducted their entire immigration process, following the USCIS instructions, without participation of any attorney (whose fees I would not be able to afford).  Unfortunately, we continue to encounter significant hurdles in the process that are largely the result of our lack of information about the system. Thus, I’d like to suggest an article for your bulletin that deals with the subject of senior immigrants and the benefits available to them. This would be very beneficial to other families planning to bring their elderly parents to the US.

  The conundrum mostly applies to lower middle class families that are also highly educated people. Once the LPR reaches 5-years of continuous physical residence in the US (if the adjustment of status occurred after 1996), my parents would be eligible for benefits, according to the current legal framework. These benefits would include eligibility for Medicare.  However, in my parents’ case, since they never worked in this country, they only qualify for the “buy-in” program. At nearly 80 years of age, this represents around $750 per month in costs for each of them. The amount of $1500 monthly is unaffordable to them/us. Furthermore, in Texas, they are not eligible for Medicaid on the basis of being eligible for Medicare (which initiates a circular reasoning difficult to escape).

  At the moment we are facing the heartbreaking decision that they may have to return to their home country, where no family remains to care for them, and in the eventual but likely scenario that they finish their days in an assisted living facility, they will get one visit per year from their relatives at best.

  The irony of the situation is highlighted each time I have to take my parents to a doctor’s appointment at the local public hospital. Houston has an outstanding medical center, and the Harris County Health District (including Ben Taub General Hospital) does wonders seeing thousands of low-income patients per day. While the waiting time is long (often 5 hours or more) and the patient does not get to choose the appointment time, everybody has the chance to be seen by a health care professional.  Nevertheless, this set-up is not enough for patients with significant weakening or life-threatening heath conditions that demand immediate attention, such as my parents, nor does it works for their working-aged children with demanding full time jobs and additional family responsibilities (both my sister and I are single-parents with two school aged children each).

  In sum, the time has come for my sister and I to make the heartbreaking decision to send my ailing parents back to Argentina, with strong feelings of guilt and failure for letting my parents down during their last years. I suppose that what my family can offer is not enough to cover the costs of protection for my elderly parents: the lives we worked hard for in this country guided by the principles of scholastic excellence, professional accomplishments, and personal responsibility – and for that matter also the health commandments of Dr Calver—were simply not enough.

  I wonder many other people are in a similar situation to ours and would benefit from a well-researched article on this subject. I recognize this is not your general target audience, but it may raise awareness on the need to have a system of benefit-eligibility that is more centered on a case-by-case basis than on a one-size-fits-all approach.