My aunt, aged 94, died last week. In and of itself, there is nothing remarkable in this statement, except for the fact that she died a pauper and on medical assistance as a ward of the state of Minnesota.

How did she arrive in this sorry state? Did she lead a profligate life, go on expensive vacations and squander her resources? Quite the contrary.

My aunt and her husband, who died in 1985, were hardworking Americans. The children of Polish immigrants, they tried to live by the rules. Combined, they worked for a total of 80 years in a variety of low-level, white-collar jobs. If they collectively earned $30,000 in any given year, that would have been a lot.

Yet, somehow, my aunt managed to save more than $250,000. She also received small pensions from the Teamsters Union and the state of California, along with Social Security and a tiny private annuity. In the last decade of her life, her monthly income amounted to about $1,500.

While that was not a lot of money, it was enough, along with her savings to see her through. Or, it would have been enough, if she had not committed one grievous sin. She became sick. She was diagnosed with Parkinson's disease.

At first she managed to cope, living on her paltry income and leaving her savings untouched. But when she fell ill and had to be placed in assisted living, and finally in a nursing home, her financial fate was sealed.

Although she had Medicare and Medicare supplemental insurance, neither of these covered the costs of long-term care. Her savings were now at risk, at a rate of $60,000 a year. Why did she not have long-term care insurance, you might ask?

Well, with a monthly income of $1,500 and at her age, she simply could not afford the annual premiums of more than $3,000. In the end, she spent everything she had to qualify for Medicaid in Minnesota, which she was on for the last year of her life. This diligent, responsible American woman was pauperized simply because she had the indecency to get terminally ill.

No other industrialized country in the Western world penalizes its middle class in such a way. No other civilized nation demands that people who work hard, act financially responsible and save what they can -- in my aunt's case, an inordinate amount, given her income -- must eventually turn over a lifetime of earnings and accomplishment to the health care industry, if they get seriously ill and require long-term care.

Though I have not been able to find statistics on the subject, I am certain that there will be a massive transfer of wealth over the next two or three decades, amounting to hundreds of billions of dollars or more, from people just like my aunt to health insurers and health care providers.

Just before my aunt died, she asked me if I would be sure to execute her will as stipulated. She had wanted a small amount of her life savings to go to various nieces and nephews as a small token in remembrance of her.

I did not have the heart to tell her that she was impoverished and that not even a nickel would go to those whom she loved so dearly. It would have crushed her to realize that she was poor and had worked all her life for nothing. She did not deserve to know that this was the legacy left to her by the country she loved so much.

This week, I was about to close out her checking account in the amount of $215, the sum total of her wealth. But I received, in the mail, a bill from a heath care provider in the amount of $220.

Neither Medicare nor her supplemental insurer will pay it, because it is an unspecified "service not covered." Apparently, not even the grave can protect my aunt from the financial demands of our health care system.

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Frank Domurad is retired and lives in White Bear Lake. He held several executive positions in New York City government and was a partner in a national consulting firm on criminal-justice policy.