Age Concern’s report in yesterday’s paper on how some seniors are having to make a “Sophie’s Choice” between food and medicine shows how Bermuda is failing to meet the needs of its most vulnerable members.The problem is not new. It predates the recession, although there is no doubt that the recession is making it worse for many people.Indeed, Future Care was created with the promise of eliminating this kind of problem. Instead, it continues as Future Care scales back its offerings and comprehensive private insurance remains unaffordable for many senior citizens.Age Concern director James McCulloch’s description of a stroke victim who has stopped taking her medication illustrates the problem exactly.He said the elderly woman in her 80s was told in January that her coverage had run out. With no money, she has stopped taking her medication, apparently in order to eat.He rightly said: “I don’t see the logic from a countrywide point of view. If she has another stroke, there’s considerable chances that not only will her lifestyle be impaired but she might end up in long term care which will cost a fortune.“It would be far better to keep her on preventive medicine than it will to deal with the consequences of her having another stroke or even a heart attack. She was two months in arrears (for electricity), her light bill was $400 but it’s hard to catch up once you fall behind.”Mr McCulloch came across the woman while assessing people for electricity payments as part of the now exhausted Belco hardship fund. But she is far from alone. But there is no doubt that he is right about an ounce of prevention being better than a pound of cure.In part, this problem is arising as insurance clients pass the cap on their health insurance allowances that cover 80 percent of costs for prescription drugs. But the broader problem is that many seniors are on inadequate fixed incomes that are being drained by rising costs for healthcare and everything else.There are no easy solutions for this problem. But Mr McCulloch is also right when he criticised Government policies allowing people to raid their pension savings, or to suspend contributions. If today’s senior citizens are suffering from inadequate pensions, then this policy is creating a worse problem for tomorrow’s pensioners.That also makes the Government’s decision to reinstate land tax and car licence fees so widely on senior citizens all the more puzzling. There is no disputing the idea that senior citizens who live in the most expensive homes or who choose the largest SUVs to drive should pay something in taxes for these luxuries.But by extending the tax net to homes with an annual rental value of $4,000 a month and to many more cars, the Budget will sweep up some people who may well be land-rich but cash poor, or, as many letters have pointed out, need a car of sufficient size to cater to their physical disabilities. So rather than helping people in need, these policies may make them worse.Now, it seems, the standard insurance premium is also being increased by 7.7 percent or $19 a month, which is less than originally contemplated, which is far higher than the annual rate of inflation. This newspaper is still waiting for an intelligent explanation for why health costs continue to rise at a vastly greater rate than almost any other good or service. Since increases in the cost of labour, food, electricity and other basic requirements do not go up any faster for the medical world than they do for anyone else, it must be something else. But no one seems able to explain what it is, or why.In the meantime, senior citizens will continue to be forced to choose between food and medicine, and will continue to live with the spectre of having their lights turned off. Something is wrong with this picture.