Another Healthcare Debate Annoyance
I've got another healthcare debate comment that annoys me. I can't in good conscience call it stupid, because it's a question that when asked sincerely is just fine. The problem is that it is usually asked in a rhetorical way that makes it eye-peelingly stupid.
This question: "You complain about healthcare being in the hands of big business; would you rather it be in the hands of the government?"
Gee, let me think about that one for a -- Yes! Hell yes! I'll even go Fuck Yes. And you know why?
I have some say in our government.
Not much, I'll grant that, but I have some say. In private insurance companies, I have no say. None. The vast majority of Americans have absolutely no say. We don't even have the normal capitalist "protection" of competition, because there is no real choice. The "choices" the vast majority of Americans have are
1) the health insurance company your employer chose,
2) an insane amount of money in payment, or
3) Nothing.
Let's examine these one by one.
"Nothing" is not really a choice for most people. "Nothing" is what you get stuck with when you get screwed. Let's be honest here. Think of just about any remotely reasonable person you know. If there was no opportunity costs (i.e. you didn't have to pay or give up anything to get it), and they had a choice between no healthcare at all, and the amount of healthcare they felt they needed when they needed it, would anyone chose "nothing"? There will certainly be different lines on "what health care I need", but absolutely no one sane is going to say "I don't want access to heathcare that I feel need." The sentence hardly even makes sense.
So, insane amounts of money in payment. Let's be honest again. Outside of your mortgage or rent, can you afford a bill of $600 every month for an individual? That is the average insurance cost in this country, according to the COBRA program. Spouse and dependents, it's more like $1200 a month. Can you afford that? I can't. Frankly, it wouldn't matter if I could, because as an insulin resistant anemic with PCOS, insurance companies laugh at me when I apply for benefits outside of a group rate. So really, for most people option 2 is just a nicer way to say option 3. "More money than you can hope to afford" is basically the same as "nothing."
So, the first choice: the health insurance company your employer choses. We still don't have real competition, because I can guarantee my employer is not chosing a health insurance company by the same criteria I, or most people, would. I want a company who will give me the best care I can afford. My employer wants the cheapest care that will not send employees fleeing to the competition.
The real nutjobs will now say "well, you can go get a job at a company that has a better healthcare plan. That's part of capitalism!" Then I slap them and say "Perfect knowledge is an invalid assumption, dumbass." In my experience, you can not find out any details of a company's healthcare benefit until you have actually hired on at the company. So switching jobs for healthcare can be a game of Russian roulette. Even before you get there, though, this meta form of "shopping" they're proposing is well into EconomicsMan territory. In other words, it's at a level of life decision-making only followed by sociopaths and economists. So, sociopaths.
Now, before I finish, I want to express just how "vast" I mean when I say "vast majority of Americans". Top 2% of income. That's rich, right? That better be rich or we've got serious problems with resource distribution, right?
Well, the top 2% starts at about $250,000/year income.
I know of a medical condition for which the medication alone costs $38,000 a month. Not a year, a month. Do the math here. That is more than $450,000 a year for medicine alone. You figure out taxes and living expenses, someone would have to earn more than $700,000 a year to be able to afford that and taxes and a reasonable living. (And I am not talking a luxurious living at all. $700,000 with a 33% tax rate and that medicine would only leave you $13,000 a year for all of your other expenses -- including the doctor. )
If you figure that's close to 3 times what the top 2% starts at, we're talking fractions of a percent of people who could afford to handle those expenses themselves. Literally 99-point-something percent of Americans really could be wiped out by a health issue if they didn't have insurance. Actually, a lot of insurance plans now won't cover the super-expensive meds (mine won't), so even with insurance and a ginormous salary, it might not be enough.
This is why we need a universal single-payer system, and hell yes I want something this important in the hands of the popularly-elected goverment instead of privately owned, profit-motivated business.
This question: "You complain about healthcare being in the hands of big business; would you rather it be in the hands of the government?"
Gee, let me think about that one for a -- Yes! Hell yes! I'll even go Fuck Yes. And you know why?
I have some say in our government.
Not much, I'll grant that, but I have some say. In private insurance companies, I have no say. None. The vast majority of Americans have absolutely no say. We don't even have the normal capitalist "protection" of competition, because there is no real choice. The "choices" the vast majority of Americans have are
1) the health insurance company your employer chose,
2) an insane amount of money in payment, or
3) Nothing.
Let's examine these one by one.
"Nothing" is not really a choice for most people. "Nothing" is what you get stuck with when you get screwed. Let's be honest here. Think of just about any remotely reasonable person you know. If there was no opportunity costs (i.e. you didn't have to pay or give up anything to get it), and they had a choice between no healthcare at all, and the amount of healthcare they felt they needed when they needed it, would anyone chose "nothing"? There will certainly be different lines on "what health care I need", but absolutely no one sane is going to say "I don't want access to heathcare that I feel need." The sentence hardly even makes sense.
So, insane amounts of money in payment. Let's be honest again. Outside of your mortgage or rent, can you afford a bill of $600 every month for an individual? That is the average insurance cost in this country, according to the COBRA program. Spouse and dependents, it's more like $1200 a month. Can you afford that? I can't. Frankly, it wouldn't matter if I could, because as an insulin resistant anemic with PCOS, insurance companies laugh at me when I apply for benefits outside of a group rate. So really, for most people option 2 is just a nicer way to say option 3. "More money than you can hope to afford" is basically the same as "nothing."
So, the first choice: the health insurance company your employer choses. We still don't have real competition, because I can guarantee my employer is not chosing a health insurance company by the same criteria I, or most people, would. I want a company who will give me the best care I can afford. My employer wants the cheapest care that will not send employees fleeing to the competition.
The real nutjobs will now say "well, you can go get a job at a company that has a better healthcare plan. That's part of capitalism!" Then I slap them and say "Perfect knowledge is an invalid assumption, dumbass." In my experience, you can not find out any details of a company's healthcare benefit until you have actually hired on at the company. So switching jobs for healthcare can be a game of Russian roulette. Even before you get there, though, this meta form of "shopping" they're proposing is well into EconomicsMan territory. In other words, it's at a level of life decision-making only followed by sociopaths and economists. So, sociopaths.
Now, before I finish, I want to express just how "vast" I mean when I say "vast majority of Americans". Top 2% of income. That's rich, right? That better be rich or we've got serious problems with resource distribution, right?
Well, the top 2% starts at about $250,000/year income.
I know of a medical condition for which the medication alone costs $38,000 a month. Not a year, a month. Do the math here. That is more than $450,000 a year for medicine alone. You figure out taxes and living expenses, someone would have to earn more than $700,000 a year to be able to afford that and taxes and a reasonable living. (And I am not talking a luxurious living at all. $700,000 with a 33% tax rate and that medicine would only leave you $13,000 a year for all of your other expenses -- including the doctor. )
If you figure that's close to 3 times what the top 2% starts at, we're talking fractions of a percent of people who could afford to handle those expenses themselves. Literally 99-point-something percent of Americans really could be wiped out by a health issue if they didn't have insurance. Actually, a lot of insurance plans now won't cover the super-expensive meds (mine won't), so even with insurance and a ginormous salary, it might not be enough.
This is why we need a universal single-payer system, and hell yes I want something this important in the hands of the popularly-elected goverment instead of privately owned, profit-motivated business.