Posted on Saturday, September 5th, 2009 at 3:11 pm
Author: Sarah Jaffe
For a country that relies on the bootstrap myth, the U.S.A. certainly has a health care system that punishes people who attempt to live that way. The self-employed, the small business owner, and most especially the scraping-by creative types—artists, designers, freelance journalists—have no easy way to get health insurance. We are stuck buying our own care on the “free” market, where a single person has very little bargaining power.
On Tuesday, September 1st, I became one of America’s 46 million uninsured. I have a graduate degree, a decent amount of published writing, and multiple regular freelance clients. There is a better-than-average possibility that I could pay my bills with my writing, except for that one problem. A survey by AHIP, the national organization of health insurance providers, reports that I can assume to pay an average premium of $4734 in New York state, where I reside.
Paul Krugman explains that employer-based health insurance is regulated by the government. Corporations can get tax advantages for providing health care for employees; benefits are not considered taxable income, so companies pay less in wages and make it up in health care. Krugman notes, “[T]o get that tax advantage employers have to follow a number of rules; roughly speaking, they can’t discriminate based on pre-existing medical conditions or restrict benefits to highly paid employees.”
Campus Progress reports that only 60% of the population is covered by employer-provided health care. 26 million small business owners or their employees remain uninsured despite having a steady source of income—because it simply costs too much.
AHIP reports that the nationwide average premium for a family buying private insurance is $5799, but this presumes a lack of “preexisting conditions,” for which one’s premiums can be raised, or coverage denied. Without the bargaining power of a large corporation behind you, you’re stuck paying what you can to whomever will accept you. My self-employed parents, in their early 60s, were paying $3300 a month for health insurance. That’s $39,600 a year.
They recently switched companies, taking a cut in the benefits that would be paid out, gambling on their own health at exactly the time that they need health insurance the most. They’re betting that they won’t have to shell out more than they already were in insurance premiums for health care before Medicare—a single-payer government-run system—kicks in when they turn 65. And they’re lucky. They make enough money to be able to afford those premiums. The average American family, meanwhile, makes just $50,740.
It’s here that the public option would come in; at least, if we end up with a version of the current House bill. Subsidized for people who make up to 400% of the federal poverty level—that would be on a sliding scale up to $43,320 for individuals and $88,200 for a family of four—the plan would provide care for those who are willing to live on less money to be their own boss or to work for a small business that can’t afford a large health insurance plan. It would allow people greater choice and freedom in the job market, in addition to providing competition for the health insurance companies that are often bloated and wasteful, spending sometimes only 60 cents of each premium dollar on actual health care.
So why is there such widespread resistance to the idea of health care reform that could make it easier for Americans to actually live the so-called American dream? Could it be that the idea of real equality makes a lot of people nervous?
Access to health care, after all, depends on more than just money. According to Adam Serwer, “Nonwhites are 52 percent of the uninsured population, the largest proportion of which is Hispanic, at 30 percent — but those numbers don’t tell the whole story about access. Even when people of color are covered, their access to quality care is diminished heavily by ongoing segregation and poverty; in nonwhite neighborhoods, it’s simply harder to find a primary provider than it is in white neighborhoods.”
As it is now, if you are white and well off, even if your health insurance costs you a bundle, you can get it—and it seems that some people would prefer to keep paying too much for their own care than pay a few dollars toward someone else’s, particularly if that someone else is not like them.
Amanda Marcotte wrote:
“They don’t want racial minorities and people without means sharing spaces with them, and especially not when they’re sick and being reminded that they’re the same flesh and blood as everyone else. The idea that a 14-year-old immigrant might get service first because she needs it more, and that there’s no way to pull rank? That’s the sort of thing that keeps the nutters up at night. When we say that the protesters are fundamentally racist, this is what we mean. They want health care access to be a privilege, a marker of class status. . . . They’re focused solely on their own potential to lose some status if others have the right to be treated like human beings, and they just can’t get past that.”
When the anti-health care reform crowd shouts about “rationing” and “waiting in line,” then, this is what they mean: they can’t use their pull to leap ahead of someone who doesn’t have the same advantages. For the same reason that large companies enjoy being able to attract better employees by being able to offer benefits the small businesses can’t match, rich people enjoy being able to push past those whose complaints might be much more serious simply because they have money.
The people protesting at health care town halls, though, aren’t all rich. Instead, many of them are barely hanging on themselves, yet seem terrified that “immigrants” or people of color might be granted the same quality of care they have. As if granting better care to someone else would take it away from them.
Disease, injury, and chronic pain are great levelers, after all: no matter how much money you have, cancer can strike or you can slip and fall. It’s arbitrary. You can’t buy your way around it. Yet our health care system purports to treat people as though you could; as if the people who get sick simply deserve it.
Countries that provide health care to all, by contrast, treat people on the basis of their illness, not their income, class, or skin tone. British journalist and comic book writer Kieron Gillen notes, “It’s one of the few things about my country I feel genuinely proud of. That we decided our country should have such a thing. . . it’s right. In a tedious, old fashioned way, it’s how the world should be.”
Providing basic health care to all citizens would be the furthest thing from un-American, from denying people’s freedom of choice. It would allow people the choice to leave jobs they hate without fear of losing benefits. It would allow people to strike out on their own without being punished with higher premiums and less coverage.
A public health care system would be an extension of the social contract that says what most Americans believe to be true already: that this country is stronger and better for the entrepreneurs, the creatives, the dreamers, the people who are willing to take a risk and fail. Those people deserve to have their basic needs taken care of. The only rights that will be stifled by a public health care system is the right of the rich to have a monopoly on innovation and risk-taking.
The current state of our economy can testify to how well that’s worked out for us.
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