News flash: our health care system is broken. That is to say, it is broken from the standpoint of the people who need medical treatment. From the industry investor standpoint, it’s working just fine. People are making a killing, quite literally, from COVID and other illnesses, lending credence to that line from our song Well, Well, Well: “from every misfortune a fortune is made.”
I say this on a week when women’s health is under attack to an even greater extent than usual. The Texas anti-abortion law, which the U.S. Supreme Court has allowed to go into effect, has effectively made abortion illegal in the lone star state, regardless of what their moronic governor claims. This inevitably will be followed with similar restrictions in other “red” states. But even under the best of circumstances, women have trouble accessing and affording care precisely because of the kind of system we still have.
Promises, promises
When he was running for president, Donald Trump promised that he would replace the ACA (“Obamacare”) with something much better, a plan that would cover everyone, etc. Of course, that was a transparent lie that he had no intention of even pretending to make good on. Then last year, when he was running for president, Joe Biden promised adding a public option to the ACA. No sign of that yet, either.
I don’t know what Biden’s plans are for the reconciliation package with respect to health care. What I do know is what he said during the campaign. Back then, he claimed that workers loved their employer-based healthcare and suggested that they had “negotiated” for it. I pointed out back then on my podcast Strange Sound that this was balderdash. Less than 15% of American workers (generously) have union contracts. No one other than a subset of unionists ever “negotiates” the particulars of their health coverage with their employer. The plain fact is that employers provide substandard coverage to their employees, by and large, and that it leaves tremendous gaps.
The six thousand dollar man
As some of you know, I spent about a week in the hospital at the height of the COVID first wave back in April 2020. (It was an ailment unrelated to COVID, as it happened.) After I got out, I got bills that amounted to about $6,000. Now let me be clear – if I did not have health insurance, provided by my employer, the cost would have been much higher. But with this great insurance that Joe Biden suggested I love so much, I was six grand out of pocket over an unexpected illness. I opted for a payment plan with the hospital (which, I should point out, receives a lot of public subsidy).
That is not the way it works in civilized countries. In civilized countries, they do their best to make you well, and that’s it. No bill, or none of any consequence. In Britain and France, I believe, they even give you money when you leave the hospital, under certain circumstances. Why are we not a civilized country? I don’t know. Ask Joe Biden. And every other president, for that matter.
I am fortunate that i had the resources to bear that cost with only minor sacrifices. Most people – including many with employer based coverage – are not that lucky. We need a system that works for those people, not the people who seek to profit from our misfortunes.
luv u,
jp
This entire situation – I won’t say “debate” because there hasn’t been any – is ridiculous largely because no one in Washington will admit to what the ACA’s core problems are. The Republicans, and to a certain extent many Democrats, continue to insist that competition and a freer market in health insurance will deliver affordable coverage to everyone; just pull those sick people out of the system and into an underfunded high-risk pool, and the market can do its magic.
That’s the stuff conspiracy theories are made of. So … why does he keep fucking doing it? If there turns out to be no serious collusion between Trump’s people and the Russian government, his administration is the most productive conspiratorial smoke machine ever constructed. Major administration advisors had conversations with Russian officials during and after the campaign, lied about it, then fessed up when the lie was exposed. If it’s above board, why don’t they just effing say so? I don’t get it.
It’s vintage American political theater, kind of like the ubiquitous flag pin. (Pin on, hero! Pin off, traitor!) We are so obsessed with symbolism that we invariably miss the fundamentals. Reverend Barber was talking about this over the last few days, countering a lot of the happy talk about everyone coming together and pulling down that offending flag. Seriously, when I watched Nikki Haley making her dramatic announcement, all I could think of was the thousands of working families in South Carolina – many of whom are African-Americans – who could benefit from Medicaid expansion under the ACA, if only she and her party would allow it. Sure – symbols mean something to those who have suffered under them. That’s reason enough to pull the stars and bars down. But let’s not stop there.
Now, technical issues like this have historically been corrected by an act of Congress. This was the case with many major pieces of legislation, such as Medicare. But because our Congress is ideologically driven and dysfunctional in the extreme, this is not even a remote possibility. So it is left to the courts, thanks to the determination of many on the right to hobble and destroy the ACA, as well as many thousands of families who depend upon it. It’s manifestly obvious that disallowing subsidized coverage through the federal exchange will dramatically drive up the cost of health insurance in the affected States, crashing the system and throwing 9 million subscribers into chaos. Just as bad, it will initiate a death spiral of rising rates and canceled policies that will affect many millions more.