By Caitlin Kelly
If you move to the United States from any nation with single-payer government-run healthcare, you might be gobsmacked by what you encounter here.
You’ll learn new words and phrases like:
“pre-existing condition”, “co-pay”, “annual deductible” and “usual and customary.”
If you get a full-time job with benefits, you will be mostly preoccupied with how much medical coverage it offers you and your family, at what cost, and with what amount of deductible — i.e. how much more money you have to shell out after already paying a monthly premium for what is supposed to be full coverage.
It’s a bizarre, byzantine way to handle healthcare, because it puts millions at risk, as anyone following the current, bitter political debates over repealing and replacing the Affordable Care Act, (aka Obamacare), well knows.
If you work full-time for an employer who can afford to offer it, you’ll get health insurance through them, often heavily subsidized.
If not, welcome to free market capitalism!
My husband worked 31 years at The New York Times, as a photographer and photo editor. He retired from there, although we’re both still working. As a retired former staffer, he pays $400 a month for his health insurance. That, we can easily handle.
The company decided to save money by refusing this same subsidy to retirees’ spouses — so I pay $1,400 a month for the same plan. That’s $20,000 pre-tax I have to earn just to avoid medical bankruptcy — the single greatest cause of personal fiscal disaster in the U.S.
I’m a reporter, so as I debated choosing a much cheaper plan I queried the billing managers for two of our physicians. Both said: “Hell, no! If you like what you’ve got, keep it.”
They know better than anyone what a crazy and costly mess you can face if your cheap-o plan doesn’t cover something like — oh, you know –— the anesthesia for your four-hour surgery.
That surprise bill could be high enough to knock you out cold once more.
My first steps with my new left hip, February 2012.
As an aging jock with orthopedic issues that have required multiple surgeries and a lot of physical therapy — the co-pays alone costing up to $60 a week — not having excellent coverage is a gamble I’m not willing to make.
As more and more Americans are forced into the “gig ecomomy”, i.e. self-employment or precarious, poorly-paid contract work, we’re forced into free-market pricing for our most precious possession — our health.
When Representative Mo Brooks said it was unfair that healthy “people who lead good lives” should have to subsidize the insurance of unhealthier ones who presumably don’t, he bluntly raised an often unspoken question that runs through policy debates in Washington: Who deserves government aid and who does not?
Such proposals can be — and often are — couched in the language of economics, with advocates and critics calculating the efficacy of incentives, returns on investment and long-run savings. As Ben Carson, the Trump administration’s housing secretary, commented last week while touring publicly subsidized housing in Columbus, Ohio, “We are talking about incentivizing those who help themselves.”
But the judgment of who is deserving — as opposed to what is most effective — is at heart a moral one.
In pushing for repeal of the Affordable Care Act last week, Mr. Brooks, an Alabama Republican, suggested that people with pre-existing conditions deserved to pay higher premiums, because they had not “done things the right way.” That could include a cigarette smoker’s lung cancer — or a newborn’s congenital heart disease.
Couching this as “government aid” completely distorts the larger issue — are you really happy living in a country where you’re just fine — but millions of others aren’t?
This kind of self-righteous garbage, the “deserving”, makes me so angry.
Yes, those who live in a single-payer system do pay the costs of treating other people’s cancer (some are smokers!) and diabetes (some are obese!) and people who injure themselves while high or drunk or are torn to pieces by a dangerous, distracted driver.
No one admires or wants to support stupid, careless behavioral choices.
But I’d rather know that everyone can get good care quickly than smugly snuggle into my personal bubble, knowing for certain that others live in terror of losing their insurance or access to the drugs and care they need.
I grew up in Canada, to the age of 30, never once seeing or paying a medical bill. Nor have my parents, who still live there, in two different provinces, despite multiple surgeries and, for one, months of big-city hospital care.
I’m no fan of endless taxation. But a vast percentage of the U.S. federal budget goes to defense, waging endless wars against often undefeatable enemies.
And the outrageous rates I pay are giving health insurance executives’ massive salaries. I find that disgusting.
I believe healthcare is a right, not a rare privilege only granted to those who someone decides is “deserving.”