Dear America – We Have A Health INSURANCE System, Not A Health CARE System; They’re NOT The Same Thing

Until we get the framing right, we’ll never fix the problem: our health CARE system is broken because it’s NOT a health CARE system. It’s a health INSURANCE system.

The first question anyone gets asked when they walk into any facility for health CARE isn’t “How can we fix you?”, it’s “How ya gonna pay for this?” Right off the bat, that’s ass backwards. The inmates are in full control of the asylum.

No other industrialized nation has a system like ours — where most Americans get their health INSURANCE (not care) through their employer. There’s a reason — and it’s not because we’re so clever and exceptional. It’s a historical anomaly that we’ve simply never dealt with, addressed or even admitted to.

Back during World War II, every available dollar was put toward the war effort. Rules prohibited companies from giving employees raises or raising salaries for new hires. Big companies, wanting to compete for the best employees, needed another incentive so they began offering free health care — well, they’d pay the insurance premiums.

Note — big companies were able to do it because they could afford (at first) to handle the additional admin and cost of running a health insurance program. As the war went on, more big companies offered the same health insurance benefit. Then the war ended… but the health insurance benefit didn’t — even though it should have.

After the war, all those big companies looked to get out of the health insurance business. They subcontracted out the work to the burgeoning health insurance industry to serve as the “gatekeepers” between workers and their health CARE. To keep costs down, the insurance companies eventually cut deals with doctors to get better rates. All very reasonable except that the insurance companies had now created EXCLUSIVITY where there wasn’t any.

Suddenly insurance companies could control which patients a doctor could see. And then they made their gatekeeping integral to the whole health CARE system itself.

Corporations — like health insurance companies — have a fiduciary responsibility to their shareholders (the preferred class, not the regular class of shareholders) first and foremost. They have NO actual responsibility to “patients”. The insurance company doesn’t actually care what happens to any patient. It’s in their interest to spend the least they can get away with on each patient while collecting the maximum amount of income from him/her.

Is universal single payer perfect? FFS, there’s no such thing as “perfect”. But at least it takes the FOR PROFIT gatekeepers out of the health CARE equation. There will still be gatekeepers for sure — government gatekeepers. But We The People can control how they keep the health care gates for us. We can’t do the same with a corporation.

It is even more absurd to run around all Chicken Little-like about Elizabeth Warren says she’d pay for her Medicare For All plan — without comparing it to either 1) what our current health INSURANCE system costs each & every one of us in cold, hard cash terms or 2) ever asking a Republican EVER what their “health care plans” cost or how THEY might get around to paying for it.

FFS – the Republicans pulled off a massively destructive (to the middle class) tax cut to the rich that they had no intention of every paying for — except by gutting social security and welfare.

America keeps getting tripped up by greed. Greed is what allows Big Pharma to charge extortionist prices for insulin when it’s inside America’s borders and reasonable prices everywhere else.

Greed never makes anyone smarter. It ain’t gonna cure anyone’s ills either.

Get Used To A Gig Economy. It’s The Future For Most of Us

Back when I was growing up, there still existed this ‘notion’ that one’s goal was to educate oneself just enough to score a job with a Big Employer who would then be ‘Your Daddy’ till the day you retired.  And, as your Employer was the source of your pension, too — they were going to take care of you till the day you died (and, if there was employee-provided life insurance, they’d ‘take care of you’ after you were dead and buried too).

Most people don’t know the story how & why America is the only place where one’s health care is left up to one’s employer instead of, say, the government (like every OTHER civilized country).  It started during WWII.

Because the war effort demanded all available cash, employers were prohibited from giving raises to employees or offering a new employee higher pay for a job than it paid previously.  To compete for good, new employees though, companies had to do something.  A few came up with what was, at the time, a clever idea:  “Free Health Care”.  That wasn’t prohibited.

Soon, lots of companies were offering it.  Then the War stopped.  But the practice never did.  It continued though it no longer actually made economic sense for anyone — especially while Europe was re-building and instituting socialized  systems for health care and education and old age pensions that were paid for via taxes not as some perk offered by employers). What Europe was doing made far better sense — both as economic policy and as social policy.

The citizens of Europe are far healthier, better educated AND MORE COMPETITIVE than most Americans.  And now the rest of the shit pie comes out of the oven.

The old Employer-Provided Health Care System is crumbling under its own unsupportable weight.  It makes business expensive.  Makes goods and services more expensive.  Example — an Airbus doesn’t have to build in the cost of its makers’ health care and old age pensions.  Boeing, for instance, DOES.

There ARE Real World impacts.

And people don’t work for anyone for Life any more.  And companies are scaling back their health care & pensions to MOST employees (not the ones at the very top of course, NEVER the ones at the VERY top…) because they’re too expensive.

America’s business are already gearing up in every way they can to shed ’employees’ and hire ‘contractors’.  Gig Economy people.

When that happens, the other vital benefits that Americans came to rely on will go unattended to — with dire consequences.  It ain’t rocket science to make that call.  It’s so obvious it hurts.

Makes me wish I had a job — so I could go to a doctor about it…