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.

Americans Need To Get It Out Of Our Heads: We DO NOT Do Everything Right

My gut is, this very American attitude — “How WE Do It Is How It Should Be Done” — flows from, the MALE of the American species. It’s definitely got a “I alone can fix it” pong to it.

You know how men are kind of “famous” for refusing to ever ask for directions when lost? Yeah — same chromosomal character flaw. We don’t HAVE to know how to do something, we assume we can figure it out. Then, when we stare at the wreckage our ignorance produced, we can blame the manufacturer or inadequate customer service for the mess. Men — dirty little secret here that I just KNOW I’m gonna pay for — are a lot like Ikea product instructions. You’re never going to “read them” through first; instead you’ll plunge in and get two-thirds of the way through before you realize you put the key piece on BACKWARDS at the very beginning and now the whole goddamned thing has to be taken apart so you can start over.

That’s men. That’s us. No kidding.

Men were mostly responsible not so much for founding the country as taking credit for it and making up all the rules. Women’s role in the founding has gone — shocking, right? — under-reported. I guess, in the men’s minds, someone had to “put the kettle on”. Being men, in whose same minds they were always right, they applied that fallacy to the document (and the country) they created.

If we — White Christian Men — say a thing is so, it MUST be so. Now go and Manifest Destiny already.

White Christian Men decided that slavery was okay. They thought it passed muster that black people were 3/5 of a white person. These things are embedded in our character. They’re part of our swagger (along with the things for which we’re justifiably celebrated as a culture). It’s a package deal. Like everything. Good is a fellow traveler with bad.

But, in our case, that “bad” has caught up with us. I blame the high bullshit content of our swagger.

America does not do healthcare right. We don’t do public education right. We don’t do secondary education — college, university, trade school — right. We don’t do taxes right. We don’t do humanitarianism right any more (we’re hellbent on the exact opposite). On healthcare — we’re the only country that ties healthcare to employment. There’s a REASON we’re the only country stupid enough to do that.

During WWII, employers weren’t allowed to give raises to employees (the money was redirected toward the war effort). To keep good employees from leaving — and to entice new hires — companies offered up healthcare instead. Lots of companies did that. Then the war ended. But that job benefit didn’t. The companies found it hard and expensive to keep providing healthcare. Insurance companies took over the workload — and sank their hooks in deep. They put themselves at the core of American healthcare.

The first question you get asked when you seek medical attention in America isn’t “How can we help you?”, it’s “And how are you going to PAY for this?”

Money, sadly, sits at the heart of what ails America. Greed has undermined the Greatest Experiment in Human Self Government Ever. Let’s be honest, if greed’s involved, the fix is always in. Nothing “trumps” greed. Ever.

America’s greatness flows from its largesse — which, in turn, flows from its diversity. Nothing but cold, Christian calculus (as opposed to Jesus-like, Do-Unto-Others thinking) flows from the White People who believe THEY and they alone are the keepers of the American Flame. They’re the remnant of the Boys Club that — thinking it was always right — sat down to make up the rules some of us still follow that others (Republicans all) blatantly piss on.

I guess “doing it right” is a matter of perspective. If you’re the majority of Americans — we feel in our gut that children dying on our southern border is us DOING IT WRONG. If you’re a republican however… if you’re Donald Trump — you’re a guy waving his dick around, thinking how awesome you are — and how “right” everything is in the world.

The Republican Dream: TWO AMERICAS

Clarity.

Ya have to give the Republican Party full bonus points for having ‘Clarity’.  They know EXACTLY the ‘kind of America’ they want our country to be.  Too bad it’s 1850 America.

The republican party aspires to live in a White, Christian, Male Dominated World.

Demographics do not line up with that world any more.  They never actually lined up back in the day.  Maybe that’s why ‘certain people’ were considered only ‘3/5 of a person’.

Literally EVERYTHING the Kochs & the Mercers have paid huge money for would FIX America in a perverse hybrid world that ‘lives’ in 1950 but wishes it were 1850 — complete with slavery.  Republicans want the rich to get richer and everyone else to get poorer — approaching a kind of economic slavery where our function is to produce goods we can no longer afford to buy ourselves.

Beyond that however is the CULTURE WAR declared principally by the Anti-Abortionists for whom ‘Life’ is sacred only in the abstract.  Their single-minded loathing of women’s vaginas and reproductive organs has reached a state of virtual & perpetual psychosis.

Mitch McConnell’s whole power grab — the denial of Merrick Garland and, now, the rush to fill Justice Kennedy’s ‘sudden’ vacancy (this story is going to get ugly, uglier, ugliest) — was centered on filling as many SCOTUS seats as he could (ditto as many other judgeships.) And the goal of that is to outlaw abortion, birth control, immigration by un-white people and on and on and on.

Where abortion is concerned, the intent is to throw it to the states so that each state would have its own birth control rules & regs (the ultimate, ultimate goal is to turn EVERY state into a replica of Salem, circa 1600 where women know their place and keep to their place).  But, before we get to Salem 1600, we’ll go through a long, tortured patch where some states have kept abortion legal while others haven’t.  Women NEEDING abortions in the anti-abortion states will head to the nearest state where their HEALTH CARE NEEDS and their decision to be or NOT BE a parent can be answered in the way that best suits THEM.

This cultural division of course will go far, far beyond just abortion and birth control.  Repressive, Chritian-ized States will experience an extreme Brain Drain.  It’s a ‘no-brainer’.

States on that side of the cultural divide will put creationism in their science classrooms — exactly like they’ve dreamed of doing.  Creationism in a science classroom will NOT produce science students who can complete in the Real World.  Rather it will produce fools, Magical Thinkers and incompetents.  The people who pass through its doors will be set up for failure.  And fail they will — as will their states — from top to bottom.

Want a little taste of it?  Look at the ‘Kansas Miracle’.

Within a generation, there WILL be Two Distinct Americas — the one that lives up to its promise and produces greatness because that’s what diversity does.

The other country will look a lot like the very shit hole countries a certain president loves to call out — while doing everything in his corrupt power to turn US into THAT.