Ben Buckman.net

A colleague and friend discovered for himself recently how absurd our health care system is, and his story reminded me again of the stakes. I tweeted about it and a facebook debate ensued between myself and a Republican relative:

Me: Married friend seeking health insurance: "All maternity options require a 365 day waiting period for benefits to begin." For $817 a MONTH.

Relative: Would you expect an auto insurance company to insure you today and cover an accident that happened yesterday?

Me:

Of course not, which is precisely why the private insurance model is inappropriate for health care! Health isn't an "accident" and people shouldn't have to plan their lives around insurance company timelines. How does this whole system not strike you as grossly unconscionable?

It doesn't make any sense to me that of all the factors a responsible person should take into account to plan their lives, insurance companies' profit interest should be the #1 immovable object, around which all else operates. Forget what you want, what your family wants, what your community or society wants, the insurance company says wait 3 years and stay where you are and keep this job, so do that. To me that order of priorities is totally fucked, and needs to be turned on its head. Health and happiness are first, companies who can successfully monetize health care should be saluted for doing so, but not the other way around.

Relative: 

I can only agree that health insurance should not be coupled with employment. However almost all goods and services are sold by companoes whose goal is to be profitable. That is why it is so important for the government to facilitate a basic foundation for all US citizens and let free market competition drive prices.

1200 amendments! Do u really think anything with 1200 amendments should be voted. The only people dumber than our Congressman are the Americans who tolerate this. Mr. Obama campaigned on not tolerating earmarks. He is a well schooled freshman senator and president who lies as well as the rest of them. A trillion bucks for 9 million people! Still leave 35 million uninsured. What will that cost? How about reducing the 100 billion in annual legal spending (tort reform), capping settlements, having more offices open after 5 p.m. Instead of sending patients to hospitals. How about charging premiums to smokers, the obese, drug addicts for causing everyone's costs to rise. Allow insurance companies (1500) to sell across state lines. Allow small businesses to get group rates. Ben, there are so many more things that can be done instead of goernment getting involved. It should be a facilitator not the solution.

Me: 

From "almost all goods and services are sold by companies whose goal is to be profitable" it does not follow that health care should be run that way. That logic is also circular: say "provided by companies" and you beg the question, what about firefighters? They exist to handle emergency situations and they're not for profit in most places. They're "socialized." Only a fool would require someone to pay the fire department the full cost out of pocket for putting out their burning house.

Of course $1 trillion for health care is insane. But put it in context: that's spread over many years; we spent $2.2 trillion on health care in 2007 alone! So the money shifts from the private sector to the public sector. That might or might not be bad; it's not bad simply because it's a shift.

I agree with you completely that the legislative system is a catastrophe. Every congressman wants to please the insurance companies who fund his campaign. I'll bet the majority of those 1200 amendments are corporate loopholes to squeeze out more profits. Reform could be done better and cheaper, absolutely, and what we'll get will be a terrible compromise. But the only realistic alternative on the table is dropping the basic principles of universal care as a social right and reverting to the free market jungle we have now, where profits come before anything as a matter of ideology.

Across state lines: absolutely, it's the point of the "exchange" and would be key to a public option. Premiums to smokers: sure, or raise the taxes on cigarettes to offset healthcare costs.

Conclusion: No person should go bankrupt because they get sick or injured. A family able to support a child should get the care they need to have that child. Emergency surgery is like your house burning down, not like an [injury-free] car accident. Society has an interest in universal firefighters, and universal healthcare. Responsible people can do everything right in a free market health care system and still be totally destroyed; that is a fundamentally flawed system.

My blood's starting to boil again about this and I'm remembering - not that I forgot, but it's good to remember - why I worked for Barack Obama to be elected. I just wish he'd push for less incrementalism and more radical change. So much lies at the doorstep of Congress. There seems to be a huge disconnect between people's experiences and Congress' reading of the public will, and I don't understand it, nor do I really understand how people can be so wedded to free market ideology that these people's stories don't phaze them at all.