Why Don't Americans Want National Health Care?

As you might have noticed from my previous posts, I tend toward the logical and pragmatic, and I will use that approach here, as well.

So, let us begin with the premise that health care is neither a right nor a privilege, but a necessity. We have all been sick at one time or another. We have had a disease or an injury or a condition, and we knew that we should see a doctor to have it diagnosed and treated. Some of us, however, could not go to a doctor because we could not afford it for one reason or another. We waited and waited, using whatever home remedies we could think of, or whatever was suggested to us by family, friends, and acquaintances, it got worse, and we wound up in an emergency room.

Even if you wind up in the emergency room – which is no one’s preference – there is no guarantee that your condition can be treated. It may be too late. And even if you will be gone, your family, friends and acquaintances will miss you, and your family will be stuck paying those massive hospital bills – OR they will have to be paid by the American people through their tax dollars, if not directly, then by the hospital being able to deduct the loss of fees as a loss on its tax return. Either way, you make the entire American public responsible for a huge bill that could have been entirely avoided had you been able to afford to go to the doctor in the first place.

As has long been known, “An ounce of prevention is worth a pound of cure” (Poor Richard’s Almanac). So, say you begin to experience symptoms of the same condition, but you head immediately to your doctor’s office, s/he diagnoses you, prescribes medication that you have to take for a week, and you’re done. Personally, I would, and do, find that preferable. There is nothing like the feeling of being able to go for medical care as soon as we experience symptoms. It generates a sense of relief, which contributes to your recovery. A two-fer, if you will. And it saves EVERYONE money, time and resources.

Now, imagine that you’ve been employed for thirty years and your employer has been paying for your health insurance, but a pandemic happens along and you lose your job and health insurance. And imagine that the week after your health coverage expires, your child has a bicycle accident resulting in a broken wrist. This is the Murphy’s Law part of the equation. You can and must take your child to the Emergency Room, but you no longer have insurance to list on the intake form and you know that bill is coming to you and you will be expected to pay it in full with money you no longer have or your credit rating will plummet. So your child has x-rays, a radiologist to read them, and an orthopedist to apply a cast, not to mention the actual administrative staff and x-ray technician, orderlies and nurses and all the other incidentals, which are actually covered by the exorbitant fees hospitals normally charge. What this does is begin to excavate a hole in your stomach lining.

Before you accuse me of being partisan or socialist or anything else, think carefully whether any of this has ever happened to you or anyone you know. Think of the consequences, the sequence of events, and what eventually happened to that person or that family. And think carefully whether this is something you WANT to happen to you, or your family, friends or acquaintances. And think – try to take a global approach – of what this means in terms of our economy. For so many people to be uninsured, to wind up being hospitalized, and eventually to default on their payments, only to have to have the American government make the payment from the tax dollars you pay. Ultimately, this lack of foresightedness could bankrupt us. Again, hospitalization should only be a treatment of last resort because, except in the case of sudden injury or an unforeseen affliction, like a bursting appendix, the most efficient and cost-efficient thing to do is to see a doctor.

Regular medical care is a necessity. Regularly changing the oil in your car is also a necessity. Why are people more likely to change the oil in their cars than to go to a doctor on a regular basis? If you don’t take care of the oil in your car, the engine will freeze up, resulting in a costly repair OR the need to buy a new car. Regularly servicing your body – or not – can have similar results, except that we can’t always get spare parts for our bodies, and we certainly can’t replace them. So the notion of health care being a right or a privilege absolutely does not apply.

Now we get to the halls of Congress and the President. When we elect our representatives, we do so – I hope – with the idea that they are just a little bit smarter than we are and that they will not only be willing and able to represent us, but that they will be able to articulate, on our behalf, exactly what we want and need in terms of policy. In addition, we would prefer to elect people who are familiar with the basic policies under consideration: health care, economics, international relations, education, ecology, etc. I admit that no one person can know everything, but they should have a cursory knowledge of all these things because they will be making legislative decisions on our behalf on most or all of them.

And let’s go ahead and remember that the President, Vice President, Senators, Representatives and all the various personnel that make up any administration have health insurance that is provided by the government. And, let’s remember that they are human beings, just as are we, who elected them. So why is it that we don’t ALL have government-sponsored health insurance?

And let us remember that ANYONE can get sick or injured AT ANY TIME. This includes Democrats, Republicans, Liberals, Conservatives, Libertarians – members of any party. We need to stop thinking of people of other party affiliations as not people. We are ALL people and we will ALL need health care. So why is it that health care has become so politicized?

Well, the first reason is MONEY. Money as a motivator is a primary component. The advent of health insurance brought about a whole new, very profitable, industry. Despite all the people who are sick and use whatever health insurance they have, health insurance companies still make money and owners are still multi-millionaires. If you don’t believe me, check the stock exchange. Not only do they make money, but they pay hefty dividends to their shareholders. So they are not very likely to want to give up these lucrative enterprises in favor of a national health care program. And, without pointing fingers or naming names, I suspect that many of them support candidates who are opposed to a national health care program. So when your candidate speaks out about opposition to national health care, it is not so much because of YOUR interests as because of THEIR own self-interest.

Keep in mind, also, that the Affordable Care Act (ObamaCare) has not bankrupted any of these health insurance companies. Those that wanted to participate put their actuaries to work and found a way to do so. Those that were not interested do not participate. Either way, a lot more people were able to obtain health insurance, and with it, peace of mind.

Finally, of course, are the twins Medicaid and Medicare. These are two government-run health insurance programs, and while they may not be as elegant as private health insurance, they do work, and the very poor and the retired and elderly have coverage that they might not otherwise be able to afford. Of course, Medicaid is paid for through our tax dollars, and Medicare is paid for through payroll deductions, as well as additional minor monthly premiums, but so would a national health insurance program.

So, why do we still not have national health insurance?

We could. We are part of the way there. But someone in the marketing department of the “Let’s Not Serve The People Who Elected Us” faction decided to name it “socialized medicine.” And the word “socialized” is close enough to the word “socialism” to be used as a scare tactic. People who were rightly opposed to the concept of totalitarian socialist governments made an unhealthy connection that scared them. And politicians who are getting hefty campaign donations from health insurance companies took full advantage of that confusion to convince people not to want what is really best for them, which is HEALTH CARE. So, let’s say that some of us have been bamboozled into shooting ourselves in the feet.

Try to keep in mind that the word “socialized” is related also to the words “social,” “socialize,” “society,” none of which has the ostensibly ominous significance of the words “socialized” or “socialism,” and they should not be confused. And, again, this is a catch-phrase used to scare people away from doing something that is not simply in the best interest of society as a whole, but themselves, as individual people. Ultimately, each of us wants to receive health care when we need it, so why do we deny it to ourselves in favor of large health insurance companies making huge profits?

Now let’s talk finance. I want you first to understand that the insurance business is akin to the bookmaking business and actuaries are their bookmakers. And the rule of all insurance and bookmaking is “When you win, you lose, and when you lose, you win.” (MAD Magazine) So what happens is, when you pay insurance premiums, you are betting that you will get sick and the insurance company is betting that you won’t. The insurance companies make their money from the fact that people are different, have better or worse immune systems, engage in more or less risky behavior, but for the most part, we stay healthy. And IF we get annual check-ups and follow our doctors’ advice, we are more likely to stay healthy, which is why they can give us the odds that they do. And if, for example, 99% of people stay healthy, then they really only have to pay out for the one (1%) percent who don’t. Now obviously the numbers are vastly different, but when you stop for a moment to consider the reality, it is that the healthier you are, the less worry you have, the more likely you are to do whatever it takes to remain healthy, and the less likely it is that you will be the least cost-effective participant in the plan. And honestly, do you really want to walk around with a toothache or chest pains or plantar fasciitis for weeks or months or years on end? Of course not. You want to get these relatively small things taken care of – like that oil change – so that you can get on with living your life.

And those very same actuaries who make the numbers work in favor of the insurance companies can certainly do the same for the US government. So they can work out exactly how much of a payroll deduction or net or gross income deduction it would take for everyone in this country to be insured. Keep in mind that there are people in the US with such severe disabilities that they will never be able to work, young children who won’t be able to work until they’re grown and have finished their education, and people who have worked for many years and have finally retired so they can spend some time with their grandchildren, but for the most part I imagine it would be a small percentage of our salaries or income that would be deducted, and that would cover us from cradle to grave, as the saying goes, and wouldn’t that be a huge relief? Never having to worry again about whether we could afford to see a doctor would take a large amount of worry from the minds of the American people. And we can afford it. We can combine Medicaid, Medicare and plain old health insurance into one big package. And that, ladies and gentlemen, is what Senator Bernie Sanders has been trying to sell us, but what the insurance companies have disingenuously been paying good money to avoid because they wouldn’t be able to make huge profits from us anymore.

So because of marketing and personal gain based on a necessity, we have been coerced into voting against our own best interest. And if you think that’s the way the American government should be run – tricking its own people into doing something that is bad for them – then it’s time for Logic 101. Listen, I imagine that most people do a bit of research before they shop. Food is a necessity and because we must have it, we try to find the best bargains we can. We find it at the least expensive stores and use coupons to reduce the cost even more. If food producers banded together to set the price of food so high that we couldn’t afford it, the government would step right in and tell them it is price-fixing and illegal and fine them for their abuse. Well, health care is also a necessity, and for the government not to step in to help with health insurance is a contradiction in terms.

And one more thing – even if the government provided a national health insurance program for ALL OF US, that doesn’t mean that everyone has to use it. That doesn’t mean that health insurance companies would instantly become extinct. There are always people who are willing to pay for a Bugatti when they can get from point A to point B equally well on roller blades (and avoid parking tickets), but that doesn’t mean you can’t buy health insurance from a company that provides it. Maybe they will cover cosmetic procedures that normal health insurance wouldn’t anyway. Maybe they’d cover more alternative procedures or medicines that normal health insurance wouldn’t. There would still be choice, but there would also be that safety net that people who drive Vespas and Fords need.

And the people who work at health insurance companies would not have to worry about coverage if they got laid off. But some of them would likely be good hires for the government because they already know how to administer a health insurance program. Handy, no?

And for those of you who think that a national health care program would be a disincentive for people to work, we are actually only talking about health care. If you want to eat or play golf or scuba dive or go to law school or buy your girlfriend that diamond engagement ring, you’d still need to have a job to pay for all those things, but at least you’d be healthy while you did them. Fewer lost hours in businesses, fewer lost days for hourly workers, less spreading of pandemics through universal inoculation. There’s no down side to this, except that health insurance executives might no longer earn outrageous salaries, but they’ll survive.

So the reason we don’t have national health insurance is tromp l’oeil. We’ve been tricked into denying ourselves something we need and something we deserve and now I hope I have opened a few eyes, changed a few perspectives, and a few directives. And during the next election season – provided we survive this one – the next time your candidate tries to tell you that “socialized medicine” is a bad thing, tell him or her that you’ve read a dictionary and a thesaurus and you want national health care. And if you don’t want to be generous and do it for others, at least do it for yourself.