Health Insurance: Right or Privilege?

After speaking to many people on the complicated and aggravating but necessary issue of having adequate health insurance and after reading many articles, op-eds, ‘policy’ papers even small portions of the Affordable Care Act – where one stands on the issue of this debate really depends on if they feel that the access to good healthcare is a right or a privilege. It’s not even about whether one is Republicans or Democrat, liberal or conservative, neoconservative or neoliberal; it’s about whether you think it is morally acceptable for the poor and those who live in isolated locations to be cut off from good healthcare access and those that can afford it have the access to the best healthcare available. It is whether you believe having free and unrestricted access to healthcare is a fundamental inalienable right like the right to bear arms (the right to free speech and religion have been curtailed depending who is speaking, what the subject is about and which religion is being practiced), which is about the only inalienable right left where the right is conferred upon anyone regardless if they deserve it or is responsible enough to own guns or not.

Those on the right already made their positions clear on this topic. Any half-baked, loony white supremacist has the right to purchase and own guns because to take away his right to own guns is the same as taking away a responsible person’s right to own guns. But when it comes to healthcare, only those that deserve it, have paid their dues, has paid enough taxes, who are part of the political elite and ruling class plus a few others has a right to good healthcare. Everyone else, the 47% are just asking for gifts and handouts and ‘those people’ daring to ask more than what they deserve based on where they fall in the complicated intersectionality of race, social class, income level are just entitled freeloaders who want something for nothing. But this scorn doesn’t extend to the Medicare recipients, who are people aged 65 and older because they are an important voting bloc and they’ve deemed to have ‘paid their dues’. Their position is very clear, very decisive and there’s a pretty firm line in the sand.

Democrats, liberals and neoliberals have a more wishy-washy take. Neoliberals in particular favor the ‘means test’ nonsense. Everything is means tested – even the free lunch program in public schools where the food is crap, cheap because it’s sodium laden and processed has to be means tested within hundreds of dollars in deviation of parents’ income. If America like Europe charges people to use the public bathrooms, it’d be means tested. Really poor people use it for free, and then it would breakdown to whether it’d be a nickel, dime or quarter depending on income level. And those with ‘male cis-straight white privilege’ will be charged one full dollar for taking a leak in a public bathroom. This kind of tedious, mind numbing, time consuming bureaucratic bullshit is a favorite for the neolibs who are obsessed with means testing everything. It’s like a compulsion they can’t help. The DSM needs to include this in their list of psychological disorders.

They’ve extended this ‘means testing’ to everything. Republicans demand cuts to social security and Medicare or else they’ll shut down the government, the Democrat’s response? Instead of cutting across the board let’s ‘means test’ it and adjust accordingly, it’s better than forcing cuts on everyone. Bernie Sanders proposes free college tuition for all state colleges and universities, Hillary Clinton just came out with her own cheater version, and again, it’s means tested. The Affordable Care act, instead of creating a single-payer plan or just expanding Medicare to include everyone, not just those over 65, and the Democratic president and Congress, can for once, stand up for the American people and stick it to the for-profit insurance companies and big pharma companies, what did they do? It’s another, means tested, complicated, tedious plan which after the final analysis didn’t really improve coverage or cost.

That the Democrats have such trouble saying to neoliberals and Republicans ‘No, we are not going to cut social security, Medicare or welfare, we can afford this if we can afford 2 illegitimate wars’ proves they don’t really care about their voters or their base, who have for over 30 years demanded real reform to healthcare where good health coverage is accessible to all with no caveats, no means testing, no filling out tons of complicated forms, you don’t need a ‘customer service agent’ on the phone to assist in signing up for a simple dental or health insurance plan, nothing. You are born, you are assigned a social security number and viola you have health care, just like when people turn 65, they fill out a simple form and within a month their Medicare is sorted. Social security benefits should not be cut, they should be increased – tied to inflation, Medicare should include more coverage not less and it should be expanded to cover everyone (even trailer trash and those people in the inner cities that police love to shoot). Big pharma and for-profit insurance companies should not get away with making money off of the illnesses and deaths of others. They should be made accountable for their expenditures if they plan on recouping that cost by charging their patients when their product makes it to patients for use. Getting cancer and needing treatment should not be a choice between bankrupting yourself and family to try to get well or let the disease take its natural course and die a premature death. A hospital stay due to an accident or illness should not bankrupt a family – no matter what. These are very clear black and white moral stances, I see very little room for gray here. Unless the neoliberals get a hold of you.

Their favorite argument – people will ‘value’ the privileges they get more if they have to sacrifice (pay) for it. What about the rich people? They have money to burn, they never have to worry about an illness bankrupting them, they have access to the best hospitals, doctors and treatments; where is their sense of ‘gratefulness’ or the ‘obligation’ to earn the privilege before they are allowed to enjoy it? The children of the rich get to attend Ivy League schools not because of superior academics but because daddy and granddaddy went there and the family has an endowment, which all but guarantees their offspring’s enrollment even if they are complete degenerates and wastrels. Which is no different than Hillary Clinton’s original opposition to free college tuition and that is children of billionaires will abuse the privilege – well, they already are abusing that privilege by using reeking cash to buy it. And please don’t tell me the rich worked hard to earn their money. No one works harder in America than the working class, no one’s labor is more abused than the working class people of America. To lecture the working class about the value of their hard earned money in poor conditions and low pay is an insult to their existence.

This means testing, nickel and diming is also an attempt to portray ‘fairness’; to make sure no one gets anything they don’t deserve to have and didn’t ‘earn’ to get. This is a classic neoliberal argument about why free college is a “really terrible idea”, which can be applied other benefits such as healthcare :

A basic tenet of economics is that costs should be borne by the consumer. There’s good reason for this. When consumers have skin in the game, they ration much more effectively because they’re confronted with the opportunity costs of their decisions (any money or time spent on education can’t be spent on something else) as well as the reality of paying that money back some day.

By contrast, having prospective students make unobligated investments with other people’s money would almost guarantee that more bad investments are made. That means too many people earning degrees in areas that aren’t in high demand and are unlikely to pay for themselves. It’s not that I don’t want anyone to major in art history or theology, but if you’re going to you should pay for it yourself.

We are talking having access to education and healthcare folks – we aren’t talking about buying a luxury yacht where having “skin in the game” is of paramount importance. Students are not ‘consumers’, patients are not ‘consumers’; they are trying to access essential lifesaving benefits as part of their right to exist and live in dignity (just like that racist murderer Dylann Roof has the right to buy a gun). Compulsory education ends after three years of secondary education, because it was deemed that students without at least a high school diploma cannot get good jobs. Now a high school diploma is useless, everyone needs some sort of post-secondary education to even get a toe in the door, hence the need for free college tuition. And yes, should the day come where having a graduate degree is required to get good jobs, just like Denmark, the government should subsidize that too.

To the neoliberal – everything is about economics, the deity of the free market and how upsetting this supposed ‘natural’ flow of money will bring down the whole house of cards.

The fatal flaw in this theory of one must have “skin in the game” (aka pay enough taxes to earn your privileges) is that in reality, the exact opposite happens. Millions of middle and working class Americans pay plenty of taxes, pay plenty of dues (labor and wages) and got nothing in return. Wall Street got bailed out, Main Street was left to fend for itself. Millennials are being told that the ‘gig economy’ is cool and hip when the reality is the opposite. When the city of Detroit went bankrupt, tens of thousands of retired public employees (teachers, fire fighters, civil servants etc) and those who will retire in the future saw their pensions and health benefits slashed. These are people who pay their taxes and paid their dues and they most certainly weren’t responsible for the abysmal financial state in Detroit. Why weren’t the neoliberals out in force defending their hard earned privileges? Because the market dictated that Detroit had to go bankrupt, Detroit and its residents had outlasted their usefulness. Detroit (and by extension its residents) need to be taken off life support and just expire because that’s what the market is dictating.

One day, we will all be expendable, just like Detroit and it all started with nickel and diming ‘means testing’ and allowing market forces to dictate.

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