To our Son Eric’s HealthAugust 8th, 2009 at 12:05
Our son Eric turned 23 in January and is no longer covered under my partner Sally’s family health insurance, which continues to cover her, our 20-year-old daughter Emma and me. Eric is still wrapped up in that classic, compelling, entrepreneurial American struggle to make a small business successful, now 18 months into that effort with the outcome still in doubt due in large part to launching the business just half a year before our current severe recession took full hold. As is often the case when one launches a business, Eric is taking little or no money out of it to pay himself, and is therefore living on a shoestring, which now includes living without any sort of health care coverage.
As one of 45 million Americans without health insurance, Eric is blessed to be young and healthy and certainly has a good chance of playing the odds and navigating the near future without significant medical bills. If he lived in Canada or Western Europe, health care would be a birthright and not a complicating life issue and source of negative stress. For other not yet financially successful American entrepreneurs like him, our system seems to encourage them to give it up and find a safe regular job working for “the man” that includes a good health insurance policy.
Eric’s mom continued to work at her desk job for the State of California (in public affairs for UCLA), doing her time, in part so that our family would continue to have our excellent health insurance coverage through Kaiser. Part of that tradeoff was maybe postponing figuring out “what she wanted to be when she grows up” until she was finally able to retire and still keep our coverage. How many other parents have I talked to who have made important life decisions based on keeping their health insurance rather pursuing their own gifts.
Since my partner Sally’s work path ensured us the health care coverage, I have had the luxury this past twenty plus years since Eric and his sister Emma were born, to be more choosy about the jobs I took, including having the flexibility of working as a non-employee contractor at times, if that was the most promising opportunity. Again, if our country had guaranteed health care for all its citizens, like Canada and Western Europe, all these other parents (and everyone else) would have this liberating flexibility as well.
So all that said I applaud the Obama administration’s efforts to work for universal health care coverage. Though the Canadian type single-payer system that I would prefer is not on the table, the possible emerging compromise plan, with a chance of being passed, would go a long way to ensuring that all Americans would have health care coverage. I continue to hope for success in this effort and have written my Congress-members and even participated in a Change.org “focus group” event to give input to the current administration on this issue.
But as I watch the continuing coverage on CNN, Fox and MSNBC of the effort to build a legislative consensus in Congress (in terms of a House majority and sixty votes in the Senate) I am often frustrated at the tenor, content and apparent underlying motivations in the debate. I see opposition Congress-members (Republicans) who seem to be focused more on trying to destroy Obama’s political foundation rather than contribute to finding a compromise solution on improving our health care system. Then I see my fellow citizens interviewed who oppose even the compromise solutions because they have been convinced that the current plans will impose a bureaucrat between them and their doctor and get the government involved in their Medicare benefits.
I have to laugh. I think most people I know already have an insurance company bureaucrat in the equation between them and their doctor in order to try to control costs. And Medicare is a government program that is also under constant pressure to control its costs as well. Some opinion makers out there, opposed to the current health care reform efforts, seem to be lying through their teeth, in an effort to sew political nihilism rather than plant the seeds of a solution.
Liberal legislators that I generally support have certainly been guilty of some hypocrisy on this issue as well by saying it is not going to cost the taxpayers (at least in the short run) to do this, but I think in this case they are genuinely trying to craft a solution for universal coverage in the American legislative tradition of democratic “sausage making” with all the difficult tradeoffs to attempt to build a working majority for a pragmatic solution. I feel in this instance, it is conservatives and much of the for-profit health insurance industry giving lip-service to universal health care while actually hoping to torpedo it.
I am certainly no expert on the economics of the American health care industry and the complexities of health planning. But as a parent with kids who will likely be greatly affected in their life paths by the success or failure of current reform efforts, I see a general lack of facing reality on both sides of the current debate, at least as its playing out through NPR and the cable news channels. I tend to like to frame things at an abstract “50,000 foot level”, so I admit I may be guilty of minimizing some of the complexities in the trees in favor of trying to craft a clear view of the forest as it were, but here goes…
1. We spend close to 18% of our Gross Domestic Product (GDP) on health care and have 15% of our population (~45 million people) with no health insurance plus a lot more people with less than good coverage.
2. Canada and most of Western Europe spend an average of 10% of their GDP on health care and cover everybody.
3. According to many conservatives, the government controlled Canadian and European systems have their fair share of bureaucratic waste, as much or more than ours, so that extra 8% of GDP we spend on health care seems to have a significant component of profits in it for the for-profit part of our health care industry.
4. For-profit health insurance companies maximize those profits not by trying to cover everybody, but by trying to judiciously choose who not to cover and to do whatever they legally can to limit the services to the less healthy they are already on the hook to cover.
5. Given that, the effort to cover everybody is going to cost a lot more money, or involve serious cost controls that are not in the interest of health insurance industry profits.
6. It is therefore in the interest of the for-profit health insurance industry (at least in the short term where it seems most American businesses put their focus) to oppose universal health insurance, but it would be seriously politically tone-deaf to say so, so they give lip-service support instead.
7. The mostly conservative Congress-members who are fighting for this industry’s interest in the current health care reform “sausage making” effort have a contradictory position where they say they support universal coverage but want no increase in costs yet no effort by the federal government to compete with or control the for-profit insurance industry.
8. The Obama administration and Congressional liberals and moderates pushing the reform efforts are in a bind because, particularly due to the economic situation (and spending billions already trying to fix it), feel compelled to assure people that the proposed solutions will not cost taxpayers any more money, while much of the cost controls they are proposing are opposed by moderates who want to maintain our for-profit health insurance system, without public options.
Wouldn’t it be great if we all could be truly working for the goal of universal health coverage, even if we disagree about the best means to get there? If we are going to be a functioning society in the 21st Century it seems to me we need to figure out how to do stuff like this, to work together with honest motives towards compromise solutions. We have to become politically sophisticated enough (maybe more like our comrades in the European Union) to understand the pragmatic though often not pretty “sausage making” of partnership politics that will allow us to address and solve big societal issues. Part of that I think is abandoning the view that difficult legislative efforts and the inevitable politics behind them are not a competitive sport that has to be all about winners and losers and “power over” and accept that we need to work together to achieve shared “power with”.
Again, as a parent, I would love to see some form of universal health care coverage enacted, our own kids, and all the rest of the emerging generation have a more fertile environment for pursuing their dreams to build their own vision of America.