Just Give Me This One

Trigger warning. This post is about the new healthcare bill that just passed the house. Frankly I don’t believe you should have the option to block information you don’t like to see just because you don’t like to see it. That’s the mark of profound stupidity. But I live up to my own standards, which include giving you a choice to move on and wait for the next blog, which I think will be about puppies or something. So you get the lazy man’s spoiler censor. Just highlight if you want to keep reading.

The Republicans just pushed through their version of a health care bill in the House of Representatives on partisan lines. I’m hoping it’s either dead on arrival or the Senate pushes it off their desks until Trump is impeached. Let’s just go over a few points of this plan though, which do not at all include everything that is terrible about it.  

-Ridiculously low spending that covers maybe a few percentage points of what healthcare costs. High risk pools are demonstrably ineffective, because they grossly underestimate a fundamentally unpredictable thing: medical conditions. It may take years to diagnose an illness. What a high risk pool really is is a limit on how far the bean counters are willing to go before they let a sick person fend for themselves. It’s barbaric. (The funniest thing  is that Representative Bruce Poliquin (R) had to fly back to Maine ahead of this vote because a relative got sick. Here’s the ironic tweet action.)

-Preexisting conditions are back and include being a rape victim, donating a kidney, being transgender (basically if you had the gall to actually demand justice, are a decent human being, or respect yourself and want to live an honest life , the Republicans want you to fuck off and die) Lindsey Graham had the gall to suggest that it’s okay to let Obamacare collapse because the bodies would stack up and force Democrats to play ball. Meanwhile, Congress made sure they were protected from these measures, because there’s no pretense anymore. 

-Work requirements conveniently ignore the fact that sick or poor people who need the assistance tend to have difficulty working. Also most of the people who need Medicaid work, or care for another family member. Also lots of freelancers and part time workers depend on the ACA to support their health when employers don’t want to pay for the health insurance.

-Then there’s the thing that really pisses me off: if more people get sick, fewer people CAN work and fewer people can pay into health insurance, which makes it more expensive. Supply and demand: the more demand, and the more the supply of drugs or medical services costs. But you can only charge so much before nobody can afford the service at all. Insurance companies would make a lot more money on a more stable rate just by letting people stay on their health insurance and keep paying premiums. This shit doesn’t even work out to making these bloodsuckers more money. 

Basically the work requirement, and everything about this shitstorm, is Republican business as usual. Their ideology is more important that people demonstrably suffering. Or, in other words, “I got mine, fuck you.” That’s my big beefs about this. 

But more than the anger I feel at this whole mess is the sense of pity and befuddlement watching the people who actually support this bill. I spoke to someone who said her reason for support was that she was under crushing health care payments. Even after I explained that this bill, by the economic principle of supply and demand covered above, could never lower her payments, she still reached for that chance and ethically threw everybody else under the bus. 

Now I’m not saying she’s selfish, or stupid. Ignorant, maybe. Not to mention probably has nothing to complain about, if she didn’t qualify for a lower rate. This may have been a case of somebody who could actually do with managing her life differently. But if you’re capable of processing information about current events and have the benefit of knowledge, you have no excuse to continue supporting anything the Republican party is up to. My wife pointed out an alternate theory that really explains things for me. It’s called the Lottery Ticket Metaphor on Healthcare. Basically it goes like this:

Average Joe buys a lottery ticket, hoping he will win. He doesn’t. So he buys another one the next day, and the next. One day Average Jane looks up from her free trade organic coffee and mentions that the odds are astronomical. Like literally millions to one. You’re more likely to be eaten by a shark or struck by lightning, twice. Average Joe says to her, 

“Eh. You never know.” 

Basically Joe is buying the ticket because he can imagine the winning ticket in his hand. What he isn’t imagining are the tens of millions of tickets being bought by Joes everywhere in the country. The math literally cannot fit in his head, but the image of a winning ticket does. Conveniently. It is a positive mental state. And human beings are primed to move away from unpleasant things, like mathematics, and toward pleasant things, like finally being able to afford to see the doctor. 

When it comes to healthcare, that mental witchcraft works against you. You need positive thinking because it helps the patient. Sometimes the patient is you. But if you keep thinking positive it is harder to see the monumental odds stacked between you and a sudden and mysterious benefaction. Odds like how putting a few thousand bucks toward a high risk pool is peanuts compared to a half-million dollar surgery. A high-risk pool is basically a death sentence. You’re better off robbing a bank than taking a risk on Republican health care, because the state is obligated to make sure you’re alive for the trial. How’s that for choosing a better lifestyle, Grinning Oafish Pissheads? 

There is a really simple fix for all this. Look over the border at Canada. Their drugs cost a fraction of what ours do because we pay way too much. There’s no regulation here and the insurance groups are far too small to absorb the cost of an unusual or unexpectedly expensive patient.

That’s why both the ACA marketplace plans and employer plans are set up to pay less per person than if one person bought healthcare alone: the insurance companies can spread the risk out to more healthy people as a group. If one person suddenly develops a terrible illness, the group can easily absorb the cost because each person pays proportionately less. A half-million dollar surgery split between a million people is 50 cents each. That’s how ALL insurance is supposed to work. The only reason NOT to do it this way is because it cuts out the middlemen who are making money off of the dying. Somebody starts to get sick? Use a contractual clause to kick them off the insurance. Suddenly all the money they’ve been paying for monthly premiums is pure profit. Or, hey, drop them into a high-risk pool. 

Now imagine if you had millions of people in one group. Or how about an entire country that stands to make no profit from losing its tax-paying citizens? That’s why healthcare in Canada is dirt cheap and just taken out of people’s taxes. It’s the kickstarter principle done preemptively. Single payer universal healthcare: because it’s efficient, not because it’s bleeding heart liberal. 

*drops the mike* 


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