When I’m not worried about future generations having a planet to live on, I worry about current generations having access to healthcare. The daily prompt today from WordPress is “carousel” which is oddly fitting to a post on the US health insurance system. How did the US’s current healthcare carousel get built in the first place? And why are so many people yelling, “stop this carousel, I want to get off?”
I generally knew that the current employee-based system started, like so many of our social safety net programs, with FDR. I ran across these posts which very quickly and simply explain how it started, and how quickly it became entrenched. Read part 1 here and part 2 here. Basically it began as a tax-break to help control wage and price inflation, but it was so popular that, politically, there was no going back.
Before the employee-based system, people could buy individual or family insurance plans that covered major items like hospitalization, but all routine costs were paid out-of-pocket. So let’s see, has anything changed since the 1930’s (individual insurance plans) or 1940’s (the beginning of employee-based care)? Is it any wonder that either of those models won’t work today?
Life expectancy in the US has risen by approximately 17 years since 1930. This is not because we have engineered a better human (yet), but mostly because of advances in medicine. Amazing, remarkable, expensive advances in medicine. Sometimes I think the public and our elected officials forget this.
Although I didn’t bother to research hard numbers on this, the employment picture has changed, too. People change jobs more often. The giant manufacturing industries of the rust belt have given way to more entrepreneurial, smaller businesses. And why should the ability to even have access to insurance be governed by your employer, or your employment status, or your marital status? Or by the whims and financial bottom line of insurance companies?
I get that medical care isn’t a constitutional right. But does anyone really think that it is less important than the right to carry a gun around? Ok, let me rephrase that, SHOULD anyone really think that the ability to carry a gun around should be more guaranteed by the government than the ability to get medical care?
I didn’t use to think America was ready to make the leap to the single-payer system. I honestly thought that our politicians would be able to build on the progress started with Obamacare and slowly move to improving the access to healthcare and healthcare insurance for all Americans. And then an election happened. I now believe that there is no sustainable political reality that will support taking a series of small steps to anywhere. Our politicians are taking us for a ride, not on a carousel of progress, but on the same old carousel that just goes round and round and round. Fortunately for me, I may be getting dizzy, but I’m still on the ride. Too many Americans can’t even get a ticket to get on.