Living in the South, the modus operandi is literally simply “freedom”. Freedom to own guns, freedom to practice religion, freedom to eat whatever and live wherever without anybody giving two shakes of a stick at you. Perhaps the most revered is the freedom to say what you want even if it’s unpopular, something that applies nigh universally in the South and has saved my skeptical socialist rear more times than I can count just because even if I don’t like the redneck with the rebel flag and he doesn’t like me, it’s common politesse — and, more importantly, seen as the height of personal liberty — to be allowed to disagree as we do, down here.
So when it comes to the case for a single-payer health system, I’m coming from a different place than a lot of my socialist constituents, rather literally. Here, where we’re all about freedom and liberty, there’s an infatuation with the right to choose health care.
However, this is one of the many places where the concept of choice is at best illusory, and at worst an utter fabrication.
Now, in this column we’ll be disregarding the statistical side where single-payer is clearly the most efficacious system in favor of the ethical and conceptual considerations of the various healthcare systems. The reason for disregarding is simple: when other nations spend less on healthcare and still are rated as having more effective systems than we do, clearly our system is statistically behind. The idea that these systems are better than ours is undeniable. Anybody who denies it is acting out of pure ignorance.
The question that I’m going to tackle instead is why?
The reason is actually pretty simple, ultimately.
The reason is this: capitalism is incredibly efficient at production and creation of new capital. Where socialism is a system of sustainability and equality, capitalism is a system of absolute productivity. This has its perks as well as its drawbacks. There isn’t a person, left or right, that would deny that capitalism was absolutely instrumental in the development of new capital and innovation in the last several years.
However, do we really want to apply this system to the structure which defines whether one lives or dies?
The inherent nature of private enterprise is to turn a profit. Capitalism, by nature, turns every man against one another in the name of being able to buy bread and pay the water bill. It’s this sanctification of money that I’ve covered before at length in the essay preceding my column, Money the God, that leads to a level of greed unprecedented in human society.
But enough on that; the question at hand is how this relates to the issue of private healthcare versus public healthcare.
This is simple. The profit motive shouldn’t be anywhere near life-or-death situations.
The central ideas behind capitalism dictate that competition and the market forces of supply and demand will naturally lower prices for all. The problem is that this is absolutely fine for tangible resources in a market consisting of tangible resources (idealistically, of course; in reality, tangible markets are distorted by false inflation due to dishonest selling). If I’m a carpenter selling tables, and someone opens up a shop next door selling tables, I’ll have a hard time keeping up if I don’t price competitively against him, and with more tables to go around people won’t be happy to spend more than they see as their money’s worth on a table so the relative value.
However, principally, health insurance is not a tangible market item. Relative value then is iffy at best.
The bigger issue though, is that, to go back to the table analogy, what if I want to reduce the cost of my tables in order to undermine my competitors and gain an advantage? I’ll have to cut corners, use cheaper and less trustworthy methods in order make my tables, all in the name of winning in terms of business and competition.
Is this really something that we want to happen to healthcare? Do we really want the profit motive to stand between us and life-or-death?
We already saw this in action with how, before the Affordable Care Act (which was a relative tragedy in terms of both initial scope and final accomplishment), people could be turned away for having pre-existing conditions.
What does this say? It says “we don’t care about your health — we solely want your money.”
They want healthy people who won’t have to use the health insurance, and they want them to overpay for it.
I mean, even overall, the lack of reign on the medical industry really is rather sickening. Treatments for debilitating and often fatal diseases can range in the hundreds of thousands to even millions of dollars to treat and care for. All of this is alongside soaring co-pays, deductibles, and medication costs that are crippling people’s ability to pay for medication in the first place. We’re so obsessed with the concept of a free market with as little of the big bad government interfering as possible that we fail to realize we’re having our pockets picked before our very eyes.
What doesn’t make sense to me is, to steal a line from Bernie Sanders’ stump speech, how we are in the richest country in the world, yet we rank 11th in terms of healthcare. Do we care for our citizens that little?
The common mistake America at large tends to make when they hear the words “socialism” or “socialised” or “safety net” or “public option” is that they assume that this means they’re paying for somebody else.
This isn’t true. Technically? Sure. You’re paying into a system that ensures access to quality healthcare for everybody. But when you pay into it, what you’re making certain is that you aren’t paying for an executive’s gigantic bonus when the money you’re paying to insurance is for your security. What you’re making certain is that you aren’t paying for marketing or legal action or lobbying in legislative houses or whatever purposes for which the company decides they’re allowed to use the money that you’re giving them for health insurance. There’s a lot of complaints about bureaucracy but honestly, how much bureaucracy are you paying for in privatised healthcare for Christ’s sake? And if there is the added bonus that your roommate or live-in significant other gets sick, or that if your kid gets the flu while you’re between jobs because the company you work at, you have the security of knowing you’ll be taken care of without exorbitant costs of care, then fantastic.
See, health insurance companies are a business. Business is based off of profit, of growth, of margins. So, like any business, they mark up. But there’s an essential difference between tangible and intangible industry. If you buy your kid a cheap toy and it breaks, you’re not surprised. You think to yourself “the plastic was flimsy”, “the adhesive seemed hardly the cents they paid for it”. If you buy a beat-up 2003 Camry for a thousand dollars and there’s transmission trouble, you’re not surprised. Likewise, if you saw that same Camry going for five thousand dollars, you’d say “that’s far too much”. Because with these tangible businesses, you can see and judge for yourself, generally, whether something is worth the price. Health insurance is an intangible business. You don’t see the protection your money is going towards, ever. Even if you’re in the operating room or getting a semi-annual checkup, you’re not ever seeing with your own eyes the quality of what you’re paying for. So it’s impossible for you to know how much of your money is actually going towards your personal health and how much of it is going towards lobbying or towards marketing or towards bonuses. Moreover, it’s impossible for you to know how much of a “mark-up” this service is getting.
So why? Why expose ourselves and our safety and our health to the profit motive?
None of us get health insurance wanting to use it. But we certainly should know that when we do, we haven’t been paying massive rates for somebody else’s pocket. Business will not keel over and die if we make health care public. We can save the profit motive for things like burgers or rugs or refrigerators. Let’s not let it impact our safety, our children’s safety, and the safety of our fellow man.