ACA isn't enough: single-payer is a feminist issue


#1

Originally published at: https://boingboing.net/2017/12/11/unwaged-work-is-real-work.html


#2

Then women also need to help themselves and vote for Dem’s and Progressives. Here in Utah, they still vote lockstep for the guy with an ‘R’ by their names. That isn’t going to help them.


#3

One of the pervasive ways women are disadvantaged under the ACA is its reliance on employer-based coverage. In the United States, World War II–era wage freezes helped entrench a system of employer-provided health insurance, a perk meant to attract workers in a squeezed labor market.

The perverse system hasn’t really been great for anyone, regardless of gender. My main critique of the ACA is that it kicked the can down the road a decade or more, by removing the impetus for universal coverage, decoupled from employment status or earnings. I know about the perfect being the enemy of the good, and all that jazz, but I have a sinking feeling that we will be living with this situation for many years to come.


#4

Full disclosure: I’m a man therefore I’m not a feminist. I can’t be, so my argument has nothing to do with feminism. So lets begin, the problem with the author’s argument is, that if you do the leg work in researching the healthcare systems in Europe and Canada, you’ll see they are imploding because they can no longer be sustained. Socialized healthcare is about rationing access to health care, if you don’t believe me look up the U.K., Canada, Sweden, Norway, and Denmark. Another problem, arises from the author’s suggestion of “progressive taxes” which is code for massive tax increase for everybody (except maybe rich people) look at the countries listed above their taxes are massive. Denmark and Sweden their tax rate is 70%. Imagine it, 70% of your income goes to the government, and you have to make do with what’s left, just so you can have free healthcare. London alone has a 4,000 doctor shortage because doctor’s aren’t paid enough to be able to pay off the massive debt they accumulated to become doctor’s. Wait times from appointment scheduled till actual visit is 2-3 months.(Europe and Canada) The average is 6 months if you need a specialist. This is for all non ER services, including illnesses like cancer and diabetes (look it up, if you don’t believe me). I’m not saying our system is all that good, it’s not, but socialized healthcare with the government in control of who gets healthcare would be much worse regardless of gender or economic status.


#5

Oh, hi. Welcome to boing boing.


#6

Feminism is “the advocacy of women’s rights on the ground of the equality of the sexes” (source). There is nothing in that definition that requires a proponent of feminism to be a woman.

Eh? I believe medical students incur ~33% more tuition fees than most undergrads, as medicine is a four-year course [edit: four to six years ], but those tuition fees are typically covered by student loans [edit: for the first four years, and by an NHS bursary thereafter ], which don’t start being repaid until (and if) the graduate earns more than a certain threshold. So doctors aren’t in a massively different boat from any other graduates.

Not in my experience.


#7

Well, were you taking your experiences from a Heritage Foundation report? Your experiences must not be based on adequate “leg work”, methinks. ;~)


#8

Um, so is non-socialized healthcare. The rationale for the rationing just changes to an individual’s wealth rather than the system’s collective budgeting. The wealthy can opt out of participating in a socialized care system (while still paying into it) and get better healthcare somewhere else with their extra wealth. The poor can’t opt into wealth-based care because they have none.

Denmark and Sweden their tax rate is 70%. Imagine it, 70% of your income goes to the government, and you have to make do with what’s left, just so you can have free healthcare.

If you’re paying taxes for it, it’s not free healthcare. A progressive tax would by definition not be a massive tax increase for the poorest. The wealthiest would pay the highest percentage.

Wait times from appointment scheduled till actual visit is 2-3 months.(Europe and Canada) The average is 6 months if you need a specialist. This is for all non ER services, including illnesses like cancer and diabetes (look it up, if you don’t believe me). I’m not saying our system is all that good, it’s not, but socialized healthcare with the government in control of who gets healthcare would be much worse regardless of gender or economic status.

As opposed to people being bankrupted by medical debt and not being able to afford to see a doctor at all? I think you’re comparing the experience of a person with a job and employer-based healthcare in our system to the worst case scenario in a socialized system. Take the worst of ours, someone who either dies early for lack of care or someone who gets care but whose family is never free from the debt the treatment incurred. I can wait 2-3 months for an appointment. I already schedule my visits that far in advance sometimes.


#9

I’m also quite done with the constant redefinition of what feminism “is” so people can try to avoid admitting the problem with an inherently gender-based term to rally people together for issues which being gender-based isn’t really related - simply because they refuse to just call themselves humanists.

But you are exaggerating the taxes paid and completely ignoring that the problems arising in those systems are due to being intentionally underfunded. For a normal person losing 50% of your income has a devastating effect, someone making a billion dollars ending up with 500 million dollars is not a devastating effect - it’s what happens when you’re able to marshall the education, health, transportation, and other systems that we all pay for in a nation so that you’re able to run a company capable of operating and making those revenues and profits.

Instead, in those Nations the rich are calling for austerity measures and increased defense spending because they own the defense companies and this is a way for them to claw money back.

You’re also forgetting that the point of the government is to be for the people, providing the best system for the best amount of people possible, not the American Style of massive income inequality where we simultaneously have more food than we need and still starving people and more homes than we need but also homeless people.

The bottom 5% of people will always be useless non producers, they will be more than compensated for in terms of output by the top 5% of people.

There is a reason Finland gives an income percentage based ticketing system for traffic offenses, it’s supposed to sting and make you not do that anymore.

It isn’t intended to be some pedestrian small amount of money that the rich can constantly ignore.

Continuing along in the American style system is what makes the pitchforks come out, the stooges need to realize that before it gets bad.


#10

How about you supply the evidence if you want to persuade us? Like @SheiffFatman, my experiences with single payer are not like what you describe, to the point where the only statements I agree with in your comment are:


#11

Ah, but you’re missing an important point; it seems free to those who profit from the current system and know that us plebes require a direct cash transaction (ideally unobtainable without a lifetime of debt) to understand the “value” of hard work. Without that incentive everyone will just revert back to a suckling piggie! Just look at France, Sweden, Norway! It’s a nightmare and the daily onslaught of ignored European voices crying out for the authority of more “invisible hands” in their lives continues to be the greatest of global shames.


#12

Other than a few fringe feminist groups, that has never been true.

The problem with that is there are quite a few self described humanists who have a poor history of fighting for groups who are not like themselves. I have seen this problem first hand in anarchist and socialist groups where there are almost always a few people who think that the working man’s issues should always come first. Feminism is a reaction to that, if they won’t stop treating women’s issues as less important than men’s then we will fight for them without their help.

If you really want an egalitarian world, then you need to fight for everyone, not just make things better for people like yourself and assume that the same is true for everyone else.


#13

Oh my god.

And please stop with the wait times bullshit. It is thoroughly debunked. In any event, ever try to get a non-emergency appointment in the profit driven efficient market U.S.? If your chosen physician or dentist is even taking new patients, you’re looking at a few months. That’s in a market that has physicians. In rural or not properly rich enough urban communities, there are not any physicians. It’s the Invisible Fist of free enterprise smashing the poor as per usual.


#14

The other problem is humanist already has a different meaning, and it has nothing to do with some “I think everyone should be equal” meaning.

Says the American Humanist Association:

Humanism is a progressive lifestance that, without supernaturalism, affirms our ability and responsibility to lead meaningful, ethical lives capable of adding to the greater good of humanity.


#15

Boy, do I have exciting news for you.


#16

I was using the term that they used. I prefer egalitarian for the reason that you mentioned, and feminism is one front in the fight for egalitarianism.


#17

(NB: none of the hospitals mentioned below are for-profit)

http://www.modernhealthcare.com/article/20171125/NEWS/171129969

THE TAKEAWAY
Payment shifts and regulatory mandates are putting hospital Medicare margins on a slippery slope.
While Medicare has never totally covered the cost of care, hospital executives say the chasm between the two has widened in recent years due to a number of factors: federal mandates to deploy expensive health information technology systems under the meaningful use program, a 2% across-the-board cut to provider Medicare payments under the Budget Control Act of 2011, reductions in Medicare disproportionate-share hospital payments and the move to alternative-payment models. Layoffs and reductions in services have been common coping mechanisms to avoid the income drop.

David Ramsey is in a dark place. Despite running West Virginia’s largest hospital, a sense of dread has grown about the facility’s future.

“There is no light at the end of the tunnel other than another train,” said Ramsey, CEO of Charleston Area Medical Center. “There no reason to feel optimistic.”

Ramsey, and many of his C-suite peers, are grappling with that fact that Medicare margins are in a free fall. In 2015, the aggregate margin hit a negative 7.1% across hospitals, according to the Medicare Payment Advisory Commission; margins are expected sink to a negative 10% this year.

Charleston Area Medical Center has been hit particularly hard, especially since 20% of West Virginia’s population is on Medicare, one of the highest rates in the country.

The hospital plans to cut 300 jobs by year-end. On top of that, there are plans to close a wellness program, one of its community-based pharmacies and a pulmonary rehabilitation program.

It’s a similar story in Iowa where Todd Linden is CEO of Grinnell Regional Medical Center.

Last year, Grinnell Regional closed its outpatient mental health clinic. The system has reduced its workforce during the past five years by nearly 20% in an effort to stay afloat. For decades, hospitals could rely on rising commercial reimbursement, but those raises have stopped as insurance companies struggle with their own thin margins.

“There is no silver lining from other payers,” Linden said.

Having a payer mix where 40% of patients are covered commercially has been a lifesaver for New York-Presbyterian Healthcare System, according to CEO Dr. Steven Corwin. It’s why he gets nervous whenever the idea of a Medicare-for-all single-payer program gets bandied about.

“The 150 million or 160 million people with employer insurance support the entire healthcare system,” Corwin said.


#18

That’s like saying “I’m white therefore I’m not an abolitionist.”


#19


#20

TGOP: Anything but Obama Care.