Originally published at: https://boingboing.net/2017/10/30/modern-indenture-2.html
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As a member of a union, and having been on a few contract bargaining committees, I can speak from first-hand experience that removing medical costs from talks would be wonderful. It’s a special kind of suck when you’ve fought and argued for a 1.5% raise, only to see it swept away by ever rising medical insurance costs.
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Wait, you think all that “freedom” stuff in the Declaration of Independence applied to you?
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And to add that this should include vision and dental and psychiatry, something employers love to separate out as if they’re “not really” health-based.
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I never understood that (though Psychiatry has always been covered by my plan). I mean, what with the fact that unchecked dental problems can lead to life-threatening abscesses and unchecked vision problems could lead to, well, blindness (something that has been a benefit if not a requirement at every job I’ve had), you’d think that bundling those in with health insurance would be a no-brainer.
My biggest criticism, however, is the current debate’s conflation of health insurance with health care. That, in my opinion, is like conflating automotive insurance with transportation. The conversation should take “insurance” completely out of the equation.
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Vision and dental aren’t really insurance. If something catastrophic happened to your teeth or your eyes, they wouldn’t cover you - your medical insurance would. Vision and dental are really discount plans, and if you had to pay full price, you’d just skip them and go to the dentist. It’s actually cheaper that way.
As for mental health, you’re right. We Americans really do think that’s not health-related. It’s a moral issue - if you just work harder, your depression will go away.
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But universal health care is free as in “freedom.”
The problem is that in the U.S. we’re dealing with conservatives and Libertarians who quantify everything in terms of money, a bunch of selfish cynics who, as Wilde said, know “the price of everything and the value of nothing.” Everything, including freedom and romantic relationships, is cast as an economic transaction, preferably as close to zero-sum as possible.
Until this kind of thinking loses its power in American political discourse, we’re not going to get anywhere making arguments about any outcome that doesn’t translate to money going into the pocket of someone who’s “deserving.”
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I remember reading somewhere that a certain Popular Vote Loser said in an interview, “If you lose, I win, that’s just how business works.” And he was wrong, that’s not how business works. It’s a positive-sum game, but some people just can’t imagine that.
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Add that to a universal basic income and see how fast “at will” employment ends. If employees are not tied to an employers health care plan (remember this is an employer who can say " if you don’t like X there’s the door" when he knows the door is marked poverty and homelessness) you’ll see iron clad employment contracts (weighted towards the employer of course) become the norm.
Of course as a IWW member I’m for ending wage slavery in all it’s forms.
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My doctor tells me every visit how important it is for my over all health to have cavities and such taken care of properly but when I mention that my employer doesn’t have dental insurance he just shrugs and says I’ll find a way. Yep and that way is through a care credit account with 24% intrest. All the while constantly hearing how im a bad citizen because I’m not spending or saving enough!
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And they do a shitty job of it, too. Numerous objective studies show that preventative medicine, income security, non-discrimination, etc, etc, etc all pay off in the long run, for everyone participating in the economy. They reject that reality in favor of their own fantasy of superiority, as measured by $$ in the “free market.”
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Well, I am a white landowning male.
And frankly I’d rather share the blame for this mess with as many other people as possible. 
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Can’t view that video, alas.
I added the link… Can you click thru
Yep thanks.
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Yeah, yeah, yeah.
Certainly not everything can be valued in dollars.
I for one think it would be an excellent idea if we could uncouple healthcare from employment. You are aware of course that they are so coupled in the USA as a result of collateral damage from federally imposed wage controls during WW2. (NB: no libertarians were involved in that decision).
The problem is that those who provide health care (not health “insurance”) want to receive dollars (or the equivalent) for doing so. In order to reduce the cost of health care, we can either
(a) reduce the number of health care services that are delivered. This means dealing with the reality that Americans (including those on Medicare), expect the best treatments, the most up to date diagnostic tools, delivered with little or no waiting. As a people, we don’t so much measure the quality of health care in terms of national mortality rates as we do in terms of "Can I get an appointment next week with a neurologist for my headache? or “Can I get that new arthritis drug they are talking about on TV?”* And we are quick to run to the courts when we don’t get what we think we should have. Under single payer, we will run to our Congress. And they will give us what we want, cost be damned.
(b) reduce what doctors, nurses, EMTs, lab techs, therapists, etc., etc, are paid for delivering each service (this latter is the “economies of scale” some one keeps bringing up all the time). This will work for a while. Then it will start having an effect on recruitment. Very few will want to be ICU nurses for $18 an hour, or trauma surgeons for $175,000 a year. There are easier ways to make a living.
And there is no magic (c ) that will find all the money in reducing waste and overhead. Every not for profit hospital I have worked with spends in excess of 85% of its budget on actual patient care services.
I don’t measure everything in dollars. I do measure whether a health care system is self sustaining over the long term using them, though.
*Drugs are the exception. There would be enormous savings to both the consumer and the whole health care system if we could purchase drugs from overseas, or if the patent/FDA complex was not so thoroughly captured by the pharma industry. (NB: No libertarians were consulted when these systems were put in place)
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The zero-sum view of economics is kinda odd to me because the fact that productivity always mean we’re trying, and usually are successful at doing, to make more with less labor and material inputs. If anything, single payer should be cast as a multiplier on productivity when labor doesn’t feel constrained by placement in their work they’ll gravitate toward jobs they like most and will stay longer which means less pressure on wages at least for skilled jobs like software development where job hopping is the norm if you want 10%+ raises on average. So it’s really something that capitalists should seize upon as a means to cut costs of labor by spreading it around on everyone. It just seems American capitalists are, IMO, idiots or too short sighted to see that a sick work force is a less productive one.
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