All the Democrat contenders for the 2020 U.S. presidency are making a big deal about insurance: one side demanding universal coverage for every American and even people living here illegally, the other side still critical of Obamacare or the Affordable Care Act. Well I’ve been involved in this debate for a few decades now and have concluded that our federal government and most states are not about to allow every and any body to be covered by public healthcare. It’s not like we’re talking guns here. Nope, this is a totally different, yet somehow related, debate. The America I know has always said “No way, Jose” when it comes to universal healthcare.
The Dems are barking up the wrong tree on the already dead, no pun intended, issue of expanding Medicare/Medicaid coverage so all Americans can opt in if they want or need. Americans have a long proud history of pulling up their bootstraps and making their own way, providing for their own and no one else—except for some charitable contributions, tithes and offerings, and big-hearted giving come Christmas time. That’s the America I know. But along life’s journey, I learned people who don’t look like me don’t have an American history of fending for themselves let alone taking care of their own. Whether it is bad luck at finding a good job with benefits or … well, that’s pretty much been their misfortune all along. There are tens of millions of Americans who have never had and never will have luck at landing a good job with paid healthcare, white or darker but let’s face it mostly people with brown and black skin. A good education and Affirmative Action evened the odds for millions but not all, white and people of color. And it’s bothered me my entire adult life: Why is America the only modern nation that does not consider healthcare a right and not a privilege, unlike our thinking about a driver’s license, which somehow is related?
Blessed insurance
I voted for Bill Clinton for one reason: universal healthcare. He was gonna make it happen. He was so naïve, and so was I. Shortly after taking office, he assigned his wife, Hillary Rodham Clinton, to study and propose a universal healthcare system for America. She held round table discussions with doctors, hospital administrators, insurance and pharmaceutical reps, and also American consumers. The bottom line: none of the money makers (healthcare, insurance and pharms) would take a financial reduction so that affordable healthcare could work for everyone. Being American means we support anyone for making as much money as possible. But it is interesting to know that healthcare providers around the world, including Canada, do not earn anywhere near their colleagues in the USA. So the Clintons dropped the subject. They had other fish to fry, but they gave universal healthcare a good solid try. Besides, the Republicans always were fond of saying America has the best healthcare money can buy.
That makes no sense.
Universal healthcare was placed on the back burner for awhile until Congress took it up once more. The Democrats came up with a plan to cover all Americans. The Republicans came up with a counter proposal with strict mandates like no coverage for pre-existing conditions and other restrictions seemingly at the time rather mean spirited if not spiteful. But then as President, Barack Obama simply took the Republican plan to debate and maybe pass in Congress. It was a brilliant political strategy. The Republicans had already proclaimed they would never work or pass any legislation proposed by President Obama, even their own counter universal healthcare proposal. President Obama took the issue up to the U.S. Supreme Court which passed on the question of mandatory insurance whereby every American of a certain age and income would have to be insured. It was the only way the Republican healthcare counter could work. And Obamacare became the law of the land.
I still do not know anyone who has ‘Obamacare,’ but it is tens of millions of Americans. A few friends who work for small businesses, however, told me the cost was even higher than their regular insurance. Many Americans disagreed with the mandate to get health insurance or be fined, and that issue alone had a lot to do with Donald J. Trump winning the White House. President Trump did get that part overturned, so we’re back to Americans not having to have health insurance if they don’t want or can’t afford it.
Not very reassuring
Each American has a story about insurance coverage or lack thereof. When I was in my 20s, my first job provided solid insurance. It took a lot out of my paycheck, but another one of our American sayings about health insurance is you need it ‘just in case,’ meaning the big auto crash or cancer. So I paid. I made $6 an hour, and health insurance took a hunk of my paycheck. Did I mention I hardly ever used it or didn’t need to at the time, thank God?
Then something new in healthcare crept into my large 900-employee workplace: HMO. The deal was take it or stay with the triple-increased regular insurance. I took the HMO because I was young and needed insurance ‘just in case.’ I also chose the HMO because it was very affordable: $5 co-pays in those days, $5 prescriptions, too, and no deductibles. But operating like Wal-mart, the HMO soon became the only option as co-pays and prescriptions increased: $7, $10, $15, $20. I remember the 30-somethings with kids did not like the plan at all: having to choose doctors from a list instead of keeping their usual family physicians, no coverage for pre-existing conditions, cheaper quality like equipment for insulin and generic prescriptions. But I likened the HMO to college when we saw whoever’s at the quack shack. They’re medical professionals after all. The HMO worked for me, single career gal. Yet each year, the rates increased and the plan became more restrictive in coverage. Everyone was suspicious.
Then our employer went belly up, and none of us had any insurance to complain about anymore. In between jobs, my parents were kind to help pay for prescriptions. This is a very American face of life. My next job paid $900 a month, of which $200 went for insurance. Some months later, I finally got a professional job but at a small company in a small town. The annual deductible for health insurance was, wait for it: $2,500. It was 1992, and Bill Clinton soon was elected President. When I told my father my deductible was $2,500, he said, “You’re lying.” See, he always worked in the big city and for major corporations. His insurance, though always increasing in rates, was quite manageable. Small towns and small businesses are screwed when it comes to health insurance premiums.
Nevertheless, I continued paying for insurance that I hardly used, thank God, and of course never reaching that deductible. I was indeed paying for others, not unlike universal healthcare. A few years later, I worked for a slightly larger company but in a corporation so insurance was a bit better. My deductible was $1,500. I’d never reach that figure each year either. I guess in America we should be openly thanking God for the blessing of never having to use our insurance. Has it come to that?
Eventually I returned to the big city with a big employer. I was a public school teacher, and the insurance was sweet. I opted for paying a bit more per paycheck for a $500 deductible. I could even use it for chiropractic care. I easily paid the deductible in the first few months each year after enrollment. It was a great ride for a few years until the option was gone. I’d pay not only more per paycheck, but the deductible would increase annually: $750; $1,000; $1,200; $1,500; $1,750. Then the school district switched to another major insurance company, and I lost all my doctors, some I’d seen for years. I thought of the 30-somethings I had worked with in 1990. Suddenly I felt their loss. It was a loss of control. I had bonded with doctors who knew me and my health. So I had to set my mind back to ‘college’ mode when I saw whatever doctor.
This is my personal insurance story so far as an American. I can add that in recent years I was without insurance, and thank God nothing too serious happened. Besides, I could always pay by credit card. Has being American come to this: healthcare on credit? Yes, it has for 99 percent of us. Some of my teacher colleagues, whose employee insurance was paid by the school district, could not afford the family option to cover their children, a monthly cost in the low thousands of dollars. They had to choose between a roof over their heads or health insurance for their kids. Has living and working in America come to this? Yes, it has, and it’s been this a-way for decades.