Friday, December 18, 2009

Healthcare: How Much Are You Giving Up?

Caption: You'll get this one by the end of the article.

Image credit: The Dawg Blog by Dawgdad (Click to see the whole picture - it's cute.)

There are times when Prof. Paul Krugman shows up at his blog to write erudite and informative articles about how our economy is doing, and how it could be doing better. Other times, some condescending twit shows up who writes things like this:

What’s going on with health care is very different. Those who grudgingly say “pass the thing” — a camp I have reluctantly joined — aren’t naive: by and large they’re wonks who have looked at the legislation quite carefully, understand both its virtues and its flaws, and have decided that it’s a lot better than nothing. And there isn’t much careerism involved: if you’re a progressive pundit or wonk, the risks of alienating the people to your left are at least a match for the risks of alienating people to your right.

Now, the pass-the-thing people could be wrong. Maybe hopes of improving the new health care system over time, the way Social Security has been improved, will prove to have been fantasies; or maybe rejecting this bill and trying again, a strategy that has failed many times in the past, would work this time. But it’s a carefully thought-out, honest position. And arriving at that position has, in my case at least, required a lot of agonized soul-searching.

And maybe I’m being unfair, but I don’t seem to see the same degree of soul-searching on the other side.

Health care and Iraq

Nate Silver, who also ought to be smart enough to know better, wrote this:

I know Markos and consider him a friend; I don't know Jon but always find him level-headed. So, this is not meant to implicate them. Nor am I going to go about trying to illustrate for you exactly which arguments against the bill were or weren't made out of spite.

But I've never seen things get quite so personal -- I've gotten as many nasty comments and e-mails from Democrats on this issue as I have in the past six months from conservatives (on all issues). That emotion is a factor in this debate seems self-evident to me. I do somewhat regret egging things on with a deliberately provocative headline on Tuesday.

20 Questions, 20 Responses

I could go on, but I think you catch my drift. People who oppose this bill, or the nearly equally bad House version, are ideologues, need to grow up, are ready to hand Republicans a stirring victory, or should tell them which progressive congressmen we should ask to change their votes and do what they said they would originally. Worse still, Ezra Klein had the temerity to suggest that we worry about policy over the lives of all those people who will be so much better off.

Well, while some of the other people who oppose this bill and I were running around throwing feces at each and trying to avoid getting our tails stuck in the fan, a thought occurred to me - have these people ever in their lives been poor?

There's certainly nothing in Paul Krugman's bio to suggest that he has. I don't know about some of the other folks on that list after the Nate Silver quote, but I think it's unlikely. Why do I say that? I say that, because once you've been poor, or if you know people who are, then you remember.

Being poor means doing without. You do without a lot of things. Much of what you need, like bank services and car insurance, is more expensive. Since Nate's so fond of numbers, let's just run a few to illustrate, shall we?

If you're earning minimum wage in this country and working 40 hour weeks, you're earning about $20,000 ($20K) a year. If you're trying to support two dependents on that wage, here's where your money goes:

  • You'll spend at least $800 a month for a place to live. Try finding a two bedroom apartment for significantly less than that. $9.6K.

  • You'll spend somewhere in the neighborhood of $100 a week for food. If you can get food stamps, or know a lot of folks who will give you food, then you might be able to do with less. We'll say $5K, with some qualification.

  • You have to pay utilities, electricity at a minimum. Since we're being a bit spendthrifty on food, let's say that's another $0.5K.

  • You have a car? Then you need car insurance. Where I live, that's at least $1K a year for the poor, because the poor generally have poor credit, and insurance companies are allowed to charge them more if they do. $1K.

Now, forgive me for pointing out the obvious, but $20K - $9.6K - $5K - $0.5K - $1K is $3.9K. That $3,900 dollars has to cover all the other stuff - clothing, car (and gas), medical expenses, glasses, household goods that need to be replaced. That's $400 a month and change. Try saving for a college education on that. Try going to night school yourself. Try buying a computer that will run Windows 7.

As Nate Silver pointed out in an earlier part of that article, these people would be required to spend up to $1,600 (8 percent of income) on health insurance. Now, our family only has $200 a month for all those other things. They'd better hope they don't have to drive very far to get to work.

Being in this financial condition, which more of us are falling into all the time, means that you have to save up for a new set of tires. It means that a four dollar coffee drink is a luxury, not something you pick up every day on the way to work because you're in a hurry. It means having to decide if you go without car insurance or get the kid braces.

I've been poor and I've been well off. Sometimes, it's hard to remember what it was like to be poor. Thankfully, I still know other people who are in that situation. When I mention to one of them that all they need to make their computer work better is more RAM or a new hard disk for $100, the inrush of breath reminds me what it's like.

It's like you can barely get from one paycheck to the next.

What's more, as Keith Olbermann pointed out recently, if you take home twice as much money, things don't look a whole lot better.

Most of us who have spent careers as professionals find it hard to remember this, if we ever knew. Travel in the right circles, and you might never meet someone who has to save up for a refrigerator or to take a vacation to the shore.

That's why I'm so ideological. That's why I don't search my soul, and stay immature. It's why I'm so unreasonable as to expect comfortable people to screw up a little courage and change their fucking minds when they should know they're wrong.

If you're one of the people I mentioned, and you think I am one or all of those things, or you don't understand why others are even less "reasonable", then I suggest you do one of the following:

A. Get to know people who have to live on the minimum wage, or not much more. Talk to them about things like whether their kids, who do well in school but not well enough to get by on scholarships, will go to college or not. Ask them why the landlord can't be bothered to fix the window that's been leaking air each winter.

Then tell me how you're going to explain to those people that buying insurance that, in all likelihood, won't do them any good when they really need it is going to make the country a better place, and how we just all need to pull together and make this work.


B. Kiss my furry ass.

Really, it's up to you. Except for Ezra Klein. He, and anyone else who has suggested that I and others who oppose what's come out of Congress are only concerned with policy or future considerations, don't have a choice. As someone who would "benefit" from these bills, I invite you all to go straight to alternative B. You're already worthless.

But if you opt for "A.", let me tell you that you'd better have some other explanations:

  • How either the House or the Senate bill will enforce the even the limited, new restrictions they place on the insurance industry. In particular, I want to know: Will it be done by an existing agency, or a new one? Will it be empowered to look for violations, or only able to resolve complaints? What will its budget be? How many people, including how many people directly responsible for investigation and enforcement, will this agency (or these agencies) employ?

  • How will this work so that people who are sick, and thus unable to properly fight for the money that insurance companies now routinely deny them or pay late, are not victimized after they've paid their hard-earned cash for that insurance?

  • Why do you think that progressive chances will be worse if the current bills are killed than if 30 million Americans are forced to buy insurance that they can't afford and that won't do them any good?

  • Just how much time and effort do I have to go through to show that I can't afford any of the health insurance offered? Someone who works full time and has a family, or even a life not related to work, might find this requirement pretty onerous, too.

If you don't have solid answers to those questions, you have no business claiming that you've studied this really hard, or that I or anyone else who objects is being too ideological, unreasonable, selfish, or pro-Republican. Because these questions are exactly what anyone with any sense should ask, and so far I haven't encountered any intelligent answers.

If you don't have intelligent answers, proceed to alternative B. Or you could consider talking to us like we were adults, and realize that a lot of times how alternatives look depends on how much you have to give up for them.

UPDATE: Added the Windows 7 link, and corrected my arithmetic (our family actually has $1K less per year of "discretionary" income than I thought.)

UPDATE 2: Over at FireDogLake David Dayen (A.K.A. "DDay") has a good article on the implications of how the proposed regulations would be enforced. I'd just add that the basic question of how well financed the new enforcement regime will be is another important point. No one among all the people who are telling me and folks like me that we are being immature, or whatever, has even mentioned these concerns, let alone dealt with them.

That should give you some idea why I don't take their opinions seriously.


george.w said...

By sheer dumb luck I have managed to wander into a job that pays well, late in life (retirement, what's that?) But I have not forgotten what it is like to be poor.

This thing has me torn up inside. I hate the idea of handing the Republicans a victory but they pretty much have one no matter what.


Cujo359 said...

They played their hand a lot better than the Democrats did. If the Democrats had the kind of unity the Republicans did they could have had a decent bill. That's assuming they wanted one, of course, which I frankly doubt.

Spocko said...

This is a really good post.

Cujo359 said...

You're welcome, Spocko. Thanks for commenting.

Anonymous said...

Being one of the "poor" people who do live paycheck to paycheck I can only shake my head and empathize with the people who are going to have to put money out for something they won't get anything out of and can't afford. I am lucky to have health insurance but I know a lot who don't.

There was a time when the Democratic party understood and represented those of us who struggle to make a living. Too bad that party no longer exists.

Cujo359 said...

I regret using the word "poor" so much, because this is a condition that many people in America who are well above the FPL find themselves in. If you're living from paycheck to paycheck, you're in the same boat. Marcy Wheeler made that point a few days ago.

Raven Onthill said...

[in passing]

By the way, Washington State turns out to have the most regressive state and local tax structure for the bottom income quintile in the entire USA. It's not too good for the next three deciles, either. Talk about adding injury to injury!


Cujo359 said...

Yes, trying to run a government on sales and gasoline taxes will do that. Sad to say, I don't think we'll have a better tax structure in my lifetime. The initiatives and their fallout have pretty much assured that.

Anonymous said...

Excellent post! The poor and soon to be poor are not going to be helped at all with this bill.