Without a safety net, ctd.

Yesterday’s post got an interesting comment conversation going, so I thought I’d add in a bit of data.

The term “safety net” is more applicable than some might think. Because most Americans get their health coverage from their employers, being unemployed means being uninsured. When I quit my job to move to Portugal, I was uninsured for two months. I did have the option of buying COBRA, which is a government-mandated continuation of one’s previous health insurance, but without the benefit of the employer’s subsidy. This would have cost me around $600 per month. While my non-American readers are gasping over that, I should add that the $600 figure was just for me. Had I been the head of a family, trying to cover a spouse and a child, it would have been much more.

(And that was in 2007. The monthly rates for 2012 are $990 for a single person, and between $1,327 and $1,357 for a family. Per month!)

I had a choice for those two months that I was unemployed and still living in the US: pay $1,200 for insurance, or use that money for my overseas move and hope like hell that nothing happened to me. I didn’t pay. It was a gamble and I was stressed up the wazoo about it, but I got lucky. Not everyone is so fortunate, and the sheer fear factor of being uninsured cannot be adequately described. (Though I think Mr. Zelnio did a pretty good job of it.)

Every American who is temporarily unemployed, or even newly employed — most health plans don’t kick in until at least one full month after a new hire’s start date — has either paid through the nose for coverage or experienced the high-level stress of gambling with their health and their life savings. It only takes one nasty car accident, or a diagnosis of cancer, to ring up medical bills of $50,000–100,000 and higher. Don’t even think about needing a coronary bypass or a knee replacement. And if anything happens to you while you’re uninsured, then you can forget about ever having reasonable medical insurance again, because you’ve just joined the ranks of those with the dreaded “Pre-existing Condition.”

Having medical insurance reduces this stress, but doesn’t eliminate it, because health care in the US is now provided by corporations. Yet their purpose is not to provide health care. It’s to make profits, and they have legions of lobbyists who make sure that Congress doesn’t do anything that might jeopardize those profits. What this means is that the policyholders, the people who look to these corporations for their health care coverage, are not clients. They are simply revenue sources. The clients are the shareholders who have bought stock in the health care corporations.

Since the whole point is to maximize profit, the benefits offered to policyholders are continually shrunk, stripped out, or denied. This decreases payouts to policyholders and increases revenue. The system has resulted in a tiered coverage, in which those having the highest paid jobs also have the best medical care, while those in lower-paying jobs have far less coverage and thus must pay more, sometimes much more, for what health care they get. Americans often say that the US has the best medical care in the world, and in many ways it’s true, but the corollary is that only a minority can actually afford it. The rest either get lower-quality care or just do without.

An example: My mother once spent a few months working as a temporary employee helping to stock and open a new retail outlet for Sears. She took the job to earn some money for a vacation, but near the end of her time there, she contracted a nasty stomach virus from one of the other employees.

Now, she was covered under my father’s health insurance. But his plan didn’t cover ambulances. (Stripping benefits to minimize payouts, remember.) I will never forget seeing my mother lying on the floor, writhing in pain, but still coherent enough to say, “No ambulance! We can’t afford it!”

Dad drove her to the hospital, where she was kept overnight. The resulting bill, even with his medical insurance, effectively wiped out everything she had just earned from that temporary job. No vacation that year.

Americans all live with some form of this stress. Either they have medical coverage but worry because it doesn’t cover all of their expenses (which is common and becoming more so), or they don’t have medical coverage and live in abject fear of a medical issue costing more than they can pay. It is true that in the United States, you can be driven into bankruptcy by medical bills.

When I moved to Portugal and became familiar with the medical system here, I lost that stress for the first time in my adult life. I had not realized how much it affected me until it was gone. It is a quality of life issue — and most Americans don’t have that quality of life.

Yet, somehow, many of them have been convinced that it’s the rest of us who are unlucky, because our health care is socialized. We can see a doctor whenever we want, and we live without the fear of being financially ruined by a health issue, but we’re to be pitied, because socialism is evil.

Now that was a hell of a political trick.


About Fletcher DeLancey

Socialist heathen and Mac-using author of the Chronicles of Alsea, who enjoys pondering science, politics, well-honed satire (though sarcastic humor can work, too) and all things geeky.
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8 Responses to Without a safety net, ctd.

  1. syrin says:

    You know, now that I’m finishing my rewatch of The West Wing, a show that for all intents and purposes presents the “ideal” US government, the one where you have people who actually TRY to make things better for all of us, I find it uncanny that one of the things they couldn’t get rid of were the lobbyists.
    Yes, every country has them, even if sometimes they have different names, but in the US it just seems like lobbyists are part of the culture. Which is strange because let’s be honest: what they do should be illegal…
    Oh well, Portugal might not be the best country in the world, far from it. But in terms of health care, we’re at in the middle field in Europe. According to friends who live in France, England and The Netherlands, our NHS is way better then theirs.

  2. Alma says:

    Socialism is evil? I hope that was irony on your part, because if many Americans really see it that way, that’s just scary! Capitalism is evil, in so far as a political system can be anything of that kind, and the U.S. is probably one of the most capitalistic countries on Earth.

    • oregon expat says:

      I’m afraid it’s not irony. The Republican Party has been demonizing socialized health care for years now, and the term “socialist” is a pejorative, used with great frequency to denigrate Obama and paint him as someone who “hates America.” Because, you know, wanting everyone to have equal access to health care is completely un-American. (Okay, that part was irony.)

  3. So depressing. I’m one of the fortunate ones with a job with health benefits, but I worry with this economy that my status could be erased in a moment if I were to be laid off.

    You’re one of the lucky ones to be living in a nation that realizes having the government pay for/cover healthcare is not evil–it’s necessary.


    • oregon expat says:

      Having had a job where I feared being fired, I understand exactly how you feel. Perhaps you can take some hope in the improving numbers of the US economy?

      (And yes, I know I’m lucky!)

  4. M. says:

    I think you got it right. They look for profit in wrong places. There is also something very wrong with money distribution.
    Using the same simplification, one could say that sole Apple could provide free health care and education to 38 000 000 people. But all these money are in hands of only few.

  5. Carla says:

    I know I’m very late to this party, but I’ve just now finished reading the Scientific American article and then I read this post, and I just can’t resist jumping in to say that I will never, ever understand how something that should be a basic human right is seen in the US, first and foremost, as a profit-making venture. More baffling than that for me, is the fact that there are so many people who actually support this privatized health care system (sometimes frighteningly so, as evidenced by some of the comments in that SA article).

    Sometime after Obama got elected, and talk of health care reform started coming up, I remember watching the news and seeing people protesting with signs and such against any kind of reform, with arguments like, “we don’t want the government interfering in our medical care”, and yes, the ever popular “socialism is evil” argument.

    Granted, being Portuguese and having lived in Portugal all my life, I’ll admit to not having an in-depth knowledge of this intended reform and its actual implications, but from what I understand, people would still have the right to choose, correct? I mean, if someone can get health insurance from their employer or if they can afford it or whatever, I assume they would still be able to get it and that nothing would change in that regard. But what about the millions of Americans who have a job with lousy benefits or who are simply unemployed and struggling to make ends meet? Don’t these people count? Don’t they have rights? I don’t understand how those protesters can be against something that could help millions of people. Do they actually think it’s normal to have to mortgage one’s house or take out crazy loans to pay for what in so many other countries is basic (and free) medical care? I really don’t get it. As someone said in one of the comments here, it just does not compute. I mean, having to pay thousands of dollars for children’s vaccinations? Really? That’s absolutely crazy.

    Anyway, now that I’ve rambled a bit, I’d just like to say that even though this is my first time posting a comment, I’ve been following this blog for a few months now and I’d like to thank you, Oregon Expat, for your many entertaining, amusing and informative posts which, among other things, definitely appeal to my geeky side. Also, it’s always fun to “see” Portugal through the eyes of an outsider, so to speak, so thank you for that as well. You’ve certainly given me lots of laughs with your insightful observations on Portugal and its people/customs.

    • oregon expat says:

      Thank you, Carla.

      I remember those signs saying “Get the government out of my health care” and variations thereof, which was hilarious given the fact that most of the folks carrying those signs were on either Medicare or Medicaid — both of which are government health programs (read: socialized medicine). That’s the true irony, that we already have socialized medicine in the US, and the people on those programs would (and do) fight tooth and nail to keep them. But somehow, Medicare is an American civil right, while “Obamacare” is an attempt to destroy the nation with evil Europeanized socialism.

      What it all comes down to is a very ignorant voting population, packed with people who can’t be bothered to learn anything for themselves. They just listen to their chosen demagogues and vote accordingly. Sadly, that’s not a problem limited to the US.

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