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.