In the upside-down world of the tea party GOP, the individual mandate — a solution to the health insurance crisis that was created by an ultra right-wing think tank that requires all working Americans to be covered by private health insurance — is “socialism.”
That’s right. In the topsy-turvy minds of Fox-watchers, Dittoheads and teavangelical neo-Confederates, a system that would create as many as 50 million new customers for giant private health-insurance corporations is not capitalism on steroids, it is the stuff of godless communism.
In reality, the “socialist” approach to health-care coverage is a single-payer system — which also happens to be the system deployed by most industrialized democracies in the world, including all our major competitors in Europe and Asia. These countries do not require their automakers, software companies, real-estate developers and the rest to pay for their employees’ insurance — which means that the owners of those companies aren’t forced to inflate the price of their goods and services to cover the cost of their employees’ insurance. That cost is born by the citizens of the country, collectively.
That is socialism. It is similar to the “socialist” systems we have in the United States in which we collectively pay for socialist public schools and universities; socialist public hospitals; socialist fire, police and emergency services; socialist highway, airport and seaport construction as well as socialist pensions (Social Security) and socialist health-care coverage for seniors (Medicare).
For three years, tea party Republicans have promised that they will repeal the Affordable Care Act and replace it, ostensibly with a “free enterprise” solution. The fallacy here — the upside-down absurdity in this argument — is that the system we have now is a “free enterprise” system, and, as this new study from the National Institute for Health Care Reform [PDF] shows, it is collapsing before our eyes:
Between 2007 and 2010, the share of children and working-age adults in the United States with employer-sponsored health insurance dropped 10 percentage points from 63.6 percent to 53.5 percent, according to a new national study by the Center for Studying Health System Change (HSC). The key factor driving the sharp decline was the enormous loss of employment during the Great Recession, which officially started in December 2007 and ended in June 2009. The proportion of the population younger than 65 with no workers in the family spiked 10 percentage points between 2007 and 2010, from 21.6 percent to 31.6 percent. The decline in employer coverage disproportionately affected young adults, people with a high school education or less, and people employed in small firms.
Even when employment rebounds to pre-recession levels, a return to previous levels of employer-sponsored health insurance is unlikely. Well before the start of the recession, a steady decline of employer health coverage was underway with fewer firms offering coverage and fewer workers taking up coverage—likely because of rising health care costs.
What this says is that the system that has provided workable insurance coverage to many (but not enough) Americans is coming apart at the seams. And this in turn means that if health reform goes down, we’re going to be looking at a wave of misery spreading across the land.
Most Americans simply have no clue how bizarre it is that we rely on employers to provide health insurance for most people. We’ve all grown up in this sytem, so it seems completely normal. But it’s not. It happened through a weird combination of historical accidents, and it makes no sense. Why should an airplane manufacturer also be in the healthcare business? Why should you lose your health insurance if you get laid off? Why should your choice of doctor be limited by your employer’s choice of insurance carrier? (And why should it change whenever your employer decides to change carriers?) Why should your boss be allowed to dock your paycheck if you don’t get the medical “counseling” he deems necessary? (Yes, this is real. And it’s rapidly making its way to a corporation near you.)
It. Makes. No. Sense.
There is a key point here that is never brought out by the corporate media, opinionists on the left or, certainly, by Republicans: If the health-insurance corporations have caused the crisis in their industry and, if they wanted to , they could fix it tomorrow. All they would have to do is cover everyone. That is what real capitalists would do. They would see the 50 million uninsured people in this country, not as a massive pool of bad risk, but as a potential market, ripe for the picking.
As the chart above shows, for years now, health-insurance corporations have been sloughing off their risk by systematically denying coverage to certain groups, either by their own corporate regulation — i.e, the uniquely American status of having a preexisting condition — or by charging so much for premiums that part-time workers, minimum-wage earners, the self-employed and others are priced out of the market.
In creating this pool of 30 to 50 million uninsured Americans, the insurance corporations have essentially socialized the risk in their industry. When the uninsured require health care, they generally receive it in emergency rooms, which are the most expensive health-care venues of all. Since most of them cannot afford $700 a month and more for insurance premiums, it follows that they also can’t afford the thousands of dollars in charges that are routinely racked up during emergency treatment.
When the uninsured default on their hospital bills, those costs are paid by local taxpayers. And that, too, is socialism.
The Affordable Care Act is not socialism, but it is a solution. On the other hand, what is the tea-party Republican solution to this crisis? Where is the alternative “free enterprise” system to Obamaneycare they have promised for three years?