Affordable Care Act — June 6, 2015 at 11:49 am

If you don’t want to pay for other people’s health insurance, you can’t live in a first world nation



You already pay for my health care. I already pay for yours. We just do it in the most expensive way possible.

For instance, even though the Florida House again rejected Medicaid expansion on Friday, the state will still being paying for program that could have expanded coverage to as many as 1.8 million low-income Floridians. And if these people suffer a precipitous loss of income, the government will end up covering them through basic Medicaid. Or if they get so sick they become disabled, Social Security will cover it. Or if they get a job that offers coverage, taxpayers will subsidize that with the largest tax break in our budget — the employer-provided insurance exclusion. Then, when they get old enough, they’ll be eligible for Medicare and programs that help them cover deductibles. If they eventually need to be in a nursing home and can’t afford it, Medicaid would cover this.

If we didn’t do this, we’d pay anyway. We’d pay in the monstrous loss of human capital both in the both people left alone to deal with the frailties that are common to all human beings and the family and friends who’d inadequately tend to the inevitable suffering.

Why is any of this your problem?

There’s no one in America whose health care isn’t in some way subsidized by the government, either directly via tax expenditures and tax breaks or through government investments in medical research that are then translated into treatments that almost no individual on earth could afford to fund alone.

In this way, we are like every other first world country on earth. What makes us different is that we choose to leave tens of millions uninsured — and because of this we lose about a trillion dollars a year that could go toward raises or hiring new employees.

As you surely know: Every other first world nation insures all their citizens. They all do it for less than we pay in America and they tend to get better results with lower costs, as this infuriating chart shows:


This week, Ann Arbor’s own Jonathan Cohn, one of the most respected and fair-minded health care reporters in America, got into a bit of a Twitter debate with Breitbart‘s John Nolte, one of the most Breitbartest reporters in America.

The debate quickly nosedived into a point that many conservatives believe and no Republicans run on: Medicare, public education and possibly even publicly funded stop signs are forms of fascism. Nolte favors an end to the employer-provided insurance tax break and all tax breaks replaced by a consumption tax that would be used, I assume, to fund the “common defense” while leaving our “general welfare” to private charities that chant, “Get another job!” at single moms who can’t afford health insurance.

This kind of radical honesty is refreshing because usually you have to read between the lines to get that Republicans truly oppose the things that make us a first world nation.

Offering everyone health insurance is the cheapest, most effective way for a humane society to operate. Conservatives used to have an alternative to that plan, it was Obamacare. And it’s working with our health care costs now predicted to be trillions lower than they were estimated before we passed health care reform, as we’ve experienced the best job growth of the century.

We should be talking about how to ensure the remaining uninsured and lowering out of pocket costs. (I think a Medicare buy-in would be a great way to start to do both.) Instead, we’re just trying to keep Republicans from using the courts to win political battles they lost at the polls.

Conservatives have a vision of a society so radical that it doesn’t exist in human experience.

They want the advanced health care our affluent Americans have come to expect with no government involvement. And they want us to sit back as mass misery afflicts the tens of millions of Americans, maybe hundreds of millions, who would be priced out of a private-only health system.

Medical costs paid by insurance are by nature pooled because that’s the only way the unpredictable becomes affordable. Increasing the pool reduces the individual costs and provides security that individuals could never find alone. This works in every advanced country on earth, including our own, just not as well as it does everywhere else.

In a first world nation, we all pay for each other’s health care. We do this not just because we’re good people, but because it’s stupid not to.

[Image by NIAID | Flickr]