America has been having a pretty in-depth discussion about healthcare for almost fifteen years now. The affordable healthcare plan was created under President Obama and Republicans have fought this idea tooth and nail and probably wish for a more open market system where competition will drive prices down. I think if most people saw the pharma/medical insurance machine’s ability to lobby government & influence medical practitioners with a dedicated sales force, and the money at stake, they would realize that will never happen. Medical networks break up any chance of a free market and pretty much sets the system up in the same way that makes a college text book $300. I would LOVE a free-market solution but the parties involved would never let that happen. Conservatives can’t solve their concerns with big tech with the free market but somehow believe that healthcare is different when private equity firms are digging their claws into the industry. I believe the left’s talking points around healthcare have not framed the issue correctly. “Free healthcare as a human right” will never win over half of the U.S. population. I think there are other ways to discuss the benefits of a single-payer plan that are not tied to employment and it relates more to how it can positively impact equality of opportunity, creating freedom from large corporations, protecting the rights of the individual, and drive a real impact for small business and entrepreneurship (even during pandemics). This should be a discussion on how a program could help Americans become a more free people. These ideas are not free. They would come at a cost to everyone but the benefit would be worth the prioritization. Listen, I’m a simple guy with a decent education, but I am not a medical expert or policy-maker, so think of this as aspirational vision of what could be achieved vs a technical roadmap to success.
Equality of Opportunity
I’m a big believer in allowing the individual to accumulate wealth and pass it on to one’s family but there are several gates in life that should be meritocracies (jobs, universities, etc) and other things that help ensure that everyone gets a fair shot at success (free quality K-12 education). It is my belief that a single-payer program that de-risks the entire insurance pool is important to ensuring that hard-working families, that are rising into the middle class, are not crushed by medical conditions outside of their control (cancer, etc.). When a family member gets seriously ill, it can stunt the wealth accumulation of a family for several generations. Having a fully-insured population will likely lead to increased preventative care and and maybe even reduce the risk of wealth-destroying medical events. Every American should have the ability and right to be a free and productive member of society and not be destroyed massive medical debt or have their chances of success affecting by the medical conditions of a family member.
Freedom from Corporate Control
When we tie insurance to employment, we tie Americans to large corporations because the ‘benefit’ of affordable healthcare can be more important than base pay. As far as I can see, this causes two issues:
- It hurts entrepreneurship and work flexibility.
- It can limit personal liberty.
Entrepreneurship and Work Flexibility- Pursuing a new business is financially risky and many Americans lack the means to create a new business. On top of that issue, an individual may not pursue an entrepreneurial career because they are concerned about exposing themselves to health issues and the inability to pay for medical treatments while being uninsured or the expenses associated with the open market place. If quality business people are afraid to start their own businesses due to the loss of benefits that they get from larger employers, the nation’s talented workforce will be retained in a small group of companies, which will remain in certain powerful commercial hubs (NY, LA, ATL, DAL, etc). This lends itself to geographical have and have-nots. On top of that, 1/5 of all workers in America are contract workers, meaning that they are not guaranteed benefits (health care). It is in a company’s ‘best’ interest to maximize the amount of contract workers in their work force to avoid paying for the employee’s health insurance. Publicly traded companies will always tend toward driving bottom line growth even in down markets. It lends itself to an environment to increase the number of contract employees and therefore less coverage/benefits paid for. If national affordable health insurance could be realized, it would remove some of the incentive to increase contract employees. This would give the employer greater management control over their employees and greater stability for the employee.
Limitations on Personal Liberty- We live in a time where our personal lives, political beliefs, and work lives are becoming dangerously intertwined. A person’s poor choices or just running afoul of the current cultural zeitgeist in the digital space can lead a private citizen to losing their job or prospects of future employment. It is a company’s right to let an employee go because their values do not align or their speech might damage the company however, when affordable insurance is tied to employment, it creates a defacto short and long-term financial penalty on an employee that is fired for actions that once were considered “off-the-clock.” Some people might enjoy seeing one punished for not fitting in with our norms but I see the loss of medical coverage as an extreme penalty for the loss of employment. The extension of this problem might give employees pause before pursuing union activity or expressing their political beliefs because the fear of losing medical coverage gives the employer leverage over an employee’s natural and stated rights. This gives corporate entities the power to easily trample the rights of individuals by tethering employees to needed health coverage.
Economic Prosperity for All
On the commerce side of the argument, small business would benefit the most national healthcare plan. Large corporations and cities own the tyranny of talent. Most large companies attract employees with superior benefits that small companies lack the scale to compete with. Imagine the economic boon to small towns and companies if they could attract top-tier talent because healthcare benefits are no longer a competitive advantage. Employees could escape the high cost of living of the cities and push jobs into smaller cities and rural America. This would also push the real-money economic growth in America to the local community vs the speculative gains in the stock market which only benefit a portion of the country. This argument is only as good as the desire of folks to escape urban sprawl but it helps create the mechanism for change.
A Network Built for Pandemics
Global pandemics will not go away and with exponential population growth around the globe, they will become more common in the same way that a large deer population without adequate natural predators will start to carry diseases. Our medical network needs to be unified and simple enough for the majority of the population to take advantage of during a pandemic. This is not some humane argument. The working-class American will need to drive the country’s GDP during future pandemics while limiting shut-downs. It is in our strategic interest that Americans (employees, contractors, gig-workers) are able to get healthy and keep working during a pandemic. Our current approach is like taking a NFL team through a season without team trainers and doctors for a portion of the team. The team starts to break down and overall performance degrades. We have medical coverage in the military as a matter of protecting force-readiness. Our national economic power, which drives more influence than our military, requires the same care. Globally, we compete against countries that will have this as a competitive advantage against us. We have to even the playing field.
What the founders could not have imagined…
The founding fathers were some of the most revolutionary thinkers in the history of the world. That being said, they would have been shocked by the industrial revolution and even more so by the information age. Aspects of the economy which, were unthinkable concepts, are now damaging American lives. I fully understand a healthy distrust of government but worrying about being trampled by government while being actively trampled by multinational corporations is madness. A large, nation-wide single-payer insurance model would create an environment where people could be more free to grow their own businesses, speak their own mind, be unafraid to unionize, and given a greater chance to fight corporate tyranny. It, in no way, would guarantee the success of the individual, but it would help create the security needed for individuals to grow their own personal wealth outside of the umbrella of larger corporations without the fear that health scares or pre-existing conditions will crush a family’s wealth for generation.
