Healthcare Status Quo is Not an Option
I have read all day about the democratic process in action in Massachusetts. I'm a little puzzled that one state's special election matters more than last year's national election (especially when the Democrats ran an appalling candidate), but I agree that Scott Brown changes the healthcare reform equation. Yesterday, FrumForum pictured Obama as "the biggest loser" and maybe he is. But I wonder if the real losers aren't working Americans who would like affordable insurance.
A few years ago, The New York Times reported that an unprecedented percentage of American males between the ages of 30 and 55 had dropped out of the workforce and didn't plan to go back. Some of the men were living on the equity in their homes (good luck with that, the story's from 2006), some were living off their wives, and some had been kicked out by their wives. According to the article:
[T]he fastest growing source of help is a patchwork system of government support, the main one being federal disability insurance, which is financed by Social Security payroll taxes. The disability stipends range up to $1,000 a month and, after the first two years, Medicare kicks in, giving access to health insurance that for many missing men no longer comes with the low-wage jobs available to them.
No federal entitlement program is growing as quickly, with more than 6.5 million men and women now receiving monthly disability payments, up from 3 million in 1990. About 25 percent of the missing men are collecting this insurance.
The ailments that qualify them are usually real, like back pain, heart trouble or mental illness. But in some cases, the illnesses are not so serious that they would prevent people from working if a well-paying job with benefits were an option.
In my extended family, I have two relatives (both female) who have also left the workforce, although one was over 50 when she dropped out. Both were well below retirement age, and both are now covered by Social Security and Medicare. The last part of the excerpt --"the ailments are real but not so bad that no job is possible" -- strikes me as particularly accurate in both cases. I am more familiar with the case of one relative, who was diagnosed with multiple sclerosis about 15 years ago. Her problem is real, and she fended off a challenge from the insurance company paying her long-term disability (the insurance company eventually settled with her and she used the money to pay off her condo). However, she is still able to walk, talk, drive, go shopping, go out to eat, go to concerts, even vacation in Europe. In fact, she is planning her fourth European vacation since dropping out of the workforce. She simply can't work. Her symptoms are apparently exacerbated by stress, and she finds most situations she does not like stressful. She has not worked in over a decade, and her Medicare kicked in before she turned 50.
And in the time both of my relatives have been out of the workforce, they haven't gotten any healthier -- or less expensive to the healthcare system. Disability-securing health problems of multiple sclerosis and back pain have multiplied, and now include morbid obesity, diabetes, hypertension, thrombosis and breathing difficulties. (When you don't have to work anymore, there's no reason not to slide from occasional smoker to chain smoker.) One has become an exceptionally heavy drinker.
To be fair, you have proposed ideas for reform, and have warned fellow Republicans against preserving the status quo. But I fear that preserving the status quo is exactly what Republicans, with their new "majority of 41," plan to do. And the situation I have just described is precisely the kind of perversion that the status quo enforces.
I work full-time. I volunteer. I was mildly overweight for several years, and cleaned up my act after I got a bad lipid panel result, so I have exercised for 10 hours a week for the past six years to keep my BMI at 20. I have seen a doctor just three times in the last 18 months. I cost the healthcare system very little. Right now, my health premiums are pretty affordable (Kaiser offered through the university where I work) but if I lose my job, I could be in dire straits. If I wind up working for a small employer, as I have in the past, my premiums could be exorbitant. And God help me if I develop a preexisting condition. In short, as a working American, I've got no guarantee of affordable health insurance in the long run.
And my relatives who walked away from the workforce, who will never work again, whose lifestyle-induced problems are snowballing? Their healthcare coverage is guaranteed.
Right now, convincing the system that you've got a disability and dropping out of the workforce is a surer path to long-term health insurance than getting up and going to work every day. Maybe that weird numbness in my hip or my past-their-prime knees or that stubborn case of tennis elbow or the gnawing anxiety about what the future holds qualifies me for disability, too. Maybe I'm a fool to keep working. Maybe I deserve to sleep in every day, recline in front of the TV when I do drag it out of bed, complain about "all those illegal aliens taking advantage of this country," and let some other sucker rise before dawn each morning and help keep the country afloat. You and I both know that, in today's political climate, nobody in either party is going to touch Medicare.
And in the crowing over Massachusetts, I don't hear a single Republican addressing this. Maybe I have missed it. But isn't the GOP the party of responsibility and rewarding honest, hard work? Republicans frequently talk about responsibility, but talk is cheap. At the end of the day, you get the behavior you reward.