See here the quotes: "Americans have choices, and they've got to make a choice. So rather than getting that new iPhone that they just love and want to go spend hundreds of dollars on that, maybe they should invest in their own health care."
Clarification about what he really meant: "What we're trying to say - and maybe I didn't say it as smoothly as I possibly could- but people need to make a conscious choice and I believe in self-reliance, and they're going to have to make those decisions."
OK now that we're clear, I want to introduce this person, and what I'm learning to be a SIGNIFICANT amount of people in power to what the world ACTUALLY looks like. While there may be just buckets of choices for this man and his friends, those choices look very different for others.
First: what can we agree on? Making good choices. 100% agreed. I definitely think that there are things that are far more worthy of our investment than others. I think that there are choices that most folks would agree to be universally wise, and others to be universally unwise.
What do we maybe have agreement, but some caveats about? Americans have choices. OK- in a way, I agree. Americans do have choices. But I think that a lot of Americans at the top of the food chain don't realize something, when you go down the economic ladder, your choices become narrow to nearly obsolete, or at the very least ridiculous. "Food or healthcare?" "Shelter or healthcare?" "Job or healthcare?" These are real choices that many lower income families have had to make. I think, in part, that this was the complaint of many folks with very low income (but not medicaid qualifying) about the ACA- the affordable health care still wasn't affordable, and they were penalized for not having it. I can see the frustration. It isn't a perfect plan, and I would be really happy if we could work on it to make it truly affordable for everyone (or come up with a new system all together). I also had friends who I knew to be quite stable financially complaining about their raised health care prices. I understood their frustrations, but was far less sympathetic to them. If my added contribution to the whole means that millions more get healthcare (and indeed lives were literally saved)- then it is a sacrifice I am willing to make. I understand that the more comfortable complainers may not have voted for the legislation, and therefore the sacrifice was not willing. I get it- but I'm still not convinced that your burden is unlivable. Not every painful thing is wrong.
Back to the choices that Americans have.... in an ideal world I could choose to have zero assets (so I can pay for healthcare), live in a low-cost-of living area (which incidentally also has a high job rate and high quality mass transportation so I can have a job but not need to own a car- a luxurious thing). If this was possible, I think many Americans would go for it. But this life is almost imaginary. I don't think that choice is very likely- or if it is I better be single and gifted in a very specific job field (to be announced once I find that magical place). The trouble is- where the good jobs are- often- so are the expensive houses. Funny how that works.
So when we say that Americans have choices, we mean different things. You think that Americans have a lump sum that they choose to spend on extravagant things (like an iPhone) when they should be investing in their health care. I think that you have no idea that many, many Americans do not have lump sums. In fact, many are in terrible debt. They could not get that phone (which might be their only phone, and likely was purchased second hand because if you're poor- you know about these things)- but it wouldn't make a dent. If you don't buy a TV or phone, that does not free up your finances for a lifetime of health insurance. SO you may as well be happy and entertained while you are dying.
It's hard for me to argue with this ideology (that people just need to manage their money better) because it is based on a false premise: all people have money to invest. If your argument is based on something that isn't true, it renders the rest of your argument as null and void. Additionally, if anyone thinks that health care coverage is simply about investing the right amount then they have shown their privilege card. It shines a spotlight on your ignorance of the plight of the poor. If everyone had enough money to invest (even when pinching pennies) in order to have quality healthcare- then we wouldn't be having this conversation. I think that the folks that Trump whipped into a frenzy about repealing Obamacare truly thought that they would get better health insurance that didn't cost as much. And those that were rich knew exactly what the Republicans meant and knew that maybe they wouldn't have to subsidize their employees' healthcare plans, or at the very least they could go back to providing the bare minimum. Helping the poor will always mean that those who have more money might have to fork out more money. Rich people don't like to look stingy or uncaring, so they hide behind platitudes like "self-reliant" that make poor people who don't need a doctor or government help feel like they are some kind of heroes. But it doesn't help ANYONE. Equating ability to acquire wealth with the ability to be self-reliant is a dangerous and terrible equivalency. The ONLY people who can afford to pay for their own healthcare at cost are the extremely wealthy. The REST of us HAVE to have health insurance or face bankruptcy. A wealthy person purchases health insurance because it is a better fiscal deal. A middle-class person purchases health insurance because it is a fiscal death sentence if anything happens (and as we know- shit happens to everyone). A poor person "chooses" not to have health insurance because they need to pay rent and feed themselves.
I have a friend who is in that scary space between health care and rent money. She doesn't qualify for medicaid but also doesn't have employee based health insurance. She chose rent money. The penalty is less than healthcare coverage. She shares an apartment with I think five other people. She is getting married in a year and is holding her breath until then. I found myself suggesting she elope just for the sake of getting on her husband's health plan. No one has to know you're married, I said. Isn't that a romantic story? I'm praying nothing happens before she gets married.
Health care is expensive. Too expensive. That is an issue that I believe has bipartisan agreement. The disagreement is about how to lower those costs. Unfortunately no one has figured out a way to make everyone happy. Which I get is nearly impossible. Republicans seem to be aiming to please business owners who don't want to subsidize their employee's health care, and the super elite who want a fatter paycheck at the end of the day, damn the poor. They tell the poor that they will somehow get them better health care for less money, and I'm really curious how that's gonna work out while also being this new brand of Republican that is hell-bent on "self-reliance."
I get it- we don't want to hand out silver platters, but last I checked- most people just want to be healthy and not have to go bankrupt getting there. I am not even asking for hearing aid coverage. It would be nice- but I've lowered my expectations, it's called compromise. I'll pay for my own damn hearing aids if you will not close the only nursing home that has medicaid beds. Because when I worked for hospice- that was hard to find. We had to chase dead people to get our patients into available beds that would take medicaid payment. By the way- the baby boomer generation is aging, and they're living longer, and a lot of them lost their savings when the hosing market crashed, so we're about to face a shit-storm. But back to the point.
Something that seems to be getting lost in the process of making everyone happy is all these people who can't go to the doctor or do go into crippling debt or DIE because of the INHIBITIVE cost of quality healthcare.
I was born with a spinal condition that required (as of today) three surgeries. All covered by insurance with some out of pocket expenses that were paid either by my parents or myself (two of the surgeries were while I was still under their healthcare plan). Because I am squarely in the middle class and lucked out with quality health care- I am not bankrupt, nor are my parents. Oh, I was also born hearing impaired which necessitates hearing aids. Those aren't covered by insurance, so I save a little money in order to pay for my inevitable new set of hearing aids every 5-10 years depending on the quality and luck of the set I bought. Some (few) insurance plans cover hearing aids, but as my only option for affordable insurance is under my husband's plan which is not one of the few, I accept that I am responsible for saving up for these important things myself. I cannot do life without them.
Last year a man who was under the influence of drugs hit my minivan with me and my kids in it. It was his fault, he was ticketed, and his insurance paid the bill and gave us a little extra for any health issues (which none of us had luckily). My van was older and paid for. I now have a monthly payment I did not expect because my paid-for vehicle was totaled, but as it was older, it wasn't worth as much as the newer model I now drive. I have the best car insurance, but I didn't get money for a brand new car because that's not how car insurance works. It gives you the value of your vehicle, and while my vehicle had plenty of life left in it- its greatest value was that I didn't owe anything on it. That monthly payment was not something I made a plan for because my old van still had a lot of miles left on it, so I wasn't paying myself huge payments to prepare for the next vehicle (which is what I've been trained to do after I pay off a vehicle). I had only been putting away about $150 a month towards the next vehicle because I knew I had longer to prepare for a new vehicle, and I had other payments (like the hearing aids) that I expected would come first. So I didn't have much other than the insurance to put down on the van, and now here I am with a monthly payment I didn't expect. But that's life- and that's why I have an emergency savings, because even when we weren't making a huge amount of money, we had enough to put away in small amounts.
So this is just a tiny little example of someone who is making really good choices but still had some set backs. I'm hoping that my hearing aids last a little longer than usual so that I can afford to buy the replacements without taking on debt (or dipping into emergency savings). I'm hopeful that my other, older car (that was supposed to "go" first) lasts a lot longer than I expected. Because if any other financial catastrophe happened, I may have to choose between hearing aids and a car. Which I can do- because of my current life situation.
My story is about as boring and privileged as I thought you could get. Because ultimately, I know I can make sacrifices if I need to. I have a few safety nets. Obviously my hearing aids are important, so if we have to make it work to become a single-car family, we'll figure it out. I can get a job because I have a skill set that is marketable in a field that pays more than minimum wage. But guess what- I am actually not as privileged as they get, and I think that rich people think I'm poor. The kind of poor who can choose not to have a iPhone so they can have health care. But I'm not. I'm pretty comfortable. Which makes me realize that they have NOOOOO idea what it's like to live on less than $50K a year. The medium household income for folks in the United States of America is (to round up) $52k. That's the number that takes out the outliers of crazy wealth and crazy poverty, and it is household- meaning all the people in the house.
Literally one hospital visit without insurance can put you back $52k. How do you save for that? I guess what the Republican was saying was that you save for the health insurance. Ok. Gotcha. Health insurance (the way this new plan has it) for people who desperately need it (pre-existing conditions, maternal, cancer, etc.)- is going to be hella expensive. So expensive that you might wonder if it is worth it. Or if you should just stay in pain, go off the depression and anxiety pills, stop physical therapy, not get the surgery, not have the baby or not get prenatal care and hope for the best. What does that give us? A society with sick people. Last I checked, sick people aren't very productive. And as much as I hate it- our society spins on productivity.
I live in an affluent area (not by choice, my husband is a pastor and we live in the church owned parsonage). I feel very lucky to live in such a beautiful community with amazing schools. Our last church was in a more blue-collar area and we loved it there too. I'm part of an online community with folks in this area and recently someone asked what the average tuition was that folks were paying for private school. My mind was absolutely blown. BLOWN. First, we live in one of the BEST public school districts there is. Second- people paid around $30k for each child to attend these schools. The discussion was so blasé I realized that this was normal to them. They actually had an extra $60k to spend on their kids' schooling- EACH YEAR. I'm not going to get into the whole public vs private school debate here because that's a completely different blog. However, this conversation made very clear to me just how oblivious some of these folks were to the rest of the world. One talked about struggling to make it work, and I thought- no- struggling to send your kid to private school when you have high quality schools down the street- that's not the same kind of struggle that the regular American suffers. It just opened my eyes to the wide chasm that is between the "haves" and "have nots."
So when someone says that we should just not buy an iPhone in order to invest in healthcare... I just get really, really angry. Because I realize that here is a man who honestly thinks that most of America can have quality healthcare if they just save enough money. So either this man has absolutely never met a poor person, an elderly person, a disabled person, a person with a chronic illness, or a hard working person working minimum wage, or a couple with masters degrees with a premature baby, or grandparents who saved for two and now have two grandkids because the parents died, or LITERALLY 98% OF THE UNITED STATES OF AMERICA. Either he hasn't ever met them, which means he lives in a bubble and should be revoked the right to represent if he represents a fraction. OR he doesn't give a shit. And both of those scenarios are reprehensible.
But you know, make good choices. Be born wealthy or have your hard work and luck be one of the success stories, and forget everyone who helped you get there. Because you are self-reliant. You never had teachers, friends, parents, loans, roads, nutrition, or anything. You did it all your damn self.
Make good choices. Get off the TV and go meet some Americans.
That was a mic dropper!
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