Health care is deeper and wider than most of us probably realize. That came home to me after reading a fantastic article on single-payer healthcare from Jacobin, one of my faves. It’s also a concise and critical review of the Bernie Sanders single-payer plan. Single-payer is shaping up to be the major political game-changer in the coming years. All of the major potential Democratic Presidential candidates have already lined up behind Bernie on single-payer. So, I’m passing this fine article along to my readers.

At the core of the problem is a basic fact: it’s not profitable to insure people who are sick or likely to get sick.

“Without massive government subsidization (or, in the case of Medicare or Medicaid, government financing and cost regulation), profit-seeking insurers, with relatively small pools of customers among whom to spread costs, are compelled to restrict coverage, increase premiums, illegally coerce sick people to drop their plans, or abdicate their responsibility entirely and push the costs of care onto their customers.”

The United States may be a country where Saudi princes can fly to get a heart transplant, but it remains a place where poor men die fourteen years earlier than rich men.

“In a land of resplendence, the powerful condemn the marginalized to chronic illness, because it’s not profitable to provide nutritious food or adequate shelter.”

Included in the article is a discussion on “how do we pay for this?” As well as a critique of its possible shortcomings.

https://jacobinmag.com/2017/10/single-payer-medicare-for-all-bernie-sanders

5 thoughts on “The Case for Single-Payer

  1. There is the factor of money that secretly destroys health care no matter the approach.

    I am so glad that way back when…? Our society somehow held life as a standard value. So, I could go to the hospital bleeding, not breathing – some serious emergency – and I would be treated first/ask questions later.

    This had a cost. And the cost has added up over time. It is enormous. But way before that cost added up over time, we knew the right thing to do and did it. Now, that is getting a bit cloudy because of money.

    I happen to be less suspicious of government than private corporations, but that doesn’t mean I am not suspicious. I think that either way you go, you have to figure out how to pay for it, and that will either require foregoing the standard of life or someone will have to handle a LOT of money.

    There is a term for it (I think) that I cannot remember just now. But the concept is not new… Some work we do produces real/tangible goods and services. Some work is just speculations – and playing with money. (Investors, banks, and insurance companies etc).

    Oh, I get it. The insurance company sells the service of “assuming the risk”. In theory, this is correct. But the moment it becomes a money-handling business proposition, our soul is sold to the devil.

    When my grandpa was a kid, he lived on a farm in East Texas. He might be out ploughing the field and see smoke over the trees from a neighboring farm. IF that happened. he dropped the plough, ran up to the house and grabbed some essential things, and then ran to the neighbors to help fight the house or barn fire. And all the neighbors from all the surrounding farms did the same.

    This is why State Farm Insurance uses the slogan “Like A Good Neighbor”. This is a social phenom of yesteryear. Just be virtue of being neighbors, people felt a sense of responsibility for one another. And the guy burned out knew that next week it might be the other guy, and he would drop his plough.

    Whatever the case, many of these communities would gather at the fire site. Help put out the flames if possible. They would likely stay (and eat and all – sometimes for a day or two) and not leave until the whole community had rebuilt the barn or the house.

    This is what COMMUNITY is all about. (And to my way of thinking, HOME is at the center of that!)

    We have replaced this system with private corporations that have handled larger and larger sums of money for centuries, really. The business of it all has grown exponentially.

    When it started, sure… the humble insurance company and/or bank needed to make a profit margin on which to live. A banker needs to eat too. I get it. But eventually, this business really took off. It was not a matter of a banker needs to eat… It has become a matter of a banker needs a private jet. And we give our little 5% here and there to these organizations where just the giving really adds up eventually. But then they take that money and invest it, and it starts making more money. Then the banker and ins guy can afford a second home and a fancy vacation of my 5% and yours and the next guys, because that is adding up on the one hand and getting investment returns on the other.

    And somewhere along in here, me and my neighbors stop seeing each other as people of mutual dependence and more as “those filthy Democrats” or “those nasty Republicans” etc… And it becomes a foreign idea that if my neighbors house floods or burns that I might have any responsibility toward her. I think the dumb ass Democrat should have invested wisely and bought a better ins policy, and that his problem has nothing to do with me.

    Somewhere along in here, the Ins guy starts saying, Hey. We have 10% of our customers committing fraud against us. That is cutting into our profits. How can we compete with Allstate and Geico if we have this fraud going on? So they get investigators on the payroll to police the customers. But then you gotta pay the investigators now out of the profits, so you jack up the premiums a bit, and everyone just thanks God they can afford to have a policy.

    But then the Allstate guy starts saying, we have fraud too, and we have investigators, let’s lawyer up and deny some of these claims! Then we can keep more of our hard earned money!

    Hard earned???

    Yeah, jerk. Shut up and pray to God or something! I am making a buck off you.

    And then the state legislature enacts laws requiring I get the insurance! Wow! Now I am forced into the game that used to be practically free – except the love of neighbor. But my banker, his lawyer, and the politician are all getting rich while my 5% becomes 10%.

    And I am sitting around with my thumb shove in my crack thinking Those Democrats are going to help me…

    Look. I like Bernie too. If I were a voting kind, I would vote for him. But Obama was a good president. I will not worship the guy. I did not like all his choices. But I like the guy and thought he did as good a job as a black president can in a racist country. And it really doesn’t matter that Bernie is white.

    And if we get the government to do the same money game as the private jerks, then it spoils that honesty and integrity too. That is just what Mammon does.

    Liked by 1 person

    1. Agent X: “When my grandpa was a kid, he lived on a farm in East Texas. He might be out ploughing the field and see smoke over the trees from a neighboring farm. IF that happened. he dropped the plough, ran up to the house and grabbed some essential things, and then ran to the neighbors to help fight the house or barn fire. And all the neighbors from all the surrounding farms did the same.”

      On my first full day in Alaska, I got up real early, on only a few hours sleep and flew from Anchorage to the island of Kodiak. From there, a bush plane to Larsen Bay on the opposite side of the island, and from there a little skiff for what was an hour or so ride to a commercial fish site. Actually I was with my girlfriend (at the time) and we got to collapse at her Uncle’s place.

      They have a big family, and I sort of disappeared into a chair to sleep it off. Man it felt good to start to nap, and then I heard them all discussing an epic trip they were going to take. So, an hour later I was bouncing around in a skiff again, the cold wind in my face, as we took this once-or-twice-in-a-lifetime trip to one of the major rivers where the salmon went upstream to spawn.

      We were in the skiff for a few hours and finally reached the mouth of the river. Still a ways to go, but we were almost there. Then we got redirected. A neighbor needed a hand with something. It was the same thing you described above: you drop everything and help. It doesn’t matter if you’re on an epic family trip. Nothing else matters except the fact that your neighbor needs help.

      Capitalism and modernity has us fragmented and disconnected from the concept of home and neighbor, and the consequence is that we have to completely rethink our relationship to self and others and to the greater world itself. It’s hard to make the shift and transition, and I think most homo sapiens don’t quite know how to handle it. So, as usual, we start the tribal fighting. It sucks.

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      1. Yeah.. I hear ya. Never been to Alaska, but that makes sense to me. Alaska still has better touch with the old frontier life than the rest of us with few exceptions. Neighbors are important. Your humanity and that of your fellow humans is innately important.

        In LA or NY your humanity is in my way. I need an express check out stand so I can get past these jokers who have a full cart of groceries. And if I get stuck in the line, well, at least I have magazine covers to look at cuz I sure aint gonna look at the guy standing next to me. Heaven help me, I definitely aint gonna talk to him.

        Reminds me of the old cowboy I took care of in Hospice when I was a young man and volunteered for that kind of thing. We lived in Colo at that time. The old man told me about the first time he saw indoor plumbing at his cousins house in Denver. Said he was closer to the neighbors on the next ranch like 5 miles up the road than the guy who lived next door to him in town.

        My point above is/was that the MONEY is killing all that.

        I don’t shop much, but my wife’s Birthday is coming up and I needed to get a gift. So today I went into a store I visited only once before like two years ago… Burlington…

        So I find my gift and to the check out line. They have two registers going and an alley lane that has switchbacks at the end of which there is a sign that says, Wait Here for Next Available Cashier. And all through that switchback alley, they have needless crap to occupy my mind while they have me trapped there. My disposable income just itching to keep me looking at all the stupid crap I don’t need and didn’t come in here to get. But Burlington has studied consumer habits and they know I am not likely to talk to the others in this line. But I am likely to part with a few extra dollars for their trouble.

        In this scenario, unlike your Alaska scene or my East Texas illustration, this major retail company is playing us for all our pocket change. They got marketing people in grad schools staying up late at night plotting how to get the next $2 out of my pocket. The whole game reinforces that I don’t talk to the other customers and that I only have very cliché robotic conversation with the clerk. All for a few dollars.

        The world was not created for this.

        Rather than captitalizing on the standard Evangelical BS about heaven/hell and rapture, conservative politics, and Bible inerrancy, I am more interested in Image Bearing Theology. God made the humans to bear his image in the world, and thus to rule it. To RULE it. And he takes this image bearing humanity (male+female) and puts them naked and utterly vulnerable in the garden to cultivate it. So much of this is counter intuitive to our modern mindset.

        Now I need a few dollars to act as a medium for communication. I mean, I didn’t talk to the other customers at all. (Actually, the lady ahead of me had a toddler in the buggy that waved and smiled at me a couple times, but the lady pushing that buggy ignored me for all she was worth) And if I had not had a few dollars with which to purchase the gift I came for, I would not have had the cliché conversation with the clerk. And if I had no money, I would actually be unwelcome there. (I know… I could browse and leave and come again next time at will… but this only within reason. If I come in looking like I cant pay, a security detail will scrutinize me severely and try to find grounds to sanction me. I have homeless friends who are criminal trespassed at Wal-mart like this.)

        So the money becomes the medium with which I am able to relate with others. But in the REAL world, the one God created, there is nothing of more value than his image, and he stamps that on us. I should have intrinsic value with other people because in me they see God.

        Even barring the miraculous, if we could trade goods and services on the image of God in us, healthcare would be a completely different thing. And as a Christian, I am committed to that.

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  2. Agent X: “So the money becomes the medium with which I am able to relate with others. But in the REAL world, the one God created, there is nothing of more value than his image, and he stamps that on us. I should have intrinsic value with other people because in me they see God.”

    For sure. Hence Jesus had a suspicion of money, a root of all kinds of evil, etc. This suspicion of wealth was actually reinforced by the “church fathers” and was retained by the institutional church (which never ceases to amaze me) for many many centuries, all through the Medieval era. You could be wealthy, sure, but you absolutely had to be generous with it because everyone understood that wealth and the resources of the world were limited.

    Modernity changed that. Money became detached from the real world and hence an individual could make a lot of wealth via money, as much as s/he wanted. Everything became about the individual. Sure, all that money technically belonged to God but you could make that paper money in as large a quantity as you possibly could, and now in the digital era, money is just a number on a screen, having nothing to do with the real world.

    From my experience, so long as a Christian tithes and acknowledges that the money belongs to God, then s/he can have that big house, those nice cars, and all the toys and worldly goods: just make sure you thank God and remember where it comes from. There’s no connection between yourself, your money, and others and the greater world. After all, it’s just digits.

    This has so many dangerous results, both spiritual (for the individual) and for society. And it was largely the money thing (and all the economic bullshit that went with it) that helped drive me away from the church. After all, where your treasure is, there your heart will be also, not the other way around.

    Agent X: “Rather than captitalizing on the standard Evangelical BS about heaven/hell and rapture, conservative politics, and Bible inerrancy, I am more interested in Image Bearing Theology. God made the humans to bear his image in the world, and thus to rule it. To RULE it. And he takes this image bearing humanity (male+female) and puts them naked and utterly vulnerable in the garden to cultivate it. So much of this is counter intuitive to our modern mindset.”

    But Jesus seemed to suggest that our “rule” was sort of reversed. It was the paradox, time and again: the greatest of you is a servant, the last will be first, blessed are the poor, etc.

    The “kingdom” wasn’t imperial, it wasn’t about being at the top of the hierarchy. It wasn’t a kingdom in any Game of Thrones sense, that’s for sure.

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