Healthcare for All

Healthcare for All

Universal healthcare is one of two or three big issues that pervade the thoughts of most Americans.  The polls suggest that it is the number one issue facing voters.  This is certainly the most non-partisan issue that we face.  This morning it is being suggested that it may be the next big Washington battle ground that encompasses all three branches of government.  The administration has taken a shifting stance trying to find the middle ground between the conservatives who believe it’s not the governments business to provide care for all and the infamous “base” that are some of the largest beneficiaries of the benefits that are constantly at risk.  Congress has fought the partisan fight of Obamacare with Republicans against it (with no meaningful replacement in mind) and Democrats who support it for a range of reasons.  Now Congress is faced with the increasing popularity for the program and all its features including coverage of pre-existing conditions.  Even the courts are getting in the act with lower courts declaring Obamacare being unconstitutional and higher courts girding their loins for the coming fight.

The crazy thing is that both parties are happy about the issue coming up at this point of the post-Mueller Report environment.  Republicans are thrilled to go back to one of President Trump’s embarrassing loss in repealing Obamacare.  Some even suggest that Trump’s untimely attacks on John McCain last week were the set-up for the reinvigoration of the efforts to finally repeal Obamacare.  Re-litigating the past is a favorite Trump tactic, as is extracting revenge (something we are also hearing from trump as he tries to investigate anyone who opposed him on the Russiagate affair).  Meanwhile, Democrats are acting thrilled that Trump wants to reopen his attack on Obamacare.  As they lick their wounds of the Mueller/Barr report, they see the Obamacare issue as a huge loser for the President, as more and more people (especially base Republicans) have made use of and found value in the Affordable Care Act programs.

Wow, that’s a lot of politics over what to do about the next sick kid.  I would like to dissect the mind of anyone who thinks it’s OK to let a child with a pre-existing and serious condition die rather than have the government provide basic state-of-the-art and available medical treatment.  That’s a scene out of Elysium and you’re going to force Matt Damon to don an exoskeleton and come for you. Make it a lovely Hispanic child born in the USA to an illegal immigrant and drag in the immigration issue and you have a very volatile mixture to put in a bottle with a cloth wick and toss at the next gated community wall.

As a guy who just turned 65 and just became a member of the Medicare family, I find myself thinking more about the healthcare system.  I was so happy to have gotten post-retiree medical coverage from Cornell after my ten-year teaching stint and then I realized that what I was really getting was access to supplemental coverage to fit around Medicare.  OK, that should still be valuable.  In the process I discovered a fly in the ointment that I cannot explain.  My coverage from Cornell before turning 65 was $X for me and my wife and youngest son.  After 65 my coverage is $Y for my wife and son and $Z for me for the supplemental coverage.  Add to that the amount I must pay Medicare for Part A (Hospitalization) and Part B (Medical and Drug), call it $ZZ.  Adding up $Y+$Z+$ZZ = $X times 1.5.  How did that work?  It seems combining private and public healthcare is more costly than private all by itself.

Let’s ignore that and consider it a mathematical fluke of my specific situation.  Now let’s turn to that benefits summary supplied annually to us all as members of Social Security.  The accumulation of employer and employee contributions to Social Security seem to make sense to me. My numbers total an amount in the hundreds of thousands contributed over my working life (pretty much maxed out from what I can tell) and my Social Security benefit (payable in full starting on my 66^th birthday if I choose) looks to be mathematically accurate.  That is to say, assuming a rational lifespan, I will be paid out the value of what I put in.  Now then, the Medicare equation is quite different.

I will begin by telling you (because it blows my mind) that they say I have paid in about $1.7 million into Medicare over my working life.  Stop and think about that for a moment.  They had different caps on payroll deductions, presumably to accommodate the worry about rising medical costs.  They took a lot out of my paycheck and from my employers.  So how is it that I still have to pay about $1,800 per year for my Medicare Part A and Part B premiums?  Is it enough for me to bother with?  No.  Do I believe in progressive taxation and therefore paying more than my share?  Yes.  Can I make sense of the financial logic from the information provided? No.  Should it make sense in the same way the Social Security math makes sense? Yes.

The other night I went to go see the Broadway show What the Constitution Means to Me.  It is a show about a woman who grew up making speeches about the Constitution at American Legion Halls to win prizes and support her college fund.  As a side note, who should be sitting in the seat behind me but Senator Chuck Schumer, the Democratic minority leader of the Senate at a time when the Constitution is under constant attack by the Trump Administration?  One of the things the American Legion moderator tells the woman making the speeches is that she has to personalize her speech and debate perspective rather than just talk about the Constitution in abstract terms.  That was a good requirement.

When I rail about what I see happening in Washington, I force myself to put everything into a personal context to keep it real and avoid being esoteric.  I do not need much healthcare coverage just yet.  I am lucky and it’s through no great effort on my part.  I seem to have a genetic make-up that keeps me healthy despite myself.  As for healthcare, I want to know what and why I am paying for, but ultimately I am happy to pay extra for that little Hispanic “dreamer” who needs treatment.  It makes me sleep better to know that someone would take care of my great granddaughter if she ever needed it.  Try thinking about it that way the next time you take a stand on the issue.