Whenever enrollment opens for the so-called Affordable Care Act's health "care" marketplace, I get numerous emails urging me to sign up for the great coverage secured at horrendous political cost back when Congress sold us all into bondage to the health insurance companies. Every year since the trap finally snapped shut on all of us, I have run the numbers and figured out that the penalty is noticeably cheaper than the premium for a policy with a huge copay and deductible. But it's not about the money.
The ACA penalty definitely impacts my life. But there's a larger issue here. A health insurance premium goes directly to an insurance company in an industry that profits most by denying care, not by facilitating it. It's like being forced to buy bullets for the firing squad that is going to kill you. The perky little article on Obamacare Facts -- that explains the mechanics of the penalty and how it is spent -- never addresses the predatory nature of profit-driven health insurance and health care, but at least indicates that the money is used to help people in need. It's still filtered through the profit-sucking filter of insurance companies, for the most part, but at least it is not directly from my hand to their insatiable gullet.
I won't deny that I am frightened, living outside the illusion of protection. But illusion it is. The longer we keep feeding the beast, the longer the beast will live, regardless of how it shortens individual life spans in its customer base. Customer survival is not important. When you die, some other poor frightened bastard will already be there to keep paying into the system and getting little in return.
My advice to anyone, young or old, is to find something you really enjoy doing, that is likely to kill you. It can be anything: picking fights in bars, heroin, cocaine, unroped rock and ice climbing, driving a motorcycle really fast, BASE jumping, open water swimming, taunting sharks, being a mercenary, joining a doomsday cult, jaywalking without looking, Russian roulette, find it, find whatever it is, and go at it hard. Your fellow citizens want you dead. The publicity machine that tears down the idea of socialized medicine is based on the simple principle that the moneyed interests have very little use for you and are sick of supporting your worthless ass. When insurance companies can't make bank off of frightened sick people anymore, they'll take their fat investment portfolios somewhere else. It's just money to them. You are just money. And you're only good money as long as you pay in more than you take out.
Health service providers feel the same way. They're not going to come right out and say they don't care whether you live or die, because they're in a somewhat competitive marketing situation. But no one can survive in that business if they start caring too much about individual patients. Even with the best of intentions and the best of care, some of the patients are going to die, and all of the patients die eventually. So that wall of detachment goes up. Away from the clinic floor, up where accounting decisions are made, that wall never comes down. It's bricks thick and yards tall. And you're on the other side of it. You are just money. When the money stops, you'd better be gone already. By the way, your bills are still due, even if you don't make it.
Why do 88 percent of uninsured patients fail to pay their bills? Could it be that the inflated prices have been out of control for so many decades that we're in a death spiral, nearing impact? Any observer of the health care situation as it evolved could have told you that a system based on profit-driven insurance and profit-driven care providers would continue to drive inflated prices and force ordinary working people over the brink. Even with insurance, Americans have trouble paying medical bills. Meanwhile, health insurers and clinics, even cancer treatment centers, are finding the money to donate to public broadcasting. Don't get me wrong, I love public broadcasting. But if I'm giving you money to treat and cure cancer, I want all of that money to go toward treating and finding cures for cancer.
So another year goes by and I appear to slap away that helping hand. "Look, we're giving you hundreds of dollars a month." Yes, but the insurance company has set the premium well over a grand, so the remainder is still going to wipe out every penny I can scrape together. And that's before my out of pocket costs for anything I do need.
I repeat: America is the land where you must pursue happiness with all your energy, and find the good death at the end of a short, glorious run. Get out there and grab it. The 20th Century fantasy of a middle class with a reasonable work load, a pleasurable personal life, and a comfortable retirement was never going to work. Those countries where it seems to work are a beautiful beacon, as unreachable as heaven. Like a favorite TV show where the characters are all friendly and lovable but the actual actors turn out to hate each other, it's probably just a facade. In reality, we are all here to find our deadly pleasure and run to it.
I'll advocate and vote for something more sociable and compassionate. But I expect fierce resistance from many of my fellow Americans who are fighting their own battles and can't see how all of our battles relate to each other. The accounting department stands against us all. And money always wins. Prove me wrong, people. Prove me wrong.
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