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Current Affairs

A Magazine of Politics and Culture

Say It With Me: Things Don’t Have To Be This Way

On the left, we need to repeat over and over: conditions are not inevitable but result from policy choices which could be made differently. We can build a fair, just, and healthy society where everyone thrives.

A recent report from Business Insider tells us of Candice Davis, a 39-year-old teacher in Statesboro, Georgia who has to work on the side at Starbucks to pay for her medical expenses—where she receives a paycheck of $0.00. 

The problem for Davis is that she suffers from a medical condition that requires regular surgeries. Her school-provided health insurance had a deductible so high that she couldn’t afford the expenses and had gone into debt. Starbucks has better insurance plans, so she went to work part-time at a Starbucks located 45 minutes from her house. But the cost of the Starbucks insurance plan still exceeds Davis’ Starbucks paycheck, so once the premiums are deducted, she ends up getting paid nothing. (And building up arrears, though Starbucks doesn’t try to collect them. Still, she’s going into debt to Starbucks the longer she works there.) 

Davis has no complaints about Starbucks themselves. In her situation, the arrangement has allowed her to afford a decent insurance plan that approves and pays for the treatment she needs. But she admits that her situation can be “depressing because it feels like it’s never-ending and feels like I’m alone.” Davis has no significant other and no children because she  works all the time. “I don’t even have time to visit my mother and grandmother, and that breaks my heart,” she said.

Davis’ situation is maddening. Being a full-time school teacher should allow a person to have decent health insurance, obviously. You shouldn’t have to take another job on the side where you’re essentially getting paid nothing more than “the difference between a crappy insurance plan and one that actually works.” Davis is already making a major contribution to society though doing a difficult, valuable job (she’s in special education). She deserves to be able to spend time with her family and to have her basic medical needs taken care of. The situation is plainly unfair and no decent person can justify it.

But the situation is not only maddening because it’s so unjust, but because it’s so unnecessary. Davis is kept from having children and seeing her family not by some unchangeable fact of the universe, but by the policy choices of American legislators. We have a stupid healthcare system in which people are covered by “health insurance,” an unnecessary product that benefits nobody except those who work for or own shares in insurance companies. 

In a functional country, we would simply have a public healthcare system, as they do in the UK1, where sick people simply go to see the doctor, without paying anything. It’s a very simple concept: health services work like firefighting services. They are funded by the government, and when individuals need them, they just use them. In our absurd system, which ties health to ability to pay, people have to constantly be worried about whether they can afford to get well. (I recently spent a night with chest pain, thinking I should probably go to the ER, but desperately wanted to avoid paying the $1,000+ dollars it would cost, and had to fret for hours not only about the pain but trying to carefully weigh the risk to myself against the cost of seeing a doctor. Obviously in a reasonable system, I should just be able to go see somebody if I’m worried I might be seriously ill, without a second thought.) 

We have a plan that would go a long way towards fixing the stupidity in the system. It’s called Medicare For All. There’s a bill in Congress and everything. If you want to read a long explanation of what it is, why it would work, and why none of the anti-M4A talking points hold up, pick up Abdul El-Sayed and Micah Johnson’s Medicare For All: A Citizen’s Guide, which clearly explains the whole plan. (My review summarizing the arguments is here.) I have never seen a persuasive argument made against a free-at-point-of-use public healthcare system, and I have read all of the arguments. (I respond to several of the more common ones in my book Responding To The Right: Brief Replies to 25 Conservative Arguments). Most of the people who try to convince us it would be bad use tactics of deliberate deception and manipulation, such as telling people it would increase their taxes without telling them how much money it would ultimately save them through the elimination of premiums, co-pays, deductibles, coinsurance, surprise medical bills, and so forth. Or they tell them that it would “end their insurance,” implying they’d be uninsured, rather than telling them that it would render their corporate health insurance plan entirely unnecessary by making their care free at point of use. 

Every politician who doesn’t support Medicare For All is forcing Davis to keep living in her present situation. They are making a choice. They are deciding that the preservation of a parasitic for-profit insurance industry that exists solely to siphon people’s wealth away is more important than Davis getting to see her family. They believe that she ought to spend a portion of her time earning money for the rich if she wants to have her regular myomectomy surgeries. This is a morally appalling position. Those who hold it should be ashamed. And yet plenty of Democratic politicians, including the party leadership, defy the will of their constituency and actively oppose the obvious measures that could fix Davis’ situation. Even during the worst parts of the pandemic, Democrats made absolutely no effort to introduce universal free-at-point-of-use healthcare. Their failure is a national disgrace. (Instead, the best Democrats have given us is a giant lie called the “Affordable Care Act,” which clearly did not make healthcare affordable, since if it had, Candice Davis wouldn’t be working for free at Starbucks right now.) 

I’m saddened by Davis’ situation, but I’m angered by how preventable it is. And it’s the job of leftists, on issue after issue, to show not only that things are bad (an easy task), but that they can and must be fixed. Davis’ story is not a positive one of self-determination and grit, as some on the right might portray it. It’s an indictment of our corrupt healthcare system  Very simple measures can make people a lot better off. Around the country, activists have successfully pushed for $15 minimum wages, for instance. $15 still isn’t amazing (working 40-hour weeks, 52 weeks a year, you’d still earn just over $30,000) and still isn’t enough for many families to live on, and it falls far short of justice (estimates show that if worker minimum wage had kept up with productivity, it would be $23 per hour). But it’s a hell of a lot better than the shockingly low federal minimum wage of $7.25. 

Part of the job of the left is to raise people’s expectations for what they deserve, to make it clear to them that as a person with dignity and worth, in a world of abundance, they are entitled to have a good life and have their basic needs met. We can end low wages, medical debt, student debt, and so much more—and we must. Those who stand in the way of making our lives better need to be called out for imposing intolerable conditions. The climate crisis is a policy choice. Poverty is a policy choice. Homelessness is a policy choice. The question is not whether these problems can be fixed, but what our values are: which do we care more about, corporate profits or the lives of people like Candice Davis? We can structure an economic system in a way that prioritizes the former over the latter, or vice versa, and it has nothing to do with the limits of the “possible.” It is simply about what those with the power to alter these conditions decide they care about. 

It is vital to keep reminding people that we are not hopeless, and our conditions can be changed (and changed quickly, as the rapid spread of the Fight for 15 movement shows). Things don’t have to be this way. A better world is possible.

  1. The UK’s National Health Service is an easy comparison. But it’s important to understand that the NHS has been decimated by austerity cuts, so headlines about the NHS tend to be quite negative. Skeptics may point this out as a way to argue against single-payer healthcare. But it’s actually a story about the wrecking of the system by years of Conservative governance, not the ineffectiveness of single-payer healthcare. 

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