Health Care Reform – Benefits that Bind

My British friend, and neighbor, is often baffled by our health care. He cannot understand why there is no public system. Most of his points I’ve heard before and agree with, so we end up shaking our heads together in mutual resignation, and he says, "It is what it is." However, recently, he has been focussing on a point that seems rarely discussed (at least by the usual pundits and pinheads, the latter of which I include myself). His point: we are slaves to our employers because we cannot easily change jobs for fear of losing health care. Further, this situation is a drain on the economy because workers who are not "happy" in what they are doing are less productive.

Taking this concept further and following it through one possible scenario, I can envision a worker who wants to look for another job, or perhaps wants to go back to school and learn an entirely different career, but cannot. If she quits, how will she pay for health care should she become sick? At least if she stays working for her employer, then she’s covered. Undeterred, she enrolls in night school, but sees that the course of study, at the rate of two classes per week, would take her five years. No matter, she thinks, she will persevere. We Americans love a good underdog story of perseverance and eventual success, the heroine winning out in the end, getting her dream job after years of schooling, and of course falling in love. However, sometimes reality isn’t so pretty.

Our brave woman is confronted with a new ambitious boss, stepping toward the next promotion, who makes new demands. Our heroine is working overtime, sixty hours per week, and going to school. And our movie becomes reality. Despite her efforts, she is not a super hero, and she develops physical ailments, making her further dependant on her employer’s health insurance. The ailments make her less productive, while the demands are ever increasing. But she needs the job to pay her medical bills, and obviously, school pays nothing, covers nothing. She’s no dummy. In order to survive, she must cut back. (Either that or succumb to someone rich in exchange for monetary support.)

Eventually, her ailments nag at her, and she gives up on changing careers for now. Wait until she feels better. While too good a person to consciously undermine the company, over the next few years, she is a drag. Resentment settles in. The demanding boss has long since gone, and she smiles at each new boss, nods her head, and slogs on. One day, ten years along, she realizes that she has been stuck in, what is for her, a dead end job. She feels terrible. But it is, what it is. Now, she is using her medical insurance to pay for anti-depressants because she doesn’t want to lose her health "benefit."

Recently, unemployment has gone up dramatically, and the number of uninsured and underinsured has also risen. The uninsured go to the emergency room. This is a well-worn argument – we all end up paying for their health care anyway. But in the twenty-first century, we may all be "unemployed" at some point in our "careers." Further, many of us will be more or less independent, not associated with any company. We will form groups as needed, get the work done, fluidly solve problems, build systems, supplement institutional efforts, and we will move on. We will redefine the meaning of progress. But we cannot make this journey while being slaves to a dysfunctional health care system.