Class, Privilege, and Healthcare

James Fallows receives an email from a reader who happened to cater both Obama and Romney campaign events in Massachusetts this year (boldface mine):

The elite on both sides should talk to people who are completely outside their income brackets. When I tell my liberal professional friends that most of the people I work with hate the Mass. Health law, they are shocked. When I explain why, that they are happy taking their chances with clinics and emergency room, I get what I call the “Liberal Lecture.” “Someday they will get really sick, everyone should contribute, they will benefit….” Nice argument to make if you get an employer-subsidized plan, not so persuasive if you don’t and rely on seasonal and/or hourly wages. And the right, well, please think about how the people who work for you get by. The minimum wage matters in ways you cannot imagine to people who earn it.

Obamacare is better than the alternative, but if the Massachusetts experience is any guide, to call it affordable is a stretch, according to these data from 2008:


The 32% who earn 150%–300% of ‘FPL’, translated into English, that means 32% of those who earn $31,812 – $63,612 per year have trouble paying for healthcare–these are not poor people. There’s a simple reason for this:

“For someone my age who is making $40,000 a year you are required to lay out $5,000 for an insurance premium for coverage that covers nothing until you have spent $2,000 out of pocket,” Himmelstein said. “You are $7,000 out of pocket before you have any coverage at all. For most people that means you are already bankrupt before you have insurance. If anything, that has made them worse off. Instead of having that $5,000 to cover some of their medical expenses they have laid it out in premiums.”

While the Tea Buggerers are delusional idiots (and that’s being generous), the anger over forcing people to buy healthcare when they can’t afford it is real, if Massachusetts is any guide. It’s not a bunch of irresponsible recently graduated hipsters attempting to freeload, but people who work and are barely getting by.

It’s worth pointing out for the record that either a single payer system or allowing people to buy into a high-quality healthcare plan eliminates most of these problems.

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1 Response to Class, Privilege, and Healthcare

  1. HCA says:

    I’m both unsurprised and weirdly glad that this is the case. Unsurprised that any health system relying on private insurance would have glaring defects and ways of screwing those at the bottom, and weirdly glad in that I suspect in a decade or so these same flaws will provide sufficient justification to move entirely towards single-payer or other superior system. For now, it’s better than nothing.

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