Diary of a Low Budget Superhero

I want to hear one good reason why national health insurance cost can't be on a sliding scale based on individual income and expenses. Just one good reason. I, for one, would welcome that at this point. Because from everything I'm reading, hearing and watching, I'm starting to worry that health care "reform" is simply going to be new legislation stating that every person must buy health insurance, and that nobody is addressing the COST of it nor the list of benefits included.

Follow up:

Mandatory health insurance? That's not the same as universal. Trust a Boston chick. We residents of Massachusetts have already danced with that devil. You see, in the late 1990s to early 2000s we had been courted by the Commonwealth's new "universal health care." Oh, it was romantic. They twirled us, sang us love songs, they gave us flowers, we invited them to stay over, and in the morning they were gone and so was our dignity. The plan was activated in 2006, and our so-called "universal" coverage turned out to be simply an iron hammer of legislation: buy health insurance or pay a penalty. Wha...? Where's the coverage that was supposed to be reasonably priced? What happened to coverage that was not connected to a job? What about good care for everyone with none of that "pre-existing condition" crap? Instead they just made it mandatory to be insured.

Sure, lots of stuff is subsidized, I GUESS it's kinda "universal" but it's very murky how it's all supposed to work, AND for a lot of people it doesn't work at all. If I lose my job tomorrow, I'm not sure what I would do or where I would go to learn how to get in on this "universal" thing. Is it even working here? You know, Massachusetts didn't even have that many un-insured to begin with, it's only like seventy-thousand people or something. Low, compared to the rest of the nation. Plus, our politicians aren't even certain they can keep it going; it's three years in, and hospitals are beginning to panic at how much free care is costing them, and little businesses are worried they won't be able to stay afloat.

Not only that, but how mandatory is it, really? Most of my friends are artists and musicians, not all of them with...well...jobs. Some barely make enough to pay their rent. Many can't even swing a car payment, many are always broke. So you bet I know a bunch of people who've been ducking this "mandatory" health care law.

I don't even know yet whether avoiding health insurance is breaking the law in a serious way or in a "nobody cares" way. Is it like pulling a gun, or is it like pulling the tag off a pillow? I mean, if you don't get sick, how do they find you? Because nobody ever asks me for my insurance information except the people in scrubs behind desks in hospitals and doctor's offices. For the people who just won't buy it, will it be like the scenes in Brazil and The Fifth Element when the law comes knocking to bag you, tag you and haul your non-compliant ass away forever? My Joe didn't want to find out, so when he lost his job a year ago he signed up for Blue Cross on his own. We shell out $300 a month. The guy has been to the doctor...never...since I met him 7 years ago. Not even one time. He doesn't fucking get sick, even a sniffle, even when I'm a sweating fever-fest delirious on three different prescriptions mightily fighting the worst flu my doc had seen yet. (That was me in February). I read that if you don't get covered, your penalty will come out of your tax refund...but what if you already don't get a refund? You just get more bills? How does THAT help?

I just don't like the idea that "mandatory" is what "universal" means to some people. It is not the same thing. And I do see the point of view of young, healthy people who take care of themselves. They're pissed that it's mandatory. Why should they have to pay SO MUCH for health insurance? They're saying "Don't mandatory me. Don't mandatory us paycheck-to-paycheck peons who're trying to put aside savings and build up a better life."

I wonder what it would look like if, on a state and federal level, there was universal "sliding scale" health insurance just like there is for taxes, complete with deductions and incentives bringing all lifestyle factors into account. Home owner versus renter, number of dependents. Include certain health-related incentives. Yes, incentives. Use me for example. I'm a heavy woman right now -- if I knew that my health insurance cost will go down once I'm under the "obese" rating on the BMI chart, won't I have even more incentive to keep working towards my goal? Another incentive point if you don't smoke. Another if you don't drink. Another if you see your doctor and dentist every single year for prevention. Why not another if you work 5 hours of community service every week helping the sick or elderly? If you go to Iraq or Afghanistan, free care for your whole life and thank you for keeping us safe.

And a whole separate care package for the exceptions -- our disabled friends, our chronically ill friends, our elderly. No one should have to live in abject poverty because they're born sick, or become sick, and all they can manage to do is exist in a welfare state at the mercy of food stamps. That is NOT okay, not in a country that's invented the "celebutante" and elevates our sports guys to superstar billionaire status.

If that happens, it may end up that a healthy, young person who makes a ton of money will have higher-priced insurance. Not TOTALLY fair, I guess, but it's the same as taxes. Actually it's the same as everything in life. Whether by default or by legislative contrivance, our expenses are on a sliding scale. If you earn $28K a year, you probably rent a simple room for $650 a month, clip coupons and drive an old car (if you drive at all). Your monthly expenses don't add up to the same sum as the guy across the street who earns $70K a year, and certainly not the same sum as the six-figure earner who owns the building where you work. We all live where we can afford to live, we eat what we can afford to eat, we dress and travel and procreate and party and get taxed accordingly.

Unless you're a dumbass racking up ever-higher credit card debt in order to live beyond your means and/or popping out kid after kid for the public assistance. But that's a whole 'nother issue.

I guess that scenario would be treating health care like any of the contributors to a clean and civilized society: water treatment, breathable air, drivable roads, schools, fire and police...higher-earners pay more taxes for those things we all use. IS that the right answer for health care? And would the higher-earners still buy their own insurance? Maybe, I don't know. It wouldn't be the only thing. While that higher-earning person has the same clean tap water as the poor person, the higher-earner spends money on designer water anyway. And a public school could be right next door to a wealthy family, and even though their tax dollars support the school, they still opt to send their kids to private school. Isn't that what would naturally happen with health care? Isn't it already like that?

Too many questions, not enough answers. It's all too confusing. My biggest hope right now is that cooler heads prevail on this whole health care reform thing, and that it really is REFORM, not just, pardon the pun, a band-aid. And I wish that that CNN would stop giving the town hall crazies the air time. I'm just so sick of people mouthing off when they have no idea what they're talking about, they're happy as long as they talk about it louder than anyone else. Sit down, shut up and listen.

Suspiciously silent are the people who live in those places that already have universal health care. The only thing I know firsthand from you guys is that the wait is long for a doctor's appointment. Is that all? What else? Tell us.