It's Not About the Uninsured

Kevin Drum picks up something from the Weekly Standard (of all places) and uses it to craft what I think is the best possible strategy for pushing Universal Healthcare.

Here is what they said in the conservative Weekly Standard:

Instead of approaching health care reform as the left does, as a problem for the uninsured — a matter of charity for those less fortunate — conservatives should cast the health care crisis as what it really is: a problem for the insured, for people whose insurance plans will lapse if they lose or shift jobs, whose plans don't cover expensive crises, and who must pay extra, in the form of higher premiums, to cover the medical bills of the permanently uninsured.

From there they spiral into some market-driven fantasy solution bullshit, but as an initial sales pitch, it's gold.

Drum expands:

...If liberals want to sell the idea of national healthcare, we should quit marketing it as a welfare plan for the uninsured. Instead, we should be focused on the healthcare complaints of those who already have insurance but are dissatisfied anyway: Lack of choice in physicians. HMOs that make it hard to see a specialist. High copayments. Fear of losing coverage if you lose your job. Long waits for non-urgent care. New (and usually worse) healthcare coverage every time your HR department is told to find a cheaper plan. Fear that preexisting conditions won't be covered if you take a new job. The risk of financial ruin if someone in your family has a truly catastrophic illness.

[...]

So forget the uninsured for now. Liberals should concentrate instead on making sure that ordinary middle class workers understand just how bad and how expensive their current healthcare is, and how much better it could be under a decent national plan.

Exactly. This applies to me and my family right now. I have a poor-paying job working for a state college. But I have excellent BCBS health insurance. I have been actively seeking a better job for a while now, but I have genuine concerns that going out into the private sector is going to subject me to all kinds of bullshit healthplan compromises if not outright downgrades.

I've always been healthy, and my family history is pretty good, but my wife is 29 and has rheumatoid arthritis and a history of cancer in her family. My daughter is three and has a cataract that requires surgery and might be on the road to juveline rheumatoid. These will be pre-existing conditions. These are the kinds of conditions that absolutely kill you if you try to get your own insurance (or even life insurance). If I get a new job, am I going to have to battle some new fucking scumbag insurance company to cover my daughters follow-up care? Do I need to pay COBRA from my old job til I'm out the woods? What if in three years she needs surgery again? If I move thirty miles from Ann Arbor to Royal Oak for a job, am I in some different network requiring me to dump all of our doctors and the U-M hospital system?

This is the kind of stuff that torments families daily in this country and "Healthcare Savings Accounts" do nothing to address this. In an era where it is clear people will change jobs (if not careers) several times over the course of their worklife it makes no sense at all to stay with an employer-based healthcare system. And this isn't even addressing the advantages for businesses and employers to be free of the nightmare of constantly shifting plans to maintain coverage and costs.

Driving home the point to middle-class families that, "Fine, you might have healthcare now, but that could change or stop at any time—and—it could be even better and you could have it wherever you work or live" will likely get a better response than the more abstract "There are 40 million people you don't know who don't have health insurance."