This Really Struck a Nerve

Kevin Drum writes:

...for the first time that I can remember, this means that I have a personal stake in the election. It's not just that I find one side's policies more congenial in the abstract, but that one policy in particular could have a substantial impact on my life.

You see, I've never really intended to keep blogging until I'm 65. I might, of course. Blogging is a pretty nice job. But I'd really like to have a choice, and without Obamacare I probably won't. That's because I'm normal: I'm in my mid-50s, I have high blood pressure and high cholesterol, a family history of heart trouble, and a variety of other smallish ailments. Nothing serious, but serious enough that it's unlikely any insurance company would ever take me on. So if I decided to quit blogging when I turned 60, I'd be out of luck. I couldn't afford to be entirely without health insurance (the 4x multiplier that hospitals charge the uninsured would doom me all by itself), and no one would sell me an individual policy. I could try navigating the high-risk pool labyrinth, but that's a crapshoot. Maybe it would work, maybe it wouldn't.

But if Obamacare stays on the books, I have all the flexibility in the world. If I want to keep working, I keep working. If I don't, I head off to the exchange and buy a policy that suits me. No muss, no fuss.

So yes, this election matters, and it matters in a very personal way. It does to me, anyway. It's not just about gridlock as far as the eye can see.

I usually have a pretty thick skin for this type of stuff, but this got to me.  I wrote:

Great.  Those of us who are comfortable actually, you know, working to support ourselves look forward to subsidizing your future indolence.
Sorry, I am not usually that much of a snarky jerk, but really, that is what you are celebrating.  You are not celebrating some medical or scientific breakthrough that allows you to stay healthy at a lower cost.  You are celebrating a system to force other people to pay for your body's maintenance.  All so you don't have to support yourself for over a quarter of your life.

If you were to say that, "wow the health dice really rolled against me and I need help," few would begrudge you the help.  But this notion of an indolent retirement is radically new.  It is a product of our century's and our country's great wealth.  Retirement is a luxury good.  I have no problem with anyone consuming this luxury good out of their savings, but consuming it out of mine, and then crowing about it to my face, is highly irritating.

If I were a Republican, or if I had one iota of trust in them, I might write that this is what the election is about.  Since I don't have such trust, I will instead merely highlight Drum's thoughts as a good representation of modern entitled thinking.  For God sakes this guy is not even trying to use my money to escape, say, a coal mine early.  He wants my cash to escape blogging early, perhaps the cushiest job there is (as indicated by the fact that many of us do it for no compensation what-so-ever).


  1. MNHawk:

    At least he's being honest, in seeing the Presidential election as nothing more than who's going to give out the most free crap.

  2. David:

    As a 40-year-old with a severe chronic illness (getting daily IV therapy...), I find his attitude contemptible. I fully expect to work until I am no longer able to do so - that is, until I am either incapacitated or dead. The idea of expecting someone else to fund my indolence is appalling and frankly not part of what I consider the classic American character. Bleah.

  3. Arthur Felter:

    Great post.

    I just wanted to pick a nit with Drum's article:

    I have a relative that I'm close to that is a financial controller for a large chain of hospitals. I had a discussion with him once about health care, and I learned something very interesting: for his chain of hospitals, uninsured patients are billed at a *lower* rate than insured patients. He said that the only time that the hospital uses the insanely high rates is when the insurance company attempts to breach their contract (in such event then the hospital will bill the insurance company the high rates).

    Worth mentioning.

  4. Jim:

    It's funny, but I find this election important because I feel that with Obamacare, innovation and choice will decline, especially for people with medical problems which don't follow the norm. Drum may be happy that he has insurance, but without the actual medical *care* that he will really need, the insurance will be pointless.

  5. JamesKann:

    Ah, the great fiction through which everybody endeavors to live at the expense of everybody else.

    Great post, btw. Drum's credibility has slowly deteriorated as he has cheerleaded (Go Team Blue!) every horrible Obama indiscretion that he formerly railed against.

  6. alanstorm:

    Judging from his previous utterances, there is no chance at all that Mr. Drum is capable of understanding any objections to this.

  7. CTD:

    More or less like 99% of the left. They revealed themselves to be nothing more than partisan robots the moment Obama took office. They didn't actually care a bit about Iraq, Afghanistan, civil rights, executive overreach, or anything else they had spent the last eight years decrying. They just wanted to win. I have to give props to Glenn Greenwald over this. He's one of a tiny number of leftists whose principals didn't evaporate into the ether on inauguration day.

  8. Scott M:

    Kevin buys into the big lie - that not only will he not be denied insurance, but it will be much more reasonably priced than what he would get if he bought it himself. I don't see anything in Obamacare which actually guarantees Drum a low premium. Sure, some insurance company *must* cover him, and can't turn him down because of preexisting conditions, but they will have a high enough priced premium that he will have to go to the exchange, find a company that he could afford, and buy it. In reality, he will find the price too high, and will either opt out, or will pay the large premium and curse the insurance company and wonder where all that "hope and change" went.

  9. Richard:

    Exactly. In just a few generations, we've gone from a country of people who are trying to cram as much productivity in to a life as possible to a country of people who are trying to figure out how little they can produce and still live a comfortable life. In the past, if you outproduced what you consumed, it only meant you would leave a legacy for your children or grandchildren. Now our legacy is $16T that they will have to pay interest on.

  10. Elam Bend:

    This is my experience also. I have paid cash for many health related expenses and have been able to negotiate much better rates. Incidentally, I have also caught offices ordering biopsies and tests that I didn't order which leads me to believe that some doctors offices routinely do that for insured patients because they know insurance companies will pay for them and that consumers won't object (because they aren't paying).

  11. Jesse:

    My grandfather was an active farmer until he was 70. And this guy needs to retire from *blogging* when he's sixty? Sitting at a desk writing mindless blather is SUCH a grind. Moron doesn't even have a real job to retire from and he's complaining.

  12. Bret Banfield:

    At the hospital closest to me uninsured patients are billed out at 25% of the total price to insurance companies. That's before negotiations and payment plans. I was able to negotiate a steeper discount, plus a 6-month payment plan was approved automatically regardless of credit worthiness.

  13. MingoV:

    @Scott M: "I don't see anything in Obamacare which actually guarantees Drum a low premium"

    That part of Obamacare went into effect on June 21, 2010. Adults with pre-existing health conditions who have been uninsured for at least six months can join a high risk pool. The premiums for the pool will be no more than four times the lowest-priced premium (for a health young adult). Out-of-pocket healthcare expenses for those in the pool are limited to $5,950 for individuals and $11,900 for families (those amounts do not include the healthcare insurance premiums).

    In 2014, the high risk pool will be folded into the healthcare exchanges (if any states agree to implement them which is doubtful after the US Supreme Court decision).

  14. mark2:

    I should search around more, but when I was uninsured for a bit a few months ago, I went to my doctors office. They charged me $120 which is the same rate they initially charge the insurance - the insurance usually gives them $75. When I asked if they have a cash rebate, or some uninsured lower pay program, they told me nope, - and refused to budge.

    I am uninsured again, any tips on how to find a discount doctor?

  15. Dave Keasey:

    I have insurance, but it's mainly for catastrophic coverage, with a very high deductable. So, when I need care, I usually pay out of pocket and negotiate the best deal I can get. Depending on the care provider and the type of care provided, I've sometimes managed discounts of 50% of what would have been billed to the insurance company. Every hospital I've dealt with has a discount of at least 10% and often 25% or more for those paying out-of-pocket.

    I think that Drum's comment about a 4x multiplier for non-insured patients is extremely out-of-context... He was probably comparing what his "insured" co-payment would have been (20 to 25% of the bill) vs what the provider would bill a non-insured patient. He forgets that someone has to pay the bill; the stuff that the patient doesn't pay is never "free."

  16. AtlantaDude:

    I think this may be true for hospitals and doctors. However, when I was uninsured, I noticed that the pharmacies charged a higher price for medications than when I was insured (total price, not the copay). I think with the large pharma chains, the insurance companies are able to negotiate down rates. With the doctors and hospitals, they may have less leverage, or they may wait to negotiate until after the initial invoice is submitted.

  17. AtlantaDude:

    Would your reaction to his post change, if instead of retirement, he was going to leave his job at 60 to start a company? From a libertarian standpoint, I think that is a much stronger selling point for Obamacare - the fact that many Americans are tethered to their corporate jobs due to genetic propensity to acquire migraines, arthritis or a myriad of other non-behaviour-driven conditions that make them uninsurable as individuals.

  18. Brian:

    Whenever I see someone comment in favor of the Affordable Care Act, it's with this same line of logic. In my head, it always translates into, "I think this health insurance thing is great because now I won't have to pay for all of the products and services I'm consuming."

  19. NL7:

    I would say this election is about that mentality. Unfortunately, this election is not a referendum on that mentality, but a consensus affirming it. Romney is steadfastly opposed to any real reforms to Medicare or Social Security and endlessly talks about strengthening those programs. This election is about which party is best equipped to take other people's money and give it to seniors.

  20. NL7:

    Why is starting a business more libertarian? If anything, that's worse in the eyes of this libertarian. Somebody who has the energy and the capital to start a new business should either get the capital to get insured or take the risk of going without it.

    You seem to be conflating pro-freedom and pro-business. Just because Democrats are antagonistic towards business and abusive towards freedom does not mean business and freedom are the same thing.

  21. JLawson:

    Having tried to explain Bush's ANG point record to the folks over on Drum's site around 2004, I have little sympathy for the guy and his supporters at present. They don't WANT to know how the world works - they've got their opinions, and they won't hear otherwise. They didn't know the system they were opining on - and I'd been doing points and pay and scheduling over in the Air Force Reserve for 8 or 9 years at the unit level. They didn't want to hear that Bush had enough time for a good year for retirement and retention purposes - they were CERTAIN he was gaming the system. They didn't know that the squadron commander could authorize rescheduling drill periods, and that they'd do it for anyone in the squadron at need. (Not just 'I don't want to go' - but for things like job conflicts, childcare issues and the like.)

    And that's because, I think, they'd game the hell out of any system if they see an advantage for themselves. Screw the rules - the result is what's important.

    So this guy's transparent admission he'd grab out of this what he could, regardless, just fits with what I've seen. The folks over at MJ haven't changed a bit. And I expect them to wail and gnash their teeth if Obama loses, moaning how we're going to kill the poor and sickly...

  22. Nehemiah:

    Wasn't it our dear Nancy Pelosi who said something to the effect that, now people would be able to follow there dreams and become poets (unpaid) or artists (unpaid) that they have always wanted to be. No need to compromise your dreams because you need a job that provides healthcare and oh by the way, pays the rent and puts food on the table. Of course Obama also has subsidies for that as well.

  23. Nehemiah:

    Another thing. Having health insurance does not insure health care services. The market constraints and imbalances that will result will limit doctor access. YeePee, we all have healthcare coverage, Oh Oh, we cannot find anyone to heal us. In the not too distant future you'll be able to run your insurance policy up a flagpole and see who salutes it.