Saturday, December 14, 2013

Who's Got Time for It?

I support the Affordable Care Act as the somewhat-better thing we have vs. the horrible thing we used to have. It's not what I would have wanted. Specifically, I wrote a little while ago:

My thoughts on the Affordable Care Act are that it's way better than nothing, but that the coverage it offers (if I understand it correctly) is not good enough. Compared to not having coverage, it's good, especially if you have a modest income and qualify for subsidies. But it's not good compared to many employer-based plans.

My current coverage, for instance, has no deductible and a $2,750 maximum out of pocket, which I have never come close to. No copays for preventive care, $25 for nonpreventive doctor visits. $10 or $12 for generic drugs, $35 for non-generics. The copays are just high enough to keep you from incurring them for no reason, but not high enough to keep you from going in when you need to.

The story of Kameron Hurley, who developed Type 1 diabetes when she was 25, is instructive. If she'd had a silver plan under the ACA, she would have had to pay 30% of her care each year until she hit the cap, which while better than no cap or having no insurance at all, is still a lot of money for someone who makes $30,000 or $40,000 a year.

We need universal, single-payer health care in this country. Why is that so hard to understand that?
Aside from the looming costs of those deductibles, there's the need to keep track of all the information on your health care spending. Who wants to do that?

The replacement of pensions with 401Ks, the creation of health savings accounts, the attempt to dismantle Social Security -- it's all part of a world view that says things should be complicated and individually controlled and paid for. But what if I don't want that stress and hassle?

How many people put the time in to manage their 401K or its equivalent? I know I don't -- I assigned my money to some Vanguard funds in the year 2000 and haven't changed them since -- and every time I glance at the Sunday business section of the newspaper I feel guilty about it.

Today I read an article from Jacobin magazine by Corey Robin that brought together all these points, only a hundred times better than I ever could:
In the neoliberal utopia, all of us are forced to spend an inordinate amount of time keeping track of each and every facet of our economic lives. That, in fact, is the openly declared goal: once we are made more cognizant of our money, where it comes from and where it goes, neoliberals believe we’ll be more responsible in spending and investing it. Of course, rich people have accountants, lawyers, personal assistants, and others to do this for them, so the argument doesn’t apply to them, but that’s another story for another day.

The dream is that we’d all have our gazillion individual accounts — one for retirement, one for sickness, one for unemployment, one for the kids, and so on, each connected to our employment, so that we understand that everything good in life depends upon our boss (and not the government) — and every day we’d check in to see how they’re doing, what needs attending to, what can be better invested elsewhere. It’s as if, in the neoliberal dream, we’re all retirees in Boca, with nothing better to do than to check in with our broker, except of course that we’re not. Indeed, if Republicans (and some Democrats) had their way, we’d never retire at all.

In real (or at least our preferred) life, we do have other, better things to do. We have books to read, children to raise, friends to meet, loved ones to care for, amusements to enjoy, drinks to drink, walks to take, webs to surf, couches to lie on, games to play, movies to see, protests to make, movements to build, marches to march, and more. Most days, we don’t have time to do any of that. We’re working way too many hours for too little pay, and in the remaining few hours (minutes) we have, after the kids are asleep, the dishes are washed, and the laundry is done, we have to haggle with insurance companies about doctor’s bills, deal with school officials needing forms signed, and more.

What’s so astounding about ...the neoliberal worldview... is that it would just add to this immense, and incredibly shitty, hassle of everyday life. One more account to keep track of, one more bell to answer. Why would anyone want to live like that? I sure as hell don’t know, but I think that’s the goal of the neoliberals: not just so that we’re more responsible with our money, but also so that we’re more consumed by it: so that we don’t have time for anything else. Especially anything, like politics, that would upset the social order as it is.

1 comment:

Gina said...

I often rail against all the adult responsibilities I must deal with now that I'm an adult, including managing my spending and saving. I've been dealing with semi-complex financial issues for most of my adult life and no, they don't really take a lot of time. But then, I'm organized. And that's all it takes -- organization specific to the individual and that person's needs. The make it a liberal/conservative issue to me is laughable. It's about whether one is responsible or not.

As for the ACA, just as with the old system, some will benefit, some not so much. I will benefit -- greatly. To wit:

My deductible will be $750 per year. My out of pocket will be $750 per year. There is NO cap on what insurance expenditures are per individual. My coverage is at 90% which means I pay 10%. I have no copays. Out of network is 40% covered, both medical and pharmacy. Once my deductible and out-of-pocket expenses are paid, the only expense I have is my monthly premium of $299, which is down from the full premium because of the tax credit I was eligible for. The coverage I receive is exactly what I received when I was in the state's high risk pool and paying over $9000 a year total (deductible + out of pocket + premiums). Under the ACA, my cost has dropped to $5100 per year.

Now, I'm not employed but self-employed. I have no one to take care of me and my financial business but me. And I accept that responsibility fully. That's part of being adult....(smile)