There is something so terminally exhausting about our “healthcare” debate, which rests primarily on a deeply stupid and economically illiterate set of assumptions—namely that insurance coverage for routine and pre-planned medical expenses is a necessary part of our economy. It is not—or rather, it need not be the case. But that seems to be the only framework in which we can debate “healthcare,” by which we generally mean “health insurance,” but which actually means “expensive co-payment plan for things that would be much cheaper if we just paid for them out-of-pocket.”
This is a brutally simple and easy-to-understand argument, which is presumably why everyone—politicians, normal citizens, liberal, conservative, moderate, everyone—ignores it. We have been trained to believe that the healthcare economy is some kind of magical alternate-universe industry in which the normal economic principles don’t apply. “Under [the Graham-Cassidy bill],” writes Hawaiian senator Brian Schatz, “pregnancy will cost you an extra 17K.” Readers, Daniel Payne—the man you trust to bring you quality blog content several times a week (less during holidays)—is here to tell you that this financial figure is, to put it delicately, complete and utter bullshit. I don’t mean the price tag—I am certain that our idiot medical system cheerfully charges new mothers tens of thousands of dollars to give birth. I mean, rather, the perceived immutability of the price tag, the idea that, without legislative intervention and subsidized insurance, pregnancy and childbirth are financially-ruinous endeavors.
They are not. This is simply fact. For the birth of our first, my wife and I shelled out around $5,000, all told—that’s prenatal, birth, and postpartum combined. This, mind you, was entirely out-of-pocket. Now, surely a medical price tag can and will fluctuate based on individual circumstances, geographic location and other considerations. Yet the idea that the average mother and father need to pay as much as a down payment on a new house in order to have a baby is just false. It is wrong, and the people who tell you otherwise are lying to you either out of simple ignorance or else cynical self-interest. The same is true with any number of medical procedures that we’re regularly told would bankrupt the average patient without insurance.
You may not be aware of this, because there are a great many powerful and unscrupulous people—politicians who want you to vote for them, doctors who want your money, insurers who want you to give them money to give to the doctors—who have steadfastly avoided addressing the fallacious presumptions of American healthcare. Add to the list celebrities who believe they’re mounting some sort of justice crusade against the evil baddy Republicans who want to deny starving widows their IUD co-pays: we have had to listen to Jimmy Kimmel rant about health care for several days now because Jimmy Kimmel thinks the only approach to “quality health care” is expensive health insurance by way of a byzantine and disastrous federal law.
(It does not help that, even on the merits of health insurance itself, Kimmel and many others exhibit an economic illiteracy worthy of a college freshman who just discovered Communism: the Graham-Cassidy bill, Kimmel complains, would let “insurance companies charge you more if you have a preexisting condition.” Muppet News Flash: sick people cost more to treat than healthy people. This is not a conspiracy.)
I will admit that the healthcare debate is, at this point, frustratingly personal for me: my family will lose our health insurance at the end of this year—due to circumstances directly attributable to Obamacare—and so we will have to find new, doubtlessly more expensive insurance for next year. Had our political and pundit classes taken the right approach to this debate, we would not have to worry about jumping from plan to plan due to the volatile insurance market the Affordable Care Act created. There are simple lessons to be learned from the Obamacare fiasco: that insurance is not a medical panacea, that it is not even the most important thing about the medical economy, and that healthcare is not some mystical unicorn industry but is, in the main, a part of the economy just like everything else, one which, if properly structured, can be paid for very easily without a third party.
If we began to treat health insurance like it should be treated—as an emergency product to be used in events of catastrophic tragedy instead of a help-me-pay-for-everything tool—we would surely see a bit of sanity returned to the healthcare market. But that doesn’t make for snappy late-night monologues and idiot viral tweets. So don’t expect it anytime soon.