The YAD Guide To Health Care Reform

« July 2009 »

Memo to the Fuckery Enablers: YOU ARE DUMB.

Ah, health care reform. The subject has been debated for so long that it's devolved into minutiae, and for some reason those minutiae are being debated by fuckheads with deep financial ties to the status quo. Because the media frowns on terms like "fuckheads", they have dubbed these people "Blue Dogs". So I think it's important to take a step back and remind these Blue Dogs, and the people who might be able to exercise power and influence over them, why we're bothering to reform health care in the first place. And that reason is, if you need health care in America, you're fucked.

For-profit health insurance will fuck you. The real problem with private health insurance in America is that it's largely a complete fucking sham. I mean, insurance in general is a bit of a con job and a shell game, but health insurance is by far the worst in that regard. The whole idea behind insurance is a bit like voluntary, for-profit taxation. Everyone who gets insurance from a private company pays into that private company. In turn, that private company pays out to anyone who needs it. The private company makes a profit because most people don't need the payouts most of the time.

If you have car insurance, you can go years and years and years without having an accident. And the longer you go without an accident, the less your car is worth, so if you eventually do have one, the payout is even smaller. Home insurance is the same way. The insurance company takes in money all the time, but only gives out money when problems happen. And in most cases, the odds are that the insurance companies can turn a profit by only fucking over a small percentage of their customers. Of course, they can make BIGGER profits by being evil bastards, and many of them are, but it's still possible to run an auto insurance or home insurance business profitably and vaguely, sort of, ethically.

Health insurance is a different beast. Everyone gets sick. Not only that, everyone gets sick over and over again. And the older they get, the more likely they are to get sick. You know who the ideal health insurance customer is? Someone who starts paying premiums at 18 and gets run over by a bus, killed instantly, at age 30. And those people make up a very small percentage of the population. Ergo, for-profit health insurance will fuck you.

They may not have fucked you yet. They may not fuck you tomorrow. But at some point, when you become a threat to the profit margin, they will find a way to fuck you. It's inevitable. It happens constantly. The only way to get out of being fucked by health insurance is either to have enough money to pay for everything anyway, or to be important enough that they don't dare fuck you. This is why Blue Dogs and Republicans can somehow manage not to see the need for comprehensive health care reform. First, because they have great coverage. Second, because they have a lot of money. And third, the health insurance companies know the instant some low-level bureaucrat in the claims department denies coverage for Max Baucus' Viagra prescription, the Congress will pass European-style single-payer before you can finish saying "socialized medicine murders the elderly". The rest of us, with no power to fuck the insurance companies back? We're fucked.

If you're uninsured, you're fucked. Maybe you can be "lucky" enough to be poor enough to qualify for the current medical safety net, but since they'll never raise taxes to keep up with the cost of coverage, you will eventually get fucked the way all the poor people in California are about to get fucked. Otherwise, you're not covered at all, in which case you're fucked, because you will eventually get sick, and when that happens, you will either go bankrupt or die or, most likely, both. Good luck with that!

If you're insured, you're probably underinsured, either because you yourself can't afford a decent plan, or your employer is trying to control costs. Which means eventually, sooner rather than later, you'll get sick with something they won't pay for, and then you'll go bankrupt or you'll die, or, most likely, both. Good luck with that, too.

If you happen to be one of those rare middle-class people with a decent employer-based plan, you're fucked. Why? Because eventually you will get sick. And then you'll have a pre-existing condition, which means you'd better hope you work at that job for the rest of your life, staying on the same plan, because if you get laid off, or get hired by a different company with a different insurer, they won't pay for the treatment of the pre-existing condition, and then you will either go bankrupt, or die, or most likely, both. Again, I wish you the best of luck with that.

And if you're happy with, and able to, stay at that job and with that provider for the rest of your life after you get sick, eventually, you will get so sick that they will find an excuse to stop paying to treat you, because that's what they do. That's what they spend the money on that you and your employer send them. Accountants and administrative types who tweak the rules so that they can get away with fucking you once you get too expensive. And once you get too expensive, you will either go bankrupt, or die, or most likely, both. Luck doesn't really enter into it anymore.

And the best part? All this fucking? All this death and bankruptcy? It all exists for one reason. So that a bunch of assholes at the head of companies like United HealthGroup can make more money in a week than you will make in your entire life. Isn't that wonderful? Doesn't that make you feel warm and tingly inside? If you feel warm and tingly inside for more than four hours, don't consult your doctor, because odds are your policy doesn't cover that.

This is why we need a government option, since we can't even consider a single-payer system for some reason. Because even if the government health plan fucks us, through bureaucratic indifference, incompetence, and even rationing? Even if the government plan is as bad as the Republicans say it is, and we all get pushed out on ice floes to die when we turn 70? At least we won't get fucked for money. At least people won't end up bankrupted to buy some CEO another yacht. At least the government won't pay an administrative person $50,000 a year to figure out how to deny $50,001 a year in coverage so that some upper management asshole has a buck to tip his caddy with.

Even if NOTHING ELSE changed about the health care system, I would consider it valuable reform if, at a bare minimum, people weren't getting rich off all the horror and the tragedy and the nightmares people are going through in America every time they fall ill. Is that too much to ask? It is when the rich assholes are the ones with a dozen Blue Dogs in their back pocket. Any version of "health care reform" that doesn't address the systematic fucking over of the American people in the pursuit of pure profit is a sick joke at all our expense, no matter how "bipartisan" it is.