I was browsing about YouTube when a creator that covers an interest of mine posted a video indicating that she would commit full-time to making content, and quitting her day job. I thought, cool, it's great to see the Internet being a means for individuals to reach an audience and even make a living from it. I've been there myself, to a limited degree. But I realized in watching her that she also has an advantage in making this leap: She lives in the UK, and she will always have healthcare available to her from the NHS. She doesn't need a job to make sure she has healthcare.
If you're an American, like me, you have no idea what this is like. One of my friends from Norway half-jokingly said that maybe it's why we seem so unhappy (Norway is always a top 5 happiest country). I think most people generally acknowledge that healthcare being tied to insurance being tied to full-time employment is a chain that doesn't make sense, and we become particularly aware of it during recessions and global pandemics. We hate the thing where treatments aren't covered, there are massive deductibles and co-pays, billing almost never goes as planned.
I relate to that young YouTuber because I have been in positions before where I might have an opportunity to explore some side hustle or maybe develop a real business. But every single time, it comes down to the fact that there's no universe where I can risk financial ruin by way of an unexpected medical problem, and this is even more true now that I'm over 40 and have a family. Simon's ADHD medications alone would be impossible to cover. And thank God none of us are diabetic and need insulin to, you know, not die. Universal health care would be incredibly helpful to stimulate new opportunities among those who want to start a business or work indefinitely on gig jobs, whether it be professional consulting, performing in the arts or even driving for Uber.
Not only does universal healthcare benefit gig workers and entrepreneurs, but it so obviously gets employers out of the healthcare equation entirely, which would vastly change the equation in what they have to pay for. No employer likes paying for health insurance, and many only pay the bare minimum in the first place, leaving the bulk of the cost on the employee. This isn't just a problem for employers attracting and retaining unskilled labor, either. Even cash rich technology companies know that the insurance benefit is part of the overall compensation package and they have to be competitive.
Obviously this means another deduction line on your paycheck, but it would replace the one you probably already have. At a previous job, I was already paying about a grand of month right off the top for health insurance, and it wasn't even that good. Closing the loopholes that allow crazy profitable companies to not pay corporate income taxes would also help. At the end of the day, the important thing to accept is this: We pay more per capita for healthcare than any other country, and we don't have even close to the best outcomes. It gets worse every year. I don't understand the people who fear single-payer, expanded Medicare or even some transitional thing. Your cost sucks and outcomes suck today. You're paying for steak dinners and getting McDonald's food that will make you sicker.
Am I suggesting that it's OK to wipe out an entire system of a middle-man market, and all the jobs that go with it? Yes. That industry doubled in head count from 1970 to 2000, and in the last few years started rising again. For what? What value are we getting out of that? Health insurance pays for less and is less service oriented than ever. It's 2.5 million people, which seems like a lot, but for context, the economy added 900k jobs last month. There is larger economic opportunity ahead. And in real life, we know America doesn't have the nuts to make a bold change like that. Whatever we come up with, it will be incremental and gradual.
But let's stop with this nonsense that the free market is better at paying for healthcare. It clearly is not. The only one benefiting from the enormous per capita cost is the insurance companies.
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