Healthy, Wealthy, Wise

I’ve seen this movie before—the one where everyone who knows anything about the subject says we have to do something—in this case, reform our system of health insurance—but the vested interests and the lunatics manage to keep us from doing it.

 I know I keep yammering about health insurance reform, and I’m sure your eyes are glazing over when I re-introduce the subject yet again. But it is really, really important. And it is particularly important to the gay and lesbian community, for reasons I have also belabored.

One reason the recognition of gay unions is so important is health insurance: currently, if you are gay and don’t work for an enlightened employer, you can’t put your partner (or your partner’s children unless you have somehow established a legal relationship with them—itself not easy) on your health insurance. And that assumes your employer even offers health insurance. The number of employers who do is declining quickly as costs continue to escalate.

Even if you are one of the lucky few who do get adequate insurance through your employer, even if your employer is one of the enlightened ones who allows you to put your partner on your policy, there are significant differences in tax treatment of that benefit, and—surprise!—those differences mean that you will pay more in taxes than a heterosexual coworker who makes the same amount of money that you do and has the same number of dependents and deductions.

Speaking of jobs—as I noted in these pages back in 2006, a rational national health insurance system would mean increased economic development/job creation and would improve American business’s competitiveness with foreign companies. Today, providing employees with health insurance costs businesses more than their net profits; that is why many companies are dropping it. The cost of health insurance is the single largest “drag” on new job creation. For companies that can afford to offer health insurance, negotiating and administering those benefits, and complying with government regulations attendant to them, consumes untold hours of HR time. Smaller companies—the engines of economic growth—are often unable to offer benefits, putting them at a competitive disadvantage for good employees. Job growth benefits everyone—gay and straight.

If all citizens had basic health coverage, we would also experience a decline in the social costs caused by anxiety, anxiety that is caused in significant part by the medical status quo. When a serious illness means you might go bankrupt—when you are worried that you can’t take your child or partner to the emergency room without busting your budget or losing your house—you tend to take those worries out on others. There is a considerable body of research showing that countries with better social safety nets are more tolerant of differences in race, religion and sexual orientation. (Some studies have even suggested that Canada’s lower rate of gun violence can be attributed to their stronger social safety net.)

You just have to turn on your television to see the smoldering fury that too many Americans are feeling. Most of the people screaming and accusing the President of socialism, fascism and the like can’t even articulate what they are angry about or what they want. It is easy to dismiss them as ignorant and fearful, and most of them are. But the fact of their rage is undeniable—and when people get worked up, when they believe they are victims, when they fear for their jobs, and their ability to get healthcare when they need it, they don’t necessarily know why they are angry or look for rational objects for their fury. They take it out on anyone who is different. That—in large measure—was what happened in Germany between the two World Wars. There, the anger was focused on the Jews. There’s no guarantee it won’t focus here on gays.    

To the extent we can patch our tattered social safety net and allay at least some of the free-floating anxiety that leads to disaster, the better chance we have to avoid such outcomes. But getting healthcare reform passed this time won’t be easy. Teddy Roosevelt tried. Harry Truman tried. Nixon tried. LBJ did manage to pass Medicare. Clinton failed to get health reform done.

If Obama is to succeed, he’ll need the help of all of us. Now is the time to write your Congressman, call your Senator, talk down your crazy uncle—whatever you can. We’ll all be the beneficiaries of a more humane, less wasteful system.