I prioritize essentials like rent, food, clothing, health care expenses and utilities over everything else. When I am done with those prioritizations, I have nothing left for substantive health insurance and with an actual need to see a doctor and have regular lab work done to monitor my medication levels non-substantive health coverage would actually be a waste of money which would impede my ability to pay for my necessary health care expenses because I would be spending the money set aside for them on coverage that doesn’t pay for them.

This is a philosophical argument neither of us can win, because we have a different set of philosophical commitments about certain principles.

However, as for Medicare, I am always very interested in discussions of ‘fixing it’ and ‘figuring out how to pay for it.’ I am not certain it is ‘broken’ in a way that requires blatant ‘fixing’. Most Medicare recipients are far more satisfied with it than most holders of private insurance are with their own policies, and consumer studies bear this statement out. Someone is doing something right. At least one conservative Republican plan to ‘fix’ Medicare (CPR is the catchy abbreviation) involves breaking it beyond repair so the private sector can compete with it. This tends to suggest that the ‘problem’ with Medicare as most conservatives see it is that it is too much better than the private competition. The actual link to the write up of CPR by its creators is in my blog.

As for paying for it, it is just a matter of prioritization. I consider Medicare to be more essential than subsidizing Hewlett-Packard’s efforts to fire more American workers and send American industry to China and Singapore or to fund a war in Iraq or Afghanistan. Clearly, many in Congress in BOTH parties disagree with me. The cost of the war in Iraq, as has been beaten to death my many liberal and independent writers (and even some disgruntled hard-line conservatives such as Ron Paul), would have ’saved’ Medicare. This is just one example, and I am not trying to foist an opinion about the Iraq War (pro or con) onto you. I am simply making a statement about priorities.

Eclectic Radical wrote:

As a self-employed man without children I have the choice of paying for prohibitively priced private health care or going without health care and hoping I do not get dreadfully sick.

I am also self-employed, but I prioritize health insurance over non-essentials like vacations and tons of shoes and makeup. We all make choices. I have high deductible catastrophic insurance that doesn’t cover my annual exams, birth control, etc., but it is a financial planning tool that ensures my retirement accounts will be protected if I have a major health problem. It’s my choice to purchase that insurance, and my choice to work extra hours and take consulting gigs on the side to pay for it. Why should your tax money subsidize me if I’m capable of working my ass off to buy something I value? It’s not your job to give me peace of mind.

I doubt you’re a lazy bum and I’m sure with a pre-existing condition insurance is extra expensive. That sucks big time. But sometimes being dealt a crappy hand means you have to work a little harder to get what you want. (Sorry, I know that sounds preachy, but I’m tired and don’t feel like rewording what I wrote.)

Look, I don’t know your specific situation and what kind of disabilities you might be dealing with. But I know you spend time blogging and commenting every week. If insurance is important to you, stop giving away your writing (which is excellent) and grab yourself some freelance gigs to pay for it. Or, I hear there’s still big money in Internet porn. ;) But you’re not screwed because of your gf’s crappy insurance and your employment status, you just have a tougher time making ends meet.

You want to pay more taxes to get what you want. I’d rather work more hours to get the same peace of mind.

Oh, and let’s fix Medicare and find a way to fund it before we consider expanding the program to more people.

Honestly, as a liberal advocate of health care reform, I’m rather disgusted with the current obsession with ‘cost.’ Quality health care is never going to be cheap. It will be more cost effective for taxpayers to subsidize health care in the place of several hundred competing insurance companies, because the principle behind insurance is shared cost and the tax base can share costs FAR more efficiently than multiple companies in competition with each other. There are also artificial costs inherent in the corporate health care system we currently possess that would be eliminated by a single-payer system or a non-profit system. But costs aren’t the real point.

The real point is access to care. As a self-employed man without children I have the choice of paying for prohibitively priced private health care or going without health care and hoping I do not get dreadfully sick. I make enough to contribute my share to the household income, but not enough to pay for private health care. My girlfriend has health insurance through her job, but after a bad year in which she had to be hospitalized twice for completely unrelated issues, her health insurance is largely useless and she has had to pay large out of pocket costs for medication and co-payments which have had a serious impact on our finances. Were I to get seriously sick too, it would be a disaster. Less serious but more constant a problem, I am an epileptic and as a result I have to pay large out of pocket costs for medication without insurance, but cannot afford private insurance.

Under the current system, we are screwed. My girlfriend’s coverage was insufficient to meet her medical needs when she actually got sick and I am uninsured and will remain so for the foreseeable future. We are not screwed because we are lazy bums, we are both working. We are screwed because the insurance offered by her employer is not what it should be and because I am self-employed.

I would very happily pay more taxes to be able to see a doctor and not spend so much every year on seizure medication. I think more and more, as much as I hate to give the man credit for anything, that Ralph Nader is right and the real solution is the extension of Medicare to cover all Americans.