Out of the Woods

Is health care reform fair?

The proposed health care bills both in the house and the Senate will save a good deal of money but will also reduce the number of Americans with health insurance. If the current bills become law, 14 million people will lose their health insurance in the coming year and another 8 to 10 million will lose their insurance in the coming 10 years.

Who are these 14 million Americans?

The majority will be poorer Americans and older, retired persons. A disproportionate number of those will be persons of color. African-Americans are about 12% of the population but about 20% of the poor. About 11% Americans are Hispanic and 14% of them are poor.

Few voters are going to be moved by those numbers because they have bought into the mythology of the "welfare queen" first invented by Ronald Reagan. The story is about people of color who are too lazy to work and therefore live off government handouts. In Reagan’s story, a Chicago woman on welfare drove around in a Cadillac and carried Gucci bags. Reagan’s story was a fiction--a lie.

No doubt some welfare recipients are lazy and avoid working. But that is, of course, also true of some of the sons and daughters of the captains of industry who don't have to work and therefore don't and party instead. Think of Paris Hilton. But the made-up story about the welfare queens ignores the facts about the working poor. According to government census data 12% of people working make barely more than $15,000 for a couple. They can survive only with food stamps and other government assistance. A significantly larger number of working Americans still do not earn enough to put food on the table and to avoid being homeless.

Huffington Post gives us some examples of working poor families:

"Not so long ago, Kathleen Ann had a house, vacation time, spending money and everything else available to someone with a high-paying corporate job. Then she was discarded in a layoff, cast into a world where she could only find occasional part-time work. Ann now makes less than $20,000 a year, lives in an apartment and has been forced to accept that she is poor — a “Used-to-Have,” as she described it. “As a ‘Used-to-Have,’ I know exactly what Corporate America, lobbyists and politicians have taken away from me “,”she said.

Carla Shutak thought buying a house with her husband, who was gainfully employed as a civil engineer, would be a wise investment. When he was laid off in 2009, they couldn’t keep up with the mortgage payments and their home was foreclosed on. “My American Dream died,” she said. “Despite doing what we were taught was right by putting 20 percent down and asking for a fixed 30-year mortgage, we were now in our 40s and starting over with nothing.”

Monica Simon, 24, works full time at an online advertising firm, earning $23,000 a year after taxes. She’s still paying off her student loans and often relies on credit cards to cover basic costs. “Sometimes I get paid and then I have, maybe, $150 left over for the two weeks,” she said. “I just feel I’m getting way behind where I want to be for my age. I feel I’m just starting my life and I’m already miles and miles behind.”

A significant portion of the poor who will lose their health insurance are actually working. It is just that their jobs pay little, and their hours are quite unsteady and unpredictable. The new proposed health care bills favor the young and those who earn more than $50,000 a year. It penalizes the poor, regardless of whether they work or not.

This is blatantly unfair.

“What is fair? Everybody has their own idea of fairness.” Many people think that but they are quite wrong. When they take their children to baseball or football games they know when the umpire is unfair, when he or she does not apply the rules in the same way to both teams. There is no argument about fairness there. The same idea of fairness was involved in the Inflatagate scandal. It would not be fair if one team’s footballs were inflated to a different hardness than that of the other. The same idea of fairness forbids insider-trading. It is unfair for one person to have information not available to others. There are many more examples. Fairness means that prevailing rules are applied evenly to everyone.

Applying different rules about health insurance to the poor than to the remainder of the people is unfair.

But in American politics fairness does not seem to count for much. No one in Congress seems to worry much that the rules applying to the well-to-do do not apply to the poor.

At this point many people will try to blame the poor for their mistreatment. If they had done better in school, if they had gone to college, they would not be under-or-unemployed, they would not work at minimum wage jobs.

It may be true that if the people who are now among the working poor had managed to get more education, they would have a better income, although today some college graduates are selling cups of coffee at Dunkin' Donuts. But the fact remains that there are jobs that don't pay enough for people to live on their earnings and someone will do those jobs. Regardless of who gets an education and doesn't, 12% of American workers earn way below the poverty line and someone is going to do those jobs and be really poor in spite of working hard. These are the people who are going to lose their health insurance under the new proposed health care law.

There is no way of defending that uneven application of rules as fair.

Congress and the US government do not care about fairness. Our system is designed to favor the rich.