We Can't Afford It

Former Starbucks CEO Howard Schultz gave us some simple advice the other day, and it  led to most of the country mocking him.

One thing he said was that politics was broken, Republicans and Democrats spend too much time arguing with each other,  and that it would be a great idea if a successful businessman such as himself- a self-made billionaire -to be elected president and run the country.

The fact that he had never been in government - never run a village or a town or a city or a state or ever worked in Washington in any capacity - was just a bonus, he said.

Now, we could happily spend hours talking about what was wrong with those ideas, but it was something else that really got to me.

He said that our nation just couldn’t afford the Democratic proposal of Medicare for everybody. It is just too expensive, he said, looking fiscal responsible and showing he doesn’t have to pander to millions of poor people who don’t make ups significant voting block. But it did pander to a lot of Republicans, which is a good thing do when you want to. Be President.

Well, I do feel strongly that the United States -which has the richest and most powerful economic engine in the western world - should be able to afford the same kind of sweeping public health care you can find in England or France or Spain. Or in Cuba and Australia or lots of other nations around the globe, including Canada and Mexico.

But, that argument avoids the basic question that the reporters covering Mr.Schultz never seemed get around to asking. Just who, exactly, can’t afford it. Well, in their defense, that’s a question that should be saved for a follow-up think piece.

So, let’s think a bit. Just who is it who can’t afford health care for all of us?

Certainly not the United States government. Our federal budget for FY 2019 is 4.4 trillion dollars. Federal income is $3.4 trillion. And yes, President Trump’s budget deficit is up 18 percent from last year, thanks in large part to his big tax cut which went - mostly - to the richest  one per-cent of us. I don’t recall a single Republican opposing that idea. I remember them all smiling at a press conference.

So, let’s say the richest of us can certainly afford to pay some of the costs of a health care policy that will cover all of us. They could leave the country, of course, but every other western industrial nation would tax them for health care as well.

Maybe it’s the overburdened, over-taxed middle class that can’t afford it. Well, you can certainly argue that everyone in the middle class feels they pay too much in taxes. But, you get what you pay for. And, after all, saying you can’t afford something means something different to everyone.

So, can they really afford it? It depends on their income and their expenses, of course. Still, saying I can’t afford a car is different than saying I can’t afford to go on a vacation. Saying you can’t afford to send your child to an expensive private college is different from saying you can’t afford surgery. And saying you can’t pay for health care for all - and get health care for you and your family as well - is a complicated calculation.

If you safe money, no problem. If you break even, no problem. If you have to spend a few hundred dollars, or even a few thousand…well how much have you spent on fire insurance over the years and never had a fire.

Here’s what is happening under our current system, and it’s not pretty.

Under our current system, a lot of people just can’t afford adequate health insurance. Those include the two million people driven into bankruptcy last year because of medical bills. Then there are the people who pay for their medicine by selling their blood.

We don’t know how many there are, and more people sell their blood to buy drugs than to buy insulin -  that’s a whole different issue - but we do know that selling your blood is a thriving business.

 It’s hard too get good statistics, since the plasma industry likes to describe all blood donors as volunteers, even the ones who sell their blood for $30 to $50. And come back every 10 days. 

But we do know there are 400 licensed plasma donation centers in the United States, and the revenue from selling plasma has jumped from 4 billion to 11 billion dollars since 2008.

Do you think the people selling their blood couldn’t afford to pay for Medicare? 

Or, what about the two million people driven into bankruptcy last year because of medical bills. I bet they could have afforded it.

 So, I ask again. Just who is it who can’t afford giving the citizens of the United States the same kind of heath care that citizens all over the world get from their countries? And please don’t tell me that while the system has problems, we also have the best health care in the world, and that giving everyone health coverage would mean rationing that care.

After all, don’t the richest people in the world flock to our hospitals to get that care?

That’s true. And anyone in the U.S. who can spend $200,000 or so to see a top-flight surgeon in our country can still go see them.  Just not you or me. Not now, not ever.

So, if everyone was covered my Medicare, very few of us would get to see the world’s best doctors. Still, the government could make it possible for them to see some doctor or nurse or paramedic. Maybe our nation’s infant mortality rates would start going down.

That rate, recorded at 6.5 deaths per 1,000 live births in 2016, might even be cut in half, leaving the United States just a little worse off than England, France or Israel are today.

Anybody want to argue that we can’t afford that?