If it happened there…

I recently read a blog post on Slate, the first in a series called “If It Happened There,” that reported on the government shutdown in the tone usually reserved for articles about events that occur abroad. It was sadly amusing and highlighted the irony of the concept of American exceptionalism in light of of our government’s recent antics. It also caused me to reflect on the reasons I’m lately much more interested in reading articles about what happened “here” than those about what happened “there.”

Throughout high school and college I studied international politics and had little interest in learning about my own government. My coworkers are often surprised to learn that I never watched a Democratic or Republican National Convention before last year, and I knew little about the structure and function of my own government while in school (my current line of work has an exclusively domestic focus and often intersects with politics). The reasoning behind my reluctance to learn about my own government was pretty simple: I thought it was corrupt and dysfunctional, and didn’t want to be a part of it. Not that governments in other states weren’t dysfunctional, but for some reason I was more interested (fascinated, even) to learn about dysfunctional governments abroad than the one at home.

Not much has changed since high school and college—I still think my government is corrupt and dysfunctional (the events of late make that eminently clear). However, it is because of this dysfunction that I am now focused on domestic policy rather than international policy. I know from living abroad that the best solutions to any problem have to come from those who are personally affected by it, and who have a vested interest in ensuring its successful resolution. This does not, for the most part, describe the members of the U.S. congress—if it did, the shutdown never would have happened.

A friend of mine, a journalist from Spain, recently returned home when his visa ran out. He quickly acquired a new visa to come back to the U.S. and arrived just as the government shutdown was beginning. Many people joke that they can’t understand why he would want to come back to the U.S. in its current state. However, I imagine that he is intrigued, perhaps even amused, by recent events. As an outsider, you have the luxury of observing phenomena such as the U.S. government shutdown much like you would observe a play. Compared to events happening at home, you can analyze and comprehend them with a greater degree of clarity because they don’t generally affect you as directly. Just as it’s easier to recognize another person’s character flaws than it is to confront your own shortcomings, it can be tempting to focus on a crisis occurring “over there” rather than a the events unfolding right in your own backyard.

Obstructionists in congress know that their actions are hurting people, but only on an abstract level. Moreover, it is much more appealing for them to ignore the facts—like the polls showing that 70% of Americans disapprove of the GOP’s actions, or the news that millions of Americans visited the “Obamacare” health exchange websites despite the shutdown—than it would be to admit guilt and change course. It sure doesn’t look like they plan to face reality any time soon.

An open letter to my peers

OK friends. It’s time for some real talk here. I’m broke, too. I’m all for taking responsibility for one’s own health and actions, too. That’s why I support the Affordable Care Act.

So, you don’t want to pay for “someone else’s health care?” Neither do I. The problem is, I already do—whether I like it or not. Because when someone who is uninsured or underinsured goes to the emergency room, they have to be treated, whether or not they can pay for that treatment. Hospitals provided $62.1 billion worth of care in 2009 that was never paid for. And when hospitals are faced with those kinds of losses, they have to raise prices for those who can pay. That means higher sticker prices for those who pay out of pocket, and higher premiums for those who have insurance. Families USA estimated that in 2008, the cost of higher insurance premiums due to uncompensated care was $1,017 per family and $368 per individual. So what about all those claims from the red side of the aisle that premiums would skyrocket under the law? Turns out those “rate shock” claims were false—apparently when insurance companies are forced to compete for people’s business in a transparent manner, consumers win.

Friends, the question isn’t whether you want to pay for someone else’s health care, but rather how you would like to pay, and how much you would like those costs to increase in the future. In 2010 the Urban Institute projected that without reform the cost of uncompensated care in the U.S. would rise to up to $141 billion in 2019, whereas it would “dramatically reduce” with the passage of the health reform bill. Yet, the main economic burden of uninsurance comes not from uncompensated care, but rather from the loss of productivity caused by poorer health outcomes among the uninsured—who often don’t get the care they need early enough, if at all. According to the Institute of Medicine, the economic cost of uninsurance to society is between $65 billion and $130 billion annually.

If health reform is so great, you may ask, why do you keep hearing such horrible things about it? Well, perhaps you should consider the source of that information. Because when the same people who bash the individual mandate when it’s connected to a Democratic president claim that it’s “clearly consistent with conservative values” when it’s connected to a Republican governor, you might start to think that their opposition to the law has less to do with the law itself, and more to do with who came up with it. When their best alternative to the law they claim is such a bad deal for the American people is shutting down the government entirely, and when their desire to accomplish this goal is strong enough that they have no problem lying to the American people to do so, you might start to question whether they really have your best interests at heart.

Look, I don’t think the law is perfect either. But I do think that something had to be done to at least begin to fix our broken system. The U.S. is almost entirely alone among industrialized countries in its failure to provide universal healthcare to its citizens, yet we still pay more than twice as much per person on healthcare than countries that have “socialized” medicine. And people like you and I—the “young invincibles,” as some would call us, have worse health outcomes than young people in any other developed country. If you have objections to the law, please speak up! But you’re gonna have to go beyond saying how much you hate it an give me some constructive solutions that would work in the real world.