Down and Out with the Healthcare Bill

Be gentle, Congress.

While we applaud the Democrats’ historic victory Saturday night, our parochial concern with the rush to healthcare “reform” hasn’t changed: How much will it screw us over?

Some background, if you’ve never had the pleasure of working freelance: Neither party has ever given a shit about Americans who embody the American Dream by working for themselves.

If you’re a wage slave, you’re familiar with the Social Security/Medicare tax from your paycheck, which amounts to 7.65 percent. But that’s only half of the real tax — your employer pays the other half.

Self-employed? You have the distinct pleasure of paying both halves, or 15.3 percent — off the top, whether you earn $5,000 or $50,000. You can deduct half from your gross income, but you’re still on the hook for the percentage — which is the most fabulously regressive tax America offers, since it only applies up to $106,800 of income. If you’re wealthy, you end up paying less a portion of your income than the working poor. Even sales tax is more fair than that.

But we like using the coffeehouse as our office, so we can live with that. Beats waking up at the asscrack of dawn five days a week.

Still, there’s a significant risk to working freelance: There’s no way in hell you can afford health insurance. Not if you prefer to pay the rent. Those increasingly expensive (and employer-subsidized) group policies that are forcing the issue don’t hold a candle to what individuals face on the open market. Your only option is the one Alan Grayson parodies: Don’t get sick.

Thus, “reform”. Since we already pay a 2.9 percent tax for Medicare, we’d be more than happy to double it to provide Medicare for All, including ourselves. But that’s not on the table, since helping Americans like us to continue working for ourselves would be socialism.

Instead, depending on which version of the House and Senate bills you’re looking at, we’re faced with buying insurance that costs more than what the private market offers — or paying a 2.5 percent penalty for the pleasure of doing nothing. (The Congressional Budget Office estimates the Public Option would cost more than private insurance, since it would be saddled with higher-risk, hard-case leftovers from group policies.)

We did the math on Saturday: Buying insurance would cost ten times more (but see below) than paying the penalty. And for the good of the Republic — if what eventually emerges from the conference committee (if it ever makes it that far) actually helps a significant number of Americans — we’ll go along with it.

But please, don’t act like you’re doing us a favor. We’ll pay the penalty, but spare us the insult.

Update: Serolf Divad has found an online calculator that estimates your cost under the House or Senate bills. Including the subsidy, the Public Option would cost us about four times the penalty.


Or before said crack, “pre-crack” you might say.

Beats sitting in a cubicle sweating out your annual review and enjoying hourly visits from managers who hold out pictures of South Asians who will do “your fucking job for cents on the dollar and call me fucking god so fuck you, yeah, fuck you and your fucking attitude, just get used to the fucking fact that your asshole if fucking mine until I get me a fucking ‘Haj, you fucking douchebag!”

I’m the kind of guy who tries to live by the 80/20 rule. As long as 80% of it works fine then I can live with the 20% that doesn’t.

However, I do realize that we are dealing with people’s lives here (a US American acquaintance became a lawyer and then quit out of sadness/disgust after he took on a HMO to get a girl with cancer treated and it dragged on till she died.) Unfortunately, the reality is that there is a significant % of your populace who is too stupid or empathy challenged to realize the necessity/importance of providing decent medical coveragefor your population and the necessity to get such legislation passed.

This should have happened 50 years + ago.

Being self-employed, I kind of resent the bite The Man takes out of the paycheck, but I just don’t think about it most of the time. Health insurance premiums for a small firm like ours is astronomical, so Mrs RML stays in Dead Tree Media partly/mostly to get a better deal on ins. for us.

If only those were the only dimensions of the problem. First, the lawyers for the HMO likely were high-fiving all the way from the court to the hotel suite for the orgy and dwarf toss, cackling wildly and signing songs with the chorus, “And every corpse a Christmas bonus!” They and their executives are giddy practitioners of manslaughter-for-profit and would rather the entire country die in its own puss and shit than give up .005% of their bonus. Second, that HMO and its cohorts own Congress. Third, America is a vast lunatic preserve of raging genocidal racists who would rather their tax dollars be dedicated to hunting down brown people and gassing them than seeing them enjoy non-bankrupting medical care. Fourth, the doctors are a victim class who have never made pennies on the dollars they are worth, they’ve come to believe through repeated assertion. No one is going to budge until well after the states has been reduced to folklore traded by nomadic peoples occupying the vast desert wasteland once known as North America.

@ManchuCandidate: Unfortunately, the reality is that there is a significant % of your populace who is too stupid or empathy challenged to realize the necessity/importance of providing decent medical coveragefor your population and the necessity to get such legislation passed.

@ManchuCandidate: My Japanese girlfriend can’t believe we don’t have universal insurance. Everything is covered 70% in Japan, including dental, and you can buy an inexpensive policy to cover the rest. But hey – this is America – pull yourself up by your bootstraps, even if you don’t have any.


Where did you find the numbers? The only time I’ve ever seen mention of what the average family will pay was on a CNN show some time ago. The numbers the host mentioned were somewhere around $3500 for a family of four making $50,000 (my recollections may be waaay off, but I can’t find the story by searching). Indeed, the numbers touted by CNN were quite good, considering it currently costs over $10,000 a year for a family of 4 to self insure under the private market.

TJ: I just saw Bo the First Dog being taken for a walk on the White House lawn. The tourists from Portland Oregon thought I was a freak, I was so excited and taking photos with my camera.

@SanFranLefty: My friend in the West Wing has met Bo and calls herself his “tia”.

@SanFranLefty: I hate that dog. I was hoping Obama would get a one-eyed pit bill and spray paint, “I EAT WHITE MENS’ BALLS” on its back in yellow spray paint, let him run wild on the White House lawn and bark at the neonazis protesting in Lafayette Park. Tip one – or 17 – at Bravo Bravo for me.


There’d be a certain irony to seeing the Bull Connor teabag crowd getting attacked by a dog…

@al2o3cr: Oh, yes, to see them being dragged around Lafayette Park by their intestines, that would be gloriously ironic.

I have no snark. Only rage. Can’t wait to see how much worse they manage to make my life.

@Serolf Divad: Indeed, the numbers touted by CNN were quite good, considering it currently costs over $10,000 a year for a family of 4 to self insure under the private market.

I was starting with that $10k-$12k number for private insurance, or roughly $1,000/month. I’m also presuming I don’t qualify for a subsidy, which may or may not be the case. (I’m not rich, but I’m single.) A penalty for someone in my AGI range would be less than $100/month. (A lot less, but 10x makes a nice discussion number.)

@Serolf Divad: Oh, and one more number: The official U.S. poverty level for a single citizen is $10,830. I think they were talking subsidies for up to 150% of poverty. But you could make it 250%, and I’m still comfortably outside the range.

@Tommmcatt is hunkered down in the trenches: Every workplace is as nice as the mouse these days, it’s sort of the model for employee relations, up there with American Airlines.

Ah, finally found a calculator that allows you to see your cost under the House Plan:

For example, a single adult 40 years of age pulling $40,000 a year would get no Govt subsidy, but would only pay $3500 for health insurance through the Exchange.

The same man making $30,000 a year gets a $776 subsidy.

A family of 4 making $50,000 would get a $6000 subsidy and pay only $3400.

To my mind these are good numbers. No, it’s not a single payer program like I’d prefer to see, but it’s a good start on getting Americans insured.

@Serolf Divad: Excellent find, and I’ve updated the post. The Public Option in the House bill would apparently cost me about four times the penalty, not ten.

Still not a slam-dunk call on my part, but the conclusion remains: If this indeed helps a significant number of citizens, I won’t begrudge the penalty.

@nojo: I think the part of the deal in which you don’t get thrown into the street and stomped by lawyers the second you get sick should be taken into account. The thing that brought the AMA on board was not their islamofascist tendencies but the fact that so many policies were turning up hollow – so much not covered or capped to an extent that the daktaries would have to make decisions about stopping a program of intervention mid-way or continuing and not being paid. Insurers got too greedy to remember they needed to bribe the daktaries as well as congress.

@FlyingChainSaw: Yes, there’s that, but I also don’t want to get too hung up on the House version — this is part of my ongoing wariness that by avoiding single-payer, they might end up with something that’s actually worse than the present mess. A simpler “insurance-reform” bill might still be the better bet, in terms of what they can actually get done.

The real call will be what comes out of the conference committee. If it ever makes it that far.

This is completely, and totally nerdishly unrelated, but where the fuck did you get that picture? Is it a photomontage? Having two different thread pitches like that is either criminally stupid, or so very specialized I can’t imagine where it would be useful — the one thread pitch would cause the other to rip uselessly through the material.

@IanJ: Google image search for “self-tapping screw”. Grabbed the largest one I could find.

They’re even different materials. Someone’s pulling someone else’s leg.

Under everything but the Senate HELP committee version, I would have to pay 10-11% of my gross income. Combined with my mortgage (taken on when I made twice what I do now) and other fixed monthly expenses (NOT including gas or groceries), that equals more than 100% of my net income. I am completely screwed.

Hah. It’s on the same page as a “SLEF TAPPING SCREW” [oh yes, definitely sic] and a “WOODEN SCREW” which is clearly made of metal. I feel confident in saying that the ZHEJIANG JIAXING DAZHE FASTENER CO.,LTD. is not one I would feel comfortable purchasing fasteners from.

This has been your moment of fastener nerditry. We now return you to your regularly scheduled discussion of the futility of healthcare reform.

@IanJ: Zhejiang Jiaxing Dazhe Fastener Co. of China. And I ain’t going anywhere with that.

I have a big question with this: if an insurance cannot bar people due to preexisting conditions, would this mean that people who did have such conditions have to pay an exorbitant or increased premium?

@Mistress Cynica: I thought the House version was adjusted gross — which for me includes the deduction for half the full SS/Medicare tax.

And could someone with more research time than me determine whether the amount you pay would be deductible? Although if it falls under the standard deduction, no help there.

General point: This is what happens when we avoid yet again pegging everything to a graduated income tax. I’m so happy the House made the point of cutting folks who make $250,000 a break.

@rptrcub: Probably would be something like Oregon’s current “high risk pool” which allows you to pay $6000/yr for what is basically major medical with a $1500 deductible and a 30% co-pay. As the man said, don’t get sick.

And if you weren’t depressed enough, this is from Krugman’s op-ed today on the wingnut takeover of the GOP:

Real power in the party rests, instead, with the likes of Rush Limbaugh, Glenn Beck and Sarah Palin (who at this point is more a media figure than a conventional politician). Because these people aren’t interested in actually governing, they feed the base’s frenzy instead of trying to curb or channel it. So all the old restraints are gone.

In the short run, this may help Democrats, as it did in that New York race. But maybe not: elections aren’t necessarily won by the candidate with the most rational argument. They’re often determined, instead, by events and economic conditions.

In fact, the party of Limbaugh and Beck could well make major gains in the midterm elections. The Obama administration’s job-creation efforts have fallen short, so that unemployment is likely to stay disastrously high through next year and beyond. The banker-friendly bailout of Wall Street has angered voters, and might even let Republicans claim the mantle of economic populism. Conservatives may not have better ideas, but voters might support them out of sheer frustration.

And if Tea Party Republicans do win big next year, what has already happened in California could happen at the national level. In California, the G.O.P. has essentially shrunk down to a rump party with no interest in actually governing — but that rump remains big enough to prevent anyone else from dealing with the state’s fiscal crisis. If this happens to America as a whole, as it all too easily could, the country could become effectively ungovernable in the midst of an ongoing economic disaster.

The point is that the takeover of the Republican Party by the irrational right is no laughing matter. Something unprecedented is happening here — and it’s very bad for America.

@Mistress Cynica: Oh, shit — deductible and co-pay. I didn’t even consider that.

Sometimes it feels like a choice of whether we would prefer to be bankrupted now, or when we get sick.

Okay, one more: one quarter of my actual gross income goes to taxes. Such are the joys of freelance. But I do like my coffeehouse office.

@rptrcub: They could do so much by legislating no preexisting condition/recission and full cohort coverage. The insurers would go crazy as they’ve written the rules to basically guarantee themselves any amount of profit they can imagine, increasing to infinity forever. Might give us a snapshot of what all this stuff really costs after a few years.

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