A small bureaucratic error has given me something to write about. While I'm in the US, my employer is providing me with reasonably good health insurance, which is the normal way that people who have decent health insurance get it in this country. However, I had a relatively trivial change of status within my reasonably large employer, for which this time's paperwork was apparently handled incorrectly by the responsible parties (not me). Incorrectly: such that the department in charge of benefits (like insurance) now thinks that I am no longer with my employer. Even though I am, and all the other paperwork is correct and everything else is working fine.
However, it has given me the tiniest glimpse as to the life of the genuinely uninsured (which I am technically not, since I'd be retroactively paid any benefit denied while they sort this out). It isn't completely the case, as you may already know, that there is no social safety net in the US. There is one. There may actually be too many, in a sense.
You see, a good analogy for how the safety net works for health care in the US is with, well, a safety net. It's quite possible that the US safety net uses more rope than the Canadian one does. But it isn't a single health care safety net. It's actually a layered set of safety nets, one on top of the other---but with a very wide spacing in each net. So you're likely to fall through each individual one. If you're deft and lucky, you can arrange yourself to hang on to one of them before you hit the bottom, but it's harder.
A manifestation of this happens to be the insurance cancellation letter I received from my employer's benefits department. It contains a lengthy form with instructions in order to sign up for something called COBRA. (I'm not kidding.) COBRA, aside from being GI Joe's nemesis organisation, represents one portion of the bewilderingly complex system of health care stopgaps and "bridges", so to speak, between the different levels of stopgaps. Use of the form to sign up for COBRA itself comes with its own goodly list of instructions and limitations.
I'm given to understand that the paperwork burden for things like COBRA is even worse for the employer (not that I'm crying for them). If you have a reasonably large employer, as I do, it can be relatively streamlined. But if you're a small business, I'm given to understand that these kinds of things can be quite the crushing burden.
Of course, as a user of the system, it can be pretty annoying. Compounded with the loss of your existing insurance, of course, the paperwork pales into insignficance, since COBRA basically means you get the rate of your employer's plan, but without the subsidy. (If you try to buy decent insurance yourself, it's much much more expensive.) COBRA is only useful if you have a good severance package and/or plan to transition to other employment right quick and want to keep seeing the same doctors on the same plan. Otherwise, you fall to the next safety net, and the next, until you slip through the cracks.
Some of you have undoubtedly witnessed major health care events that have happened to you or your loved ones in the recent past. Now imagine attempting to handle these difficult situations...but with all this extra uncertainty and paperwork and complicated "bridging" strategies. Let's leave out the economic arguments for universal single payer health care. Let's even leave out the moral requirement of distributing health care fairly and the corruption of true liberty that occurs when it isn't. That alone---the social burden of complexity---is to me a pretty good argument for single payer health care. Once you insert other third-party entities into the system, you have to assemble all these complicated bridge policies and administrative systems, and it just spirals out of control.
(And, in case you were wondering, if I'm wrong and it's a major hassle to get back my health insurance rather than flipping a switch in a database, I'm high-tailing it out of here back to the True North Strong and Free. Furthermore, and confidential to the Canadian readers: don't get a swollen head.)
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