Saturday, September 26, 2009

Don't Know How She Sorts It

I just watched this short documentary, about a cook at the Sigma Nu frat house at Ole Miss:

Ten Dollars an Hour from Ben Guest on Vimeo.

Here's the math of Leasse William's life, from the whiteboard talk in the documentary:
She makes $10/hour, and works 50 hours a week, nine months a year, and either works minimum wage or gets unemployment (the income is about equal) for the other three. Her taxes (yes, people at this income level pay taxes!) are $3600, and her health insurance, which she buys on the private market, costs $2400/year. This leaves her about $14,200 in take-home pay, which is near the Louisiana poverty line -- and that already includes the possibility of government-subsidized unemployment benefits.

Now, poverty is a systemic problem, and it's not clear whether it can be simply fixed by legislation, more consideration shown to employees by employers, an insistence on racial equality, or any other individual undertaking. But the absolutely back-breaking cost of medical insurance is something we can fix with legislation, and the legislation is in Congress right now, in the form of the public option amendments to the Baucus bill.

Leasse's problem isn't just that her insurance is expensive -- it's that she doesn't have any extra resources to fight her insurance provider to protect her coverage. If, let's say, she wakes up bleeding from the nipple one morning and her insurance company refuses to cover it as an emergency, she's not going to be able to do what any smart person would want to: lawyer up and spend a couple of days making angry, pointed phone calls. She's back to work, if she can work, ten hours the next day. Every dime that insurance providers and brokers like the GradMed people (who don't provide real health insurance and wouldn't insure anybody in this documentary, but who seem like good representatives of the industry to me) steal and waste -- every bit of that $2400 a year that goes into marketing, salaries, profit, obsessive rereading of "Dying for a Public Option" -- comes out of the money that Leasse is setting aside for her own care, and it's money that she frankly doesn't have in the first place. Those costs are passed along to her in the form of claim denials, copays, coinsurance, and rescission.

And this doesn't just cost Leasse. Medical bankruptcy would put her right on unemployment (which her job seems to expect her to collect already), eventually on welfare (if she's lucky). This couple in a recent PBS NOW episode, like many others with chronically ill children, limits their own income so that they can qualify for Oklahoma state child health benefits, because their asthmatic daughter may need an expensive operation to repair her damaged lungs at any time. From a purely practical perspective, we are wasting the country's resources, both human and financial, by dumping them into the insurance industry.

And it doesn't just cost money. Our system of health insurance is unjust. It punishes those who can least afford it, and enriches those who do not deserve it and haven't earned it. Instead of strong citizens united for the common good, it creates fear and division and resentment. We can do better. We're so close to making a change for the better.


  1. Nick,

    I'm the filmmaker. Just wanted to thank you for taking the time to watch the documentary and to post about it. Universal health care (ideally single-payer) is both ethically correct AND saves the country billions. Thanks for posting. All the best.

  2. My pleasure. I'm glad you're happy I 'repurposed' the piece a little bit: I know you weren't setting out to make a piece about health insurance -- your goal seemed to be to listen very very carefully to someone interesting -- but maybe listening to the people around us and trying to make change are basically the same thing.

    Keep it up!