The New Shackle of Serfdom: Clinging to Healthcare Insurance

September 22, 2015

The shackles of this new serfdom are invisible, but no less destructive for being invisible.

One of the more remarkable characteristics of American life is our passive acceptance of systems that are so obviously completely insane. Yes, I refer to our healthcare system, a.k.a. sickcare because in America sickness is profitable and health is not, and healthcare profiteering that would be the envy of pirates and warlords everywhere is the norm.

What warlord wouldn't jump on the opportunity to jack up the cost of a medication from $13.50 a tablet to $750 overnight, or as the article highlights, jack up the cost of an off-patent med from $1 a pill to $750 a pill in a few years?

This piratical pillaging is not an outlier--it's the norm in America's parasitic pharmaceutical industry:

Cycloserine, a drug used to treat dangerous multidrug-resistant tuberculosis, was just increased in price to $10,800 for 30 pills from $500 after its acquisition by Rodelis Therapeutics.

Imagine getting to jack your weekly wage from $500/week to $10,800/week while issuing a laughably lame excuse.

These profiteering prices are not the shackle of serfdom, at least not directly; few pay these prices in cash--insurers pay. And when prices rise, insurers jack their rates up accordingly (plus a bit to cover their costly political lobbying and the profit margins expected of quasi-monopolies).

Healthcare insurance is the new shackle of serfdom: Americans are forced to cling to whatever coverage they have, lest they lose coverage and risk bankruptcy.

Low-income Americans theoretically don't have to worry, as their medical care is covered by Medicaid. (They only need to find doctors and clinics that accept Medicaid. Good luck with that....)

Retired Americans only have to scrape up the few hundred bucks for Medicare Parts A, B, C, D, and of course E through Z (shall we talk about insane levels of complexity in the system? Perhaps another time...).

Modern capitalism has one necessary dynamic: the mobility of labor and capital. Financial capital is entirely mobile now; a click of a mouse button is all that's needed to send capital almost anywhere.

What happens to labor mobility when no one dares quit because that would mean losing their medicare coverage? Yes, I can already hear the obvious: the new employer will provide the same coverage.

Oh really? What if the new employer is the worker himself? What if the new employer is too under-funded to afford America's insanely costly healthcare?

And please don't offer ObamaCare as the "solution": in high-cost regions such as the left and right coasts, any household with a moderately middle-class income doesn't qualify for ObamaCare subsidies.

Please explain the wisdom of shackling employers to employees' medical insurance, and employees to these employers. You can't, because there is no wisdom in this insanity. The system is not the result of planning or coherence--it's simply the result of a jumbled series of historical accidents.

Yet this is the system we cling to. Why? 1) We have no choice or 2) it's so insanely profitable for those at the top of the heap. Are these good reasons?

Is shackling our workforce to their current employer simply to avoid the risk of not having insurance and not qualifying for subsidies good for the economy? No.

This system makes no sense whatsoever.

There are only one way out of this insanity: break the shackles from employer to employees' healthcare insurance and from employees to employer.

There are only two ways to break these shackles:

1. Offer everyone universal healthcare coverage via a government agency

2. Go back to a cash-only system. The "Impossible" Healthcare Solution: Go Back to Cash (July 29, 2009)

Guess how many pills the pirate would sell for $750 each if insurers were eliminated and cash payments by patients were the only form of payment: yup, near-zero. The parasitic pirate would either have to drop the price back to $13.50 (or better yet, $1) or go broke and have to sell the rights, or be accosted by those who'd lost loved ones to his rapacious greed.

The shackles of this new serfdom are invisible, but no less destructive for being invisible.

Of related interest: Shadow Work and the Rise of Middle-Class Serfdom

A Toxic Work World

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