A strange kind of government

Just a shower thought, not the actual main essay which is forthcoming. (I hope.)

A crazy fact I guess I forgot to name (to myself)

Maybe this isn’t new to you. But it’s a new thought to me and yet I’ve always known it. There should be a word for that. (French, ideally.)

A thought that suddenly feels new even though it was there the whole time. A wonderful and terrible sensation. Yeesh. If you can coin the word pls do so in the comments.

SO, in the good old U.S., we describe healthcare as a “benefit” of employment.

That framing is so old, most of us never notice what it means: that we’ve literally assigned the gatekeeping of life-saving medical stuff to fucking employers.

Isn’t that weird? Idk.

It’s weird to me.

We’ve outsourced this so thoroughly, for so long, we barely register how it all works.

Maybe we should look at it with fresh eyes, together, right now. Because in all the other good countries, the state doesn’t do that.

What is the state even?

I mean, I guess it’s a group of us teaming up to avoid violence and protect the common good.

Promote the general welfare, etc. Mainly we divide up things in a smart way, so that the weak or unlucky don’t band together and go marauding, and the strong and talented do good stuff that helps all of us. It’s a balance. And the U.S., in theory, is a pretty damn good balance. Or could be.

Most modern liberal democracies copied us. Their goal is to ensure access to baseline conditions required for survival. For all the right reasons. Fine.

BUT. Is healthcare one of those things?

I think it should be. Just my opinion. One opinion, one vote. I’m not whining. Just opining.

If I have a treatable disease and need insulin (I don’t, just an example) who gets to govern whether I can get it, and for how much?

In most liberal democracies, the answer is the state.

In the U.S., it’s the employer.

Hmm. 🤔

We CHOSE that? Weird.

How the FUCK did we choose that?

Are we dumb?

We could elect people who change that. Easily.

We don’t.

Fine.

I guess that’s the way the U.S. works.

Nobody to blame but ourselves.

So basically your ability to get a kidney transplant, get your insulin, get psych care so you don’t slip into pure nihilistic despair, is decided by whether you do LABOR for a BOSS.

All of it is then also brokered by some sick, predatory insurance market that uses AI to deny coverage as much as possible, to crank it all the way up until the people start shooting CEOs in Manhattan streets in broad daylight, apparently. I guess that’s how they do their market research? Sheez, man.

So, what I’m thinking is…HOW is that all not a form of government? I mean, the employer, the insurer, holds absolute discretion over which medical care options you get, or even SEE, and how subsidized (or not) they are.

Employer-as-state is what we have. Deal with it.

A “state actor” is:

• The one who gets to say which rights are conditional on what

• Says who is eligible

• Gets to remove support if you don’t meet the terms

• Defines what happens if you don’t participate

Correct me if I’m wrong, but in the U.S. often the employer selects the health plan. They define coverage tiers. Decide whether it’s just the employee or if dependents get access, too.

The employer then unilaterally terminates your insurance if you quit. (Like if you decide they suck and don’t pay enough, they will axe your healthcare, and your family’s.)

This feels like a state function outsourced to a firm.

That’s really what we want, guys? We voted for that?

Hm. Wow. Okay.

Did we KNOW we were doing that?

Do we care?

How is this fine?

The American labor market talks a good game about freedom. Work where we want. Quit when we want. Negotiate our salary. Such freedom.

BUT. Life changing care is conditional on working for SOME employer. You can’t opt out. Not really. Not without your health taking it on the chin.

So is freedom attached to this labor contract? Meh. Not really. I’m not seeing it. Feels like they got us by the short reds.

That’s just my opinion. Like I keep saying, one opinion, one vote.

Democracy. A beautiful thing.

But I’m just a little stymied.

How is it that we, the people, continue to allow this?

Are we…dumb?

YES, we are free to quit our jobs.

But if you have a kid with cancer, and the chemotherapy stops when you quit (because your boss is a prick and the job hurts your body or soul) that’s FINO, right? Freedom in name only?

What’s new about any of this?

Nothing. No new theories. I don’t have a clever new analogy for y’all. Not here to moralize or attack the system. We voted for this. We could change it by supporting candidates willing to change it. We didn’t. We likely won’t.

I’m merely saying what it IS, mainly to myself. But also to you. Clearly. Out loud.

It’s real. It’s happening. We’re letting it. And it’s gross.

What else are we doing that we know about but don’t know about?

Aside from letting the richest country in the world offload a basic life or death social function to private dickfucks.

(I mean dickfuck in a nice way.)

These employer dickfucks aren’t bad people, probably just looking to make a buck, and they control and contain our lives by holding basic healthcare hostage. They don’t make the rules. They just get to…make the rules.

What gets me is that healthcare is state-provided in just about every other civilized country. Sure you can pay extra for luxury care, but nobody is getting stiffed on the life-or-death stuff.

The U.S. boasts the top GDP but we don’t even crack the top twenty in quality of life scores. How is that not fucking sick? Look it up. It’s true. Doesn’t that bother you? If not, why?

Our world happiness metric is abysmal, and we’re the richest country by far. Strange.

And we fucking did this to ourselves. This isn’t the fault of a sinister politician. Or the evil corps.

It’s us. WE did this. And continue to do it.

All I ask is that we say it out loud.

See it. Say it. Here it is. Hiding in plain sight.

OK. Shower’s over.