#BetterThanCanada: Our Plan for Crowdfunded Universal Healthcare
And so, my fellow Americans: ask not what your country can do for you — ask what you can do for your country. — John F. Kennedy
JFK’s most famous line, spoken at his presidential inauguration in 1961, is often bandied about as an admonition to serve your government rather than expecting your government to serve you. These days, it may be unfairly interpreted as a directive to stop asking for free stuff and to start contributing to the economy.
But let’s look at the last part of JFK’s sentence: ask what you can do for your country. YOU means each of us. And YOUR COUNTRY means all of us. JFK said, Ask what each of us can do for all of us. Or, in other words, What can we do to help ourselves? A tremendous thing that we can do to help ourselves is to give ourselves universal healthcare.
What Is Universal Healthcare?
According to the Most Learned Book of Knowledge (that is, Wikipedia), universal healthcare is a health care system in which all residents of a particular country or region are assured access to health care… It is described by the World Health Organization as a situation where citizens can access health services without incurring financial hardship.
We should give ourselves the gift of a universal healthcare system. It might not be completely free, unless someone is bad off. But it will be available to everyone, and affordable for everyone. Our universal healthcare system will be similar to the Canadian healthcare system. Most Canadians think their system is better than ours, and I hate it when Canadians make fun of our healthcare system. Our goal is to be slightly #BetterThanCanada. We don’t need to blow the Canadian healthcare system out of the water. We need to be just good enough so that Canadians can’t make fun of us.
How Does the Canadian System Work?
I’m not Canadian, and I’m not an expert on the Canadian healthcare system, so I might get some things wrong. And the Canadian system varies between provinces, making it difficult to speak in generalities. But the Canadian system works something like this…
Canadian Medicare provides coverage for about 70 percent of healthcare needs, with the remaining 30 percent being covered by private insurance. Canadian Medicare covers medical care, hospitalization, surgery, and oral surgery. It does not cover basic dental care, home care, long-term care, prescription drugs, or vision care, though some provinces offer plans that cover those items. Most Canadians use private or employer-sponsored insurance to cover the areas not guaranteed by Medicare.
The doctors and health care providers send all of their bills to the government or to the province’s insurer instead of to a bazillion different insurance companies like we do. That’s why it’s called a single-payer system. The patients do not get involved in the billing. The Canadian billing system is very efficient and cost-effective.
The #BetterThanCanada System
Our system will be slightly #BetterThanCanada by including prescription drugs and basic dental care. Often, the prescription drug is the health care. There’s no point in getting a free medical exam, only to be told that the solution to your problem is a drug that you can’t afford. So we’ll cover prescription drugs. And there’s no point in covering oral surgery without covering basic dental care. People go to oral surgeons after being referred by a dentist. So offering the surgery without the dentist is putting the cart before the horse. We want everyone to have nice clean teeth without cavities so that we’ll all have nice big smiles when we make fun of Canada for having such a shit healthcare system.
How Much Will It Cost?
Good question. In the next few years, Americans will be spending about $5 Trillion (that’s a 5 with twelve zeros) each year on health care. If we just multiply that by ten years, we’ll be spending $50 Trillion on health care over the next ten years. That’s close to what Elizabeth Warren said her Medicare for All plan would cost, give or take several hundred billion. Bernie Sanders said his plan would cost $34 Trillion over ten years, but the general consensus is that Bernie was low-balling us.
The #BetterThanCanada plan doesn’t have all the bells and whistles that Liz was promising. And we’ll save money over our current system by forcing the doctors and drug companies to accept lower prices (a somewhat un-American benefit of a single-payer system). And our administrative costs should be much less than our current system. But, on the other hand, #BetterThanCanada will have more users than our current system, because we will be helping the millions of people who can’t afford to get health care today. Plus, the US government has a talent for always making everything more expensive that it needs to be. So let’s go with $50 Trillion over ten years. If it costs less, then good for us.
Who Will Pay for #BetterThanCanada?
When we talk about these huge numbers, our eyes tend to glaze over and we lose track of the enormous magnitude of these sums. We forget that a trillion is one thousand times greater than a billion.
One of my Twitter friends, in a 240-character discussion of healthcare costs, said that there is an abundance of money in Jeff Bezos’ bank account that could be used to pay for universal healthcare. Jeff hasn’t shared his finances with me, but I imagine that he has a relatively small amount of liquid cash in his bank account. What he does have is an investment account statement indicating that he has an abundance of shares of Amazon stock that the free market valued at $105 Billion on the afternoon of March 16. That’s $5 Billion less than he had at the beginning of the day. Sucks to be rich, doesn’t it? Unfortunately, when Jeff became $5 Billion poorer today, you and I did not get $5 Billion richer. In fact, I’m somewhat poorer than I was at the start of the day, too. Thanks, Coronavirus. This concept of rich people hoarding our wealth doesn’t really work like they tell us it does. Of course Jeff still owns a newspaper and a space company, so he’s not hurting.
Just to make the math easy, let’s say that Jeff is worth $100 Billion, which is probably close to what he’ll be worth tomorrow. To pay for our $50 Trillion #BetterThanCanada healthcare, we would need 500 Jeff Bezoses! Well, guess what, folks (to borrow a Bidenism): there aren’t 500 Jeff Bezoses out there. We could take every cent of every billionaire in the US, every mansion, every Bentley, every rocket ship. And we might pay for two years of healthcare. Then who will pay for the next eight years? Or the next fifty years?
Amazon has annual revenues of $280 Billion. Take all of it, every year. At the end of ten years we’ll be only $47 Trillion short. As Joe Bauers said in Idiocracy, ‘That’s a mighty big minus, isn’t it?’
If we want universal healthcare, then we will all have to chip in and help pay for it. Have you ever donated to a GoFundMe campaign for a sick friend? Well, think of #BetterThanCanada as a massive crowdfunding effort for our own health care. All of us will donate, and we’ll donate every year. But that’s OK: we’ll all be doing it.
Rich people will donate more. People who make less will donate less. People who don’t make anything won’t donate anything. Your favorite waiter will donate a small amount. I’ll donate more than your waiter because I’m a little better off. Jeff Bezos will give A LOT MORE than any of us because he’s the richest man in the country. But we don’t want Jeff to give too much. We want Jeff to keep making lots of money so that he will have a lot of money to donate every year.
Amazon will pay A LOT. Amazon hasn’t paid much income tax lately, because they were getting credits for all those years when they were losing money. But now that Amazon is making money, they’ll be ready to help out. We want Amazon to stay in business and make a lot of money so that they can donate a lot of money every year. It will be OK. It’s just crowdfunding, and we’re all in the crowd, even Jeff Bezos and Amazon. It’s just all of us pitching in to give ourselves a better healthcare system.
Everyone will donate, even those in the middle class. Elizabeth Warren, bless her wonky little heart, stood on her head trying to create a Medicare for All financing plan that wouldn’t burden the middle class. And people who are smarter than me and more Progressive than me found that it was $8 Trillion short. We will all donate. But it’s OK. We’ll all get some back when we’re sick. And we’ll feel good because we helped ourselves. There’s a bazillion self-help books out there telling us how to help ourselves. Forget the books: let’s help ourselves by giving ourselves #BetterThanCanada healthcare.
Most of us are already donating. My wife and I have been paying Medicare payroll taxes our entire working lives even though we aren’t on Medicare. And we pay a premium for our employer-sponsored insurance. And we have co-pays and annual limits and all that. We’ll just be donating our money to the #BetterThanCanada plan instead of donating it to Aetna or to our doctors. At the very worst, our donations to the #BetterThanCanada plan will be no more than what we’re already donating to Aetna. If we’re lucky, we’ll be able to donate less. After we give ourselves #BetterThanCanada healthcare, it might suck to be Aetna, though they will still make a killing by selling insurance for all of the things not covered by #BetterThanCanada. There will probably be some contraction within the insurance industry. But at least the displaced employees will have affordable healthcare.
For older people, the donation to #BetterThanCanada will be similar to what they are already paying for Medicare. Medicare isn’t free. Even Brenda, my mentally-challenged sister-in-law, has to pay for her Medicare. But it isn’t very much; it’s a small amount that’s taken from her Social Security payment. So even Brenda will donate to #BetterThanCanada. I think she will be proud of that. She’s a very generous person.
What we all need to remember is that the ten-year cost of #BetterThanCanada isn’t $50 Trillion extra. We’re already paying close to $5 Trillion each year for our healthcare. If we did nothing at all, the ten-year cost of our healthcare would still be $50 Trillion! Because $5 Trillion x 10 years = $50 Trillion. You know, math. We’re not adding more money. We’re just re-directing what we’re already paying for healthcare, and spreading the money around a bit. Whatever we get from Jeff Bezos and Amazon will help pay the healthcare costs of those who can’t donate much.
How Will We Donate to #BetterThanCanada?
Most of us will donate when we pay our income taxes. We could let everyone send their money through Venmo, or set up a GoFundMe page, but the tax way is easier. We know how to collect taxes; we’re good at it. But it’s really a donation to ourselves.
Rich folks will also donate a small portion of their excess wealth that they don’t really need to live on. I mean, does Jeff Bezos really need to go to the moon? Corporations will donate whatever they are currently paying for their employee’s health insurance, plus something extra based on their corporate revenues and profits. The military might have to donate the value of a submarine or two.
Whatever donation system we choose, it won’t be perfect. No matter what we do, some people will think that they should pay less, and everyone will think that Jeff Bezos and Amazon should pay more. But let’s just do something that seems fair and see what happens. If it isn’t perfect, we’ll try to make it better. If the whole thing is messed up then we’ll just shitcan the whole hasenpfeffer and do something else. The important thing is that we will all have good health care, no matter how much or how little we donate. We will all have good health care, even if Jeff Bezos still has more money than any of us.
We need to stop making this about YOU vs ME. We need to stop making it about how YOU are going to pay for MY health care. Let’s make it about how WE are ALL going to pay for OUR health care. And about being #BetterThanCanada.
Who Should We Vote For?
I would be happy to run the #BetterThanCanada campaign through GoFundMe, but I’m very bad at this sort of thing. The US Government is also very bad at this sort of thing, but – unfortunately – they’re the only show in town when it comes to setting up nationwide programs funded through the Federal income tax. Which means we need to elect people who want to be #BetterThanCanada so that they can help us set up the program.
As far as presidential candidates go, if the choice is between Biden and Trump then we have to go with Biden. But I’ve lost faith in the ability of presidents to push through a domestic agenda. A president trying to push through a domestic program is like trying to push toothpaste back into the tube. That’s why presidents spend all of their energy on international affairs: it’s something they can do without going through Congress.
This will have to come from the bottom: from the Congress and the Senate. We need to elect Congresspersons and Senators who will help us be #BetterThanCanada. Liberals, moderates, and conservatives should all be down for this because who doesn’t want to be #BetterThanCanada? Politicians who have accepted large contributions from the insurance lobby, or from the Medical-Industrial Complex, may be a problem. But let’s not write them off yet. Let’s try to work with them first. What these people want, more than anything, is to get elected or re-elected. If they don’t want to help us be #BetterThanCanada, then we’ll vote for someone who does.
And so, my fellow Americans: ask what you can do for your country. What we can do for our country is to give ourselves #BetterThanCanada healthcare. It won’t cost any more than what we are all, collectively, already paying. Just remember… It isn’t a tax; it’s a donation. It isn’t socialism; it’s crowdfunding.