It recently has come to my attention that at least three people I know don’t realize there are limits to who you can insure on your health care insurance plan in the USA. First, let me explain briefly how health insurance works in the US. There is no socialized insurance, except for people over 65 and people who meet a particular definition of poverty. Only certain jobs offer insurance benefits paid for partially by the employer. Having insurance paid fully by your employer is rare. You can purchase insurance on your own, but it costs a lot (employers get group rates, and single buyer rates are priced much higher), and many people have to choose between having health care coverage and paying rent.
Therefore, if you are lucky enough to get insurance through your job, then you have the option of also insuring certain people in your household on your plan, for a little extra money each month. These people do not include imporverished relatives living with you or your brother who has functioning difficulties but doesn’t meet a legal definition of “disabled.” The people you can tack onto your group insurance plan at an affordable rate include strictly:
- Someone you’re fucking, i.e. your spouse or in some cases your domestic partner. But only one partner, so polyamorous folks can, ahem, go fuck themselves.
- Someone who’s alive because of your fucking, i.e., a child.
This is across the board. This is every insurance plan there is. People who depend on you for reasons not connected to fucking can go fuck themselves, as far as the insurance industry in the USA is concerned. Insurance is only concerned with the next generation. If you’re trying to care for your own generation of family, or a previous generation of loved ones, you’re on your own. I’ve been told the idea is to keep it all statistically in the same generation, because of course, older people typically use more medical care. But since you also can’t cover a sibling, and you also can’t cover your impoverished friend who’s too depressed to work yet doesn’t meet his state’s narrow definition of “disabled” (yes, it happens), and because so many marriage partners are from entirely different generations, I’m calling bullshit. The USA has always been loathe to reward any definition of family that didn’t result in bouncing baby consumers.
You see, once upon a time, long before anyone asked the USA to consider giving gay partners or unmarried heterosexual partners similar benefits to married couples, “family” actually included grandparents, aunts and uncles, etc. It was the US government that defined the “nuclear family”, and while politicians yelp about how awful it is to have a household smaller than mom+dad+kid, they were the ones who worked hard to dismantle the idea of households that also included extended family. Who’s anti-family, again?
Anyway, if these non-nuclear-family-type dependents or someone who loves them can’t afford to buy them insurance at the hideous single buyer rates, they don’t get insured. They can go die now, while politicians who object to socialized insurance complain about how no one’s selfless enough to take care of their loved ones anymore.
Politicians, by the way, get all their insurance needs and then some taken care of for free.
The people I’ve explained this to recently were appalled. What happens to these impoverished relatives? They go uninsured. Because insurance at single buyer rates would be several hundred dollars a month for semi-decent coverage. By semi-decent coverage, I’m talking about coverage where you receive a procedure the same year you started needing it, where you can choose a half-qualified doctor instead of a quack who won’t even diagnose you properly if it might cost his overlord the HMOs a penny extra, where you get the medication your doctor believes you need instead of the one your insurance plan insists on even though you’ve tried it and had no benefit. (It’s not worth paying $200/month for a shitty HMO plan when you can just pay for your medical services outright and, well, hope you don’t have many of them.)
And soon, under the politicians’ solution, people who can’t afford to fork out several hundred dollars a month for private insurance, but don’t meet the government’s ever-amusing definition of poverty, will be guilty of breaking the law. And anybody who says “I’m sure the government will recognize who really can’t afford insurance” has never lived in that large and growing nebulous world between lower middle class and what the government thinks is “poor.” You need to check your privilege and realize the government has always been extremely over-conservative about its definitions of poverty because while Republicans* love handing billions to folks like AIG, they just can’t stand it when some poor jackass gets $25 they don’t think she deserved. Keeps them up at night, it does. Makes baby Jesus weep, too.
*I have no love for Democrats, who are just too useless to live, but I can’t lay this particular bit of hypocrisy on anyone but Republicans with a straight face. This is pure right-wing asshattery.