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Wednesday, August 19, 2009

On the Profoundly Ironic Illogic of Screaming “Keep Your Government Hands Off My Healthcare!”

When a system has been in place throughout your entire nation since well before you were born, it’s easy to make the conclusion--unwarranted, given a lack of exploration of the evidence--that it's normal and that it makes sense. So it is, it seems, with the opinion of many Americans about our employer-based healthcare system, which is anything but normal among the major economies of the Western world.

It is a natural human phenomenon, one of the faults in our cognitive wiring. Thinking that “the way it’s always been” is normal and sensible is no different than a child who is just beginning to become aware of foreign languages refer to his or her own native tongue as “normal talk.”

To those who, at town hall meetings, are screaming “KEEP YOUR GOVERNMENT HANDS OFF MY HEALTHCARE,” or brandishing signs with similar messages of indignant protest, I would ask you to take a close, critical look at one very fundamental but largely ignored question.

To indulge, for the sake of argument, in some phraseology that might among some readers get my non-party-affiliated, more-or-less centrist self branded as a lot more Lefty than I in fact really am, I would like to ask: why in the WORLD, out of all the scenarios one could possibly envision, would you want your EMPLOYER’S bottom-line-driven hands on your healthcare?

If you are concerned about a government healthcare plan infringing upon your privacy and your constitutional rights to life, liberty, and the pursuit of happiness, I would suggest taking a closer look at whether you might be much more vulnerable to abuses in those areas from your employer.

The right to privacy is all but non-existent in a workplace setting. Once you cross the threshold of your office building, you waive, by implied contract, many of the rights and protections you enjoy when you are out in public. Your employer can archive your e-mails and read them if they wish. Your employer can monitor your activities with hidden cameras, without your knowledge. Your telephone calls "may be recorded for training and quality assurance purposes." And your employer, of course, is involved much more intimately in your daily life than the government could ever be, unless, perhaps, you work for the government.

The potential for abuse may be greatest in small-to-midsize companies, in which the administrative infrastructure for ensuring the protection of employee rights to privacy and non-discrimination may be non-existent, as may the checks and balances to prevent personal and private information from getting into the wrong hands and being misused.

Here is just one of many scenarios. Imagine you work for a small firm of about 25 people, in which, as is often the case in small offices, there is virtually no privacy, and everyone pretty much knows everyone else’s business.

Let's suppose, further, that you or a dependent covered under your plan have had a serious, chronic illness that will require very expensive treatment for some time to come. And everyone in the office knows it, from the owner of the company right down to the guy who comes in to empty the trash at night.

And suppose, for the two years running during which this illness has been an issue, your company's health insurance provider has hit your company with a hefty increase in premiums. In a small office, it wouldn't be hard for the owner, or the operations or HR manager, or whoever else might be responsible for benefits, to put two and two together and figure out just what might be playing an important role in the increasing costs.

And finally, imagine that, after years of glowing performance evaluations, the boss suddenly becomes concerned about some previously undiscussed flaws in your performance, and dismisses you for cause -- or, even more stealthily, promotes you to be head of a new department and then, not long afterward, decides that the new department no longer fits the corporate strategy, eliminates the department and, by extension, the need for your job.

Illegal? Yes. But also difficult, if not virtually impossible, to prove. And even if you could prove it, doing something about it would be very costly--both monetarily and, quite possibly, professionally. Most employees, particularly in small communities, or in smaller industries in which managers in competing companies tend to know one another, would likely rather move on than risk the possible stigma that can follow someone who has sued a prior employer.

Do you think this scenario is unlikely? I don't. I'm sure it plays out in various permutations and combinations all the time, all over the U.S., with its wonderful, employer-based healthcare system. The best healthcare system in the world, say those who are fighting the current reform effort and screaming at the town hall meetings.

Unfortunately, many of us seem to be stuck in a cognitive loop when it comes to seeing the flaws in the most basic attribute of our current system, and to envisioning alternatives. Sphere: Related Content

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