Photo by Glyn Lowe
I work as a Medicare broker for a private exchange. Every workday, I talk to someone who has been thrown into the world of individual medical insurance and needs advice: “What plan should I select?,” “How do I sign up?,” “When can I sign up?,” “Is there something I can afford?” Depending on their age, gender, state, county, zip code, date of birth, retirement status, health, the current date, carrier-specific rules and dozens of other possible variables, I end up either advising them and getting them something that will meet their particular needs, or I do my best to sound like the news I have to deliver is not that bad.
And it’s not…usually. Medicare, as it is, does a decent job of covering those who are eligible for it. Many people I speak to end up getting better coverage for less money than their old group plans used to provide. Some people have cancer, and learn that being changed over from their group coverage means they can now, finally, get a fully comprehensive level of coverage that doesn’t threaten to bankrupt them with “cost sharing” every year. The original parts A and B of Medicare, by themselves, constitute a level of coverage I’d love to have access to. I might have insurance through my work, but it’s there in case I break my arm or if my appendix explodes—anything more mundane and I might as well not have insurance, given my deductible.
On the other hand, there are plenty of people who are poorly served by the current system. Perhaps they take insulin or use inhalers, and have to spend hundreds a month just on those copays. My coworkers who handle the non-Medicare eligible callers have it worse, and have to develop the skill of passing off four-digit premiums like they’re not a symptom of something horribly wrong with our society. They sometimes end up consoling someone who has to go from paying nothing for decent coverage to paying over half their income.
And even when I can help someone, what I’m doing is taking an extraordinarily complex system with hundreds of moving parts, and trying to make their situation intelligible. If I give too much info, they get confused and unhappy. If I give too little, they might not know what they’re agreeing to. I’ve spent months in training, getting licensed, and taking dozens of little tests for each carrier in each state I’m licensed in, and I’m not perfect. A mistake on my part might cost someone thousands. I try to be conscientious, but you don’t have to be to be in my position.
Medicare is a byzantine mass of regulations which yields decent coverage for a portion of Americans; I’m glad it exists, because without it, these people would have nothing. The private market would only exploit or ignore the populations I work with. My coworkers who work with non-Medicare eligible populations say it’s much worse, much more confusing, and much gloomier than Medicare. But Medicare is still a mess. My job exists because it’s a mess, and because companies don’t want to deal with insuring their retirees themselves. Attempting to do so often results in plans which are absolutely terrible compared to what the government provides, because in a marketplace of piecemeal plans with little bargaining power, it’s a difficult population to insure. Medical costs have been rising a long time, and they’ll continue to do so as long as it turns a profit for insurance companies and manufacturers of medical devices and pharmaceuticals.
Sometimes my mess of a job can be rewarding, because I can help someone out of a bad situation. But my job only exists because it’s part of a monstrous machine which creates this bad situation in the first place. So what if I was able to dig through obscure rules and resources to find the one special enrollment reason I could use to stop someone from going without insurance for 10 months—why is this a thing that can happen? Why do I have to keep fishing people out of the ocean while the boat I’m on circles continuously, knocking over all the lifeboats? Why can’t we just cover everything medically necessary for everybody—like other countries have already proven is possible? Cheaper, in fact! What’s holding us back?
That’s a rhetorical question, of course. It’s the people getting a million bucks for every circle they make while they drive the boat. The 1%. The CEOs, and their armies of lobbyists. The political establishment they bought. Excuse me, but fuck them. These are not my friends. I don’t want to think back to when single-payer health insurance for all was won and remember that I sided with those guys. They live off the misery they inflict, but this binds me to every other worker because we all suffer under the same source of injustice, even if it affects us differently. For example, many of my coworkers have been kept on for years without benefits because they’re technically “seasonal” employees. At least I have something.
Winning Medicare for All would mean a vastly improved system. Those on Medicare now would see improvements and would stop paying premiums, copays, and coinsurance. Medicare for All would radically better the situation of my coworkers and anyone else without decent insurance, but even people like me who actually have group insurance would see benefits. Still, Medicare for All would also mean I lose my job…and I, like many Americans, need money. Doesn’t this mean I should be against it, even if it’s good for everyone else, and even if I get better insurance out of it?
Well, no. I’ll be okay! The people fighting for Medicare for All are not like the lords of the status quo—i.e. they actually give a damn. They give a damn about people like me in part because they don’t make their living by exploiting us. I’m not driving the boat tipping over all the lifeboats, and the people fighting for Medicare for All want to join me in tossing the CEO overboard and assuming control of this thing. They want to take care of people like me whose jobs would be made obsolete by winning the fight for such a vastly improved system of healthcare. One of the principles for any socialist-approved single-payer bill is that they’ll provide job training and resources for those displaced by the change. Maybe I can finally do something worthwhile? Maybe the 2.6 million employees in the insurance sector, finally freed from useless administrative work, can do something great together. Don’t we need to shift to renewable energy ASAP, for example?
Or maybe I’m wrong, and the billionaires are right. I mean, when have 2.6 million people working together ever accomplished anything?
This Medicare Broker is an anonymous DSA organizer.