vcmw | Politics/Economics: Why I'm all in favor of single-payer health care

So, this post was on my mind for general reasons all week (tis the season for colds!) but my cold this week and the fun of dealing with it in my particular economic slice of life moved it to the forefront.

Let's talk about healthcare, baby.

Personal background: My mother was a waitress, my dad was generally unemployed. I grew up without health insurance. I was a very healthy kid, with no congenital problems, major allergies, long-term diseases, etc. The one time either my sister or I had to be hospitalized during our childhood (my little sister broke her leg at around age 2) we ended up basically dodging the health care system collection agency until they wrote us off however many (5? 7?) years down the line they did those things at the time.

During my entire life, I have had health insurance under the following two conditions: 1) My college required it for attendance and provided a heavily subsidized plan that we could purchase. (4 years). 2) I worked in a full time, unionized job for a State Government, and health insurance for both me and my spouse was a whole $80/month. I could afford this amount even on my entry level salary. (2 years).

I am now 30 years old, which means that I have been uninsured for 24 of my 30 years. My parents were not unemployed when I was a kid. I have never been unemployed as an adult. I have never even worked for minimum wage (even my earliest jobs in high school tended to be at $0.25 - $0.50 over minimum wage). I have worked at least 40/hrs a week during all but 1.5 years since I first left college at 19.

During all that time, I would have been happy to have health insurance if I could have afforded it. I suppose, under a definition of "afford" that includes "costs as much as your rent/mortgage and leaves you with no money for savings, emergencies, social spending, groceries beyond survival-level, etc." I could have afforded health insurance at several points during that time. Personally, that doesn't sound like "affordable" to me, but hey, what do I know. If I made what I do post-college and didn't have college debt, I could probably afford health insurance. But how would I make that much an hour with no college degree?

Every year I see all those health posters that say "Stay home if you're sick! See a doctor if your symptoms persist!" etc. etc.
And I hear people on TV and the radio, people with full time jobs and fully subsidized health care, going on about how they "Don't understand why people don't just stay home if they're sick. Don't infect the rest of us!"

Let me lay it out for any of you who haven't lived that particular economic reality.
Say you work a food service job. These are the people who we most want not to contaminate us with their germs! They come in to contact with hundreds of people a day, and they use their hands to prepare things that those hundreds of people put in their mouths. They're also part of the service industry, which means they're very likely to be part-time and uninsured.
Step 1: Are you even allowed to take a sick day without finding your own replacement?
Plenty of service jobs require people to call down a list and find their own replacement before taking a sick day. If you start vomiting at 2PM and you work a 3PM shift on a weekend, good luck finding a co-worker to cover for you in time! Some jobs explicitly state that failing to come to work when you haven't found someone to cover for you is grounds for immediate dismissal. I have worked at least 1 or 2 jobs with this in their written training information.
Step 2: Congratulations! You found someone to cover for you / are allowed to take time off without finding someone to cover for you.
Do you have paid sick leave? If you're part time and non-unionized, full time and work in service or for a very small company, probably not. Good for you. That means you must decide if your budget can take the hit of each successive day off. A waitress sick on a Friday or Saturday night? Goodbye to up to 1/3 - 1/2 of your earnings for the week (2/3 - 4/5, probably, if it's both Friday and Saturday). Did your budget have a spare $200 or $300 in it this month? If not, guess you're putting next week's groceries on credit and hoping to make it up with some good tips over New Year's Eve.
Step 3: You have been out sick for two days and have blown your whole budget of reserve cash for the month. But you're not getting better and/or you're getting worse. Now you get to decide if you're going to the hospital/urgent care/minute clinic/etc.
Step 3a: Is it even possible for you to physically get to a place that will treat you? Do you have a car? Do you live in an urban area? If you live in a rural area the nearest clinic is likely to be inaccessible by public transportation. Do you have a friend to give you a ride? Is your car running (if you own one)? If not, are you up for the minimum 3-5 mile walk to that rural clinic, while you run a 100+ degree temperature? If you live in a city, how many buses do you need to take to reach the nearest clinic that will accept uninsured walk-ins? Not all of them do.
Step 4: Getting to a clinic will take at least half a work day. Can you wait until your next day off? If not, add another half day to day in lost wages - a minimum of another $50.
Step 5: You decide you're sick enough that it's worth the additional lost wages. You have called in a favor/ found $50 in cab fare / mapped out the 3 buses required to get you to a clinic! Congratulations. Your budget is already short $200 in lost wages and $50 in round trip cab fare, plus another $50 in lost wages for time to get to the clinic. Now you have to accept that it will cost you a minimum of $100 - 150 just to enter the clinic and be seen by a licensed nurse or a doctor. (I have used Urgent Care a number of times in different states - that's a realistic amount. Same for if you have non co-pay health insurance - just walking in to the doctor's office will cost you about $150+ in most areas.)
Step 6: You receive a diagnosis. Any test they may need to give you beyond blood pressure and looking in your ears with a light adds $30-50 to your total. You need two tests, but they cut you a deal. You only need to pay a sliding scale. Add $45.
Step 7A: You have a viral infection! The $45 and the $50 cab fare and the extra $50 in lost wages were all wasted money on top of the $200-$300 you were already out. Enjoy the new $295-$400 hole in your budget, go home, and have some more soup.
Step 7B: You have something treatable! That $45 in tests, $50 in cab fare, and $50 in lost wages weren't wasted! Add $80 more for a drug of some kind. If it's exotic antibiotics or anything else more complicated than a basic antifungal/antibiotic/antihistamine, add $200 or more.
Go home, take the drugs, hope you don't have any side effects, and enjoy the new $375-$600 hole in your budget. Hope you don't have to take a separate cab ride to fill your prescription.

And the next time some well-meaning, full-time employed, sick-day receiving, subsidized-health-insurance carrying person tells you that a) you should just stay home when you're sick until you're fully better and b) single-payer health care will ruin this country, try to resist the urge to sneeze your infectious, unmedicated sneeze into their latte.

[edited for days of week - waitressing big nights are Friday and Saturday, not Saturday and Sunday, and I know that.]