Sometimes the most dire financial situations can lead to incredible outcomes.
Necessity is the mother of invention, after all. And look what we as a species have done with grinding, horrible poverty.
Oxtail soup. Lobster dinners. Beanie Weenies.
The most amazing things out of the ingenuity of people needing to scrape by never ceases to amaze. What has had the gold scraped off of it for me is how people who don’t need to scrape by still manage to capitalize, much to most of our detriment.
For instance, health insurance.
In times leading up to the conjoined monsters of the Great Depression and the Dust Bowl—brought about by an unholy union of unsustainable monocultural farming practices, forcible disappearance of region-appropriate animal husbandry, and rabid stockmarket speculation— it was standard practice for hospitals to ask for cash upfront upon any procedure.
So when people stopped having money to seek out any kind of care, hospitals stopped having money to run themselves soon after. But what were they to do?
Marshal Darr illuminates the answer in his two-part series published on Stretch Dollar, and it all started at Baylor University Medical Center, in Dallas, TX.
Justin [Kimball] noticed a common denominator in many of Baylor’s unpaid medical bills — they belonged to local educators. To protect the hospital against further defaults, he piloted a program in 1923 where for $0.50 a month (which adjusts for inflation to be almost $7 in today’s dollars), local teachers could gain access to an up to 21-day stay in Baylor’s hospital, should they need one.
Eventually, more hospitals adopted this plan, sweeping the nation just like all the kicked up drought dust. Some years on, it was determined that a body with lofty ideals needed to hold these plans up… and then years later those bodies ripped free and became their own separate, for-profit entities.
“The commission tapped to oversee plan admission and adherence was rebranded in 1946 as “Blue Cross.” It would later become so powerful that it would sever ties with the American Hospital Association in 1972.
While all this was happening, another organization began to emerge with a specific focus on helping lumber and mining camp workers in the Pacific Northwest pool their money to cover physician fees. This concept was eventually formalized, and the first Blue Shield plan was launched in 1939 in California — eventually growing to become the National Association of Blue Shield Plans in 1948.”
Aetna showed up, these companies merged, Kaiser Permanente made the scene, and the rest is our bloated priced history, allegedly “Affordable” Care Act or no.
Despite alternative plans, tax loopholes, and ICHRAS popping up, businesses, small businesses, and employees alike are all kind of stuck with paying thousands of dollars to end up paying yet more thousands of dollars if anything actually happens.
It is worth noting that Stretch Dollar has a particular economic interest in disrupting health insurance’s relationship to employers as it is. But so do I and my, as of time of writing, freshly broken ankle. So let’s pull back from the past and look at where we are now.
In addition to more in-depth and unsettling graphs, a report for The Commonwealth Fund authored by Sarah R Collins, Relebohille Masitha, and Shreya Roy, pointed out:
“While media reports frequently highlight unexpected health care events and emergency room visits that leave people with lots of medical bills, our survey findings suggest that the source of much debt is simply care for chronic health problems. About half of adults with debt said it stemmed from treatment they received for an ongoing condition.”
Stephen Ross Johnson of USA News reports,
“More than 6 in 10 people who lacked any type of health insurance said they or a family member delayed or skipped care because they couldn’t afford it. And among all those who reported skipping or delaying care, 57% said a health problem got worse as a result.”
According to the same report, about a third of all working Americans are in some form of medical debt as well.
Yeesh.
It’s bad, it’s getting worse, and sadly the stopgap measure that saved a hospital from collapse… just didn’t stop.
We can keep looking for ways to sever being an employer from being a healthcare arbiter (no one likes the paperwork, I know this). In the meantime… let’s all try and marry rich.
Me first, please.
You can't spell "Together" without TGOT: That Goth Over There. Staff Writer, April Bingham, is that goth; and she's all about building bridges— both metaphorically between artistry and entrepreneurship, and literally with tools she probably shouldn't be allowed to learn how to use.
