Too Many Poor Excuses

I am so tired of reading yet another story about how we -- Americans -- cannot afford things.  Not luxury items, not splurges, not nice-to-have items.  Increasingly, it seems like too many of us can't afford what most people would consider basics -- food, housing, child care, transportation.

And health care, of course. 

A new study by the United Way ALICE Project (a collaboration of United Ways in 18 states) found that 51 million households can't afford a basic monthly budget that includes food, housing, health care, child care, and a cell phone.  That is 43% of all U.S. households. 

ALICE stands for Assets Limited, Income Constrained, Employed.  Of the 51 million households, two-thirds are ALICE ones.  These are working households that, in a prior era, might have been thought of as middle class. 

Now they are living paycheck to paycheck, and fearing sudden expenses -- like an unexpected health care bills.  Maybe they can't afford their insulin, their inhalers, or their epipens anymore, due to hard-to-justify price hikes. 

And, of course, God forbid they end up in the emergency room or get out-of-network care. 

Indeed, a hospital stay may result in a permanent reduction in income, even if you have insurance, according to a study released earlier this year.  Those economic impacts may be greater than the medical bills themselves. 

Coauthor Amy Finklestein, an MIT economist, said:

The sobering truth is that even people who have health insurance don’t have anywhere close to full insurance.  Not [only] for the reasons that we’re used to thinking about, [such as] cost-sharing and high deductibles, but because health insurance doesn’t insure the economic consequences of poor health."

Benedic Ippolito, an economist at the American Enterprise Institute, told The New York Times, "It makes me wonder: What exactly does insurance insure against, and is that the thing that we really want it to insure against."

It makes me wonder too.  

We shouldn't be surprised that the Commonwealth Fund recently found that the percentage of Americans who feel confident they can afford the health care they need continues to fall.  Only 62% re very or somewhat confident, down from 69% just three years ago.  Twenty-four percent reported health care has become harder to afford over the last year. 

Another new study found that 40% of us skipped a recommended test or treatment due to cost, and 44% skipped seeing a doctor when sick or injured due to concerns about costs.  More feared the cost of a serious illness than they did the serious illness itself. 

That is seriously wrong.

And there are no signs of anything improving.  The number of uninsured is rising again.  Actions by the Trump Administration to undermine the ACA exchange markets are estimated to have drastic increases on health insurance premiums -- potentially jumping by 35% to 94% over the next three years. 

Plus, HHS has proposed rules for so-called short-term health insurance policies that the CMS Actuary says will simply increase costs for everyone else, not to mention that those "covered" under those policies will find that coverage to be skimpy if/when they need it.

This all adds up.  Kaiser Health News reports that, in addition to bankruptcies due to health care bills, nearly 40% of adults under 65 have had their credit scores lowered due to medical debts.  A 2014 Consumer Financial Protection Bureau report found that almost 20% of credit reports had at least one medical collection account listed.  Those bankruptcies, higher credit scores, and debts in collection have lasting negative impacts, such as on mortgages and credit card payments. 

Meanwhile, HUD Secretary Ben Carson is proposing raising rents for low income renters -- potentially tripling rents for the poorest -- and the GOP is trying to make significant cuts to SNAP, the Supplemental Nutrition Assistance Program that helps some 45 million low-income Americans get enough to eat. 

It's a war on the poor and near-poor, and that is a war that too many of us are pretending doesn't matter to us.  It does, or it should.

Then there is my "favorite" new statistic: 94% of U.S. public school teachers spend their own money on school supplies.  In cities, in the suburbs, in rural areas; poor kids, not poor kids.  Just think about that: 94%.  It's a not-so-hidden tax on teachers.

On average, they reported spending almost $500 per year, on an average salary of about $60,000.  Some people are talking about arming our teachers, while we're not willing to even pay for the basic supplies in their class rooms.

No wonder we're seeing teacher protests around the country. 

I have previously written about how we are failing to adequately fund not just basic health needs but also supposedly essential things like education, infrastructure, even broadband.  We're doing a pretty good job of spending on prisons and defense, and on tax cuts to big businesses and rich people, but assuring that more people's basic needs are met, not so much. 

The sad truth is that only 39% of Americans say they could handle an unexpected expense of even $1,000 -- and 34% had had a major unexpected expense over the past year.  Not surprisingly, we are doing a terrible job saving for retirement.  Increasingly, we're both saying we'll have to rely on Social Security for our retirement income, while lamenting that we're not very confident it will be there when we need it.

This is not really a question of money.  The stock market is booming.  Corporate profits are strong.  Economic grow is good.  We, as a nation, have plenty of money.  It's mainly that too much of it is ending up in the hands of too few. 

These problems are not about our having enough money.  We do.  They are not just problems for "poor people."  They are problems for the majority of us.  These are problems of priorities, and somewhere along the way our have gotten screwed up. 

We're making too many poor excuses for not doing more and for not doing better.  It's time to stop.