-- An imaginary conversation with my family doctor on the true difficulty of paying for national health care --

-- An imaginary conversation with my family doctor on the true difficulty of paying for national insurance --

Me: $1.2 million is the average income for top 1 percentile households (2006 figure). You must have made at least a couple of million last year, right? I mean you are a doctor – and you are with Columbia Presbyterian hospital.

Doctor Levine: “[Laughs].”

Me: You mean that the 15% of income share that slipped out of the pockets of bottom 90 percentile earners and into the buckets of top 1 percentile earners over the past few decades slipped right past you doctors?

Doctor Levine: “[Smiles ruefully].”

Me: Still, with the US having 135% of the per capita GDP of comparable modern economies we should no trouble devoting 15% of GDP [.15 X 1.35 = .2025] to health care, right (note parallel with 15% of income shifted to pockets of folks who earn lots more than doctors)? Unless we have too deeply gutted much of our workforce’s pay – with something like 30% of families living below the poverty line.

In real life the poverty line for a family of three -- assuming they have to pay their own health premiums – is about $45,000 (not the unreal $20,000 government calculation based on three times the price of an emergency diet – premiums alone exceed $12,000!). If you look at the Census, median family income is about $62,000. The real minimum needs line would hover somewhere around 37 percentile – if we didn't count families with paid health insurance. Knock off 7 points (guesstimate) for families on the top end with paid insurance (not those on the bottom with Medicaid) and we can reckon – it turns out very reliably -- about 30% of American families’ incomes are below minimum needs without government helps like food stamps.

Sounds like a quarter of the country must be earning less than the minimum wage or something equally crazy, right? Nearly a quarter of the workforce is earning less than the minimum wage – if we are talking about Lyndon Johnson’s 1968 minimum wage of $10/hr [$1.60/hr adjusted] – back when average income was half today’s. (FYI, tech improvement, like how much better today’s Timex is, generally not counted in inflation estimates.)

Doctor Levine: “How can something like this happen; why can’t we straighten it out?”

We can straighten out our labor market any time we wish – nothing like this happens anywhere else in the first-world. Simply institute the same labor market structure in place in virtually every modern economy (and many not so modern like Argentina and Indonesia): sector-wide labor agreements – wherein everybody with the same job description within the same locale works under identical collectively bargained terms with all the different firms – legislation required. [Note: check out French-Canadian “lite” version.]

Medical Doctor (not psychiatrist) Levine: What is holding back our big wig progressives from pushing – or at least mentioning out loud – such apparently badly needed and promisingly efficacious labor market changes?

Me: Something I call “pack check.” Males instinctively check in with what everybody else is thinking on any economic or political – or metaphorical “hunting pack” -- issue. And as long as they stay fix-focused on what everybody else is thinking it can seem impossible to them to make headway in an entirely new policy direction: so many different people require so many different approaches – and whom did we ever convert before with our most reasonable (we thought) arguments. Impostavazoo!

Sociobiology time – my lay opinion anyway: chasing wild pigs (what human males evolved doing) required a kind of perfect awareness of what every other hunting pack member was doing (pigs, as anyone who owns one can tell you, are not stupid) – was an essential survival mechanism. Without awareness of the need to break free from this innate focus-on-everybody-else’s-focus, at least for short breaks, all the economic male geeks in all the world may never initiate any new solution to the uniquely lop-side bargaining power ruining the American labor market – nor anything else – no matter how obviously practical, no matter how desperately (!) needed.

Human males are not so much pig headed as we are “pig-chase” headed.

Doctor Levine: “[Makes excuse; finally escapes].”