The "Gig Economy" And The Inevitability Of Single-Payer Health Care
It's only when one takes the time to assess the various crosscurrents playing out in the American economy and public policy sphere that they realize how hopelessly conflicted we are. One of the biggest stories of 2017 that's not being told sufficient to its long-term consequences is the all-at-once collapse of the brick-and-mortar retail industry. Every day, I read new headlines of long-time retail fixtures big and small either filing bankruptcy or bleeding cash to the point where their endgame is inevitable and right around the corner. From small operations like Payless Shoes and Gander Mountain to national institutions with storied histories like Sears and J.C. Penney, cutbacks and store closings are aplenty and the official end times are not far off. Even the heaviest hitters in the retail sector like Walmart and Target are adjusting their business models to account for the reality that their best days are behind them. America's outsized retail footprint compared to every other country on the globe coupled with insurgent online competition are driving a nail in the coffin of American retail even amidst an eight-year economic expansion, and with it will come a loss of hundreds of thousands of jobs for American workers who skew downscale, female, and middle-aged. Most of these jobs aren't great in terms of pay or benefits, but they will be damn hard to replace for many of those who work at them.
And that's where we're at in America today....even the jobs that our parents lectured us to go to college so we could avoid are no longer gonna be an option for those who didn't go to college....and for plenty who did go to college but are stuck working retail anyway. So what happens to these dislocated workers from the demographics least sought after by modern employers?
Certainly a large share of them will go the same direction as the first wave of dislocated, middle-aged, semi-skilled workers.....scrambling to find their way onto disability before it goes bankrupt and seeking out a chemical vacation from their miserable lives via opiods. Others might be able to find work in the industry displacing them, landing jobs as pickers at online retailer warehouses with Dickensian working conditions that will be all the more taxing on the body to those used to years of working retail. And, alas, those warehouse jobs are on the chopping block for automation as well, with factory floors full of robots not too far on the horizon, denying American workers one more venue to scratch out a subsistent living on their achy breaky joints. But a third option is quickly emerging for the most enterprising amongst them....the ascendant "gig economy" embodied by ride-sharing service Uber, an economy full of independent contractors likely to cause as much disruption in other economic sectors, skilled and unskilled alike, as Uber has caused among licensed taxi cab drivers.
I suppose in theory, this sort of mercenary economy provides an option for people whose services the traditional economy no longer has a use for to hustle up a semblance of a living. But it will come at a steep price to every basic notion of middle-class life in America for all but the lucky few. Workplace benefits, weekends, and vacations, among other things, all become antiquated notions for those stuck in the "Hunger Games"-like environment of the "gig economy", where it's every man for himself in a competition for crumbs. The wildest example I've come across is a story of a pregnant woman driving for Uber ride-sharing competitor Lyft who went into labor on the job, but still felt compelled to pick up a couple additional customers before driving herself to the hospital. And most amazing of all, Lyft actually cited this woman on their website in a favorable light, not even pretending that there's something dysfunctional about a business model that promotes such behavior.
Again, this is where we are in America today, and ironically it's the politicians and free-market ideologues most prone to peddle the empty rhetoric of "family values" who have long fetishized this notion of a nation of entrepreneurs that may finally be on the cusp of being realized. The most tangible recent example was George W. Bush's "ownership society" template, but it hardly began there. And it's also the same politicians and free-market ideologues who, last week, responded to the insurgence of the gig economy by passing a health care reform bill that strips away the security Obamacare brought to the health care system and replaced it with the unrelenting risk that defined a past American health care system that had far fewer "gig economy independent contractor" types who needed to roll the dice.
The volatility of the individual health insurance market is an abstraction for the majority of Americans who work for an employer that offers group rates, but if the "gig economy" blossoms at its current pace and more workers from old-line industries get displaced by a changing economy, participation in the individual health insurance market will inevitably boom right along with it. Every other nation in the world recognized long ago that the concept of a "health care marketplace" simply doesn't function in the way that a "cereal marketplace", for example, does and that they have followed one of two models towards universal health care. Obamacare was a diluted version of Germany and Switzerland's health care model, except with far more conceits to a "marketplace" that leaves gaping coverage holes the likes of which we've witness leak like a sieve in the past several months. Rather than closing those loopholes, the United States House with the President's support has voted to revert back to the dysfunctional model of the 1950s that only worked then because just about everybody had coverage through employers in the post-World War II pax Americana.
Simply put, in a nation where fewer people get their insurance through employers and where fewer yet are likely to have it a generation from now, the "health care marketplace" that Congress just doubled down on is increasingly antithetical to the reality of the ground, and eventually there will be a price to pay for it. Some analysts said Obamacare succeeded in changing Americans' perception towards the liberal viewpoint that "health care is a human right", and that voters will now not accept, among other things, the notion of insurers denying people coverage based on pre-existing conditions. There's some truth to this, and as more people become foisted into the individual insurance market with less and less security and an insurance industry more likely to deny claims and discriminate based on more metrics than ever before, it seems like single-payer is inevitable.
I wouldn't have believed this even two years ago, and it still won't come easily with politicians dedicated to the preservation of a profit-driven insurance industry middleman in the health care market above all else whenever the topic of health care reform comes up. But the successful dark horse candidacies of both Bernie Sanders and Donald Trump last year proved that we have likely reached a tipping point where the central pillars of our system are vulnerable to change by a people who won't accept the status quo that our masters have resigned us to. And the health insurance "marketplace" that was a fiction to begin with is simply not sustainable in a nation of independent contractors.
It's hard to see much good coming from just about any trend in the American economy. But the sooner we can discard of the health care "marketplace" fantasy and move to a universal coverage scheme of some sort, the better off we'll be. There's no such thing as a painless health care coverage model. There are winners and losers to every approach, and we can be sure a vigorous debate would ensue before any transition to single-payer or even a more robust version of Obamacare like Germany has, but nothing could possibly work less for the American economy of tomorrow than the model that was crafted in the immediate aftermath of World War II. That economy is gone forever, as we're reminded every day we drive past shuttered factories and shuttered Sears stores, so the health care coverage that served that economy needs to go away too.
And that's where we're at in America today....even the jobs that our parents lectured us to go to college so we could avoid are no longer gonna be an option for those who didn't go to college....and for plenty who did go to college but are stuck working retail anyway. So what happens to these dislocated workers from the demographics least sought after by modern employers?
Certainly a large share of them will go the same direction as the first wave of dislocated, middle-aged, semi-skilled workers.....scrambling to find their way onto disability before it goes bankrupt and seeking out a chemical vacation from their miserable lives via opiods. Others might be able to find work in the industry displacing them, landing jobs as pickers at online retailer warehouses with Dickensian working conditions that will be all the more taxing on the body to those used to years of working retail. And, alas, those warehouse jobs are on the chopping block for automation as well, with factory floors full of robots not too far on the horizon, denying American workers one more venue to scratch out a subsistent living on their achy breaky joints. But a third option is quickly emerging for the most enterprising amongst them....the ascendant "gig economy" embodied by ride-sharing service Uber, an economy full of independent contractors likely to cause as much disruption in other economic sectors, skilled and unskilled alike, as Uber has caused among licensed taxi cab drivers.
I suppose in theory, this sort of mercenary economy provides an option for people whose services the traditional economy no longer has a use for to hustle up a semblance of a living. But it will come at a steep price to every basic notion of middle-class life in America for all but the lucky few. Workplace benefits, weekends, and vacations, among other things, all become antiquated notions for those stuck in the "Hunger Games"-like environment of the "gig economy", where it's every man for himself in a competition for crumbs. The wildest example I've come across is a story of a pregnant woman driving for Uber ride-sharing competitor Lyft who went into labor on the job, but still felt compelled to pick up a couple additional customers before driving herself to the hospital. And most amazing of all, Lyft actually cited this woman on their website in a favorable light, not even pretending that there's something dysfunctional about a business model that promotes such behavior.
Again, this is where we are in America today, and ironically it's the politicians and free-market ideologues most prone to peddle the empty rhetoric of "family values" who have long fetishized this notion of a nation of entrepreneurs that may finally be on the cusp of being realized. The most tangible recent example was George W. Bush's "ownership society" template, but it hardly began there. And it's also the same politicians and free-market ideologues who, last week, responded to the insurgence of the gig economy by passing a health care reform bill that strips away the security Obamacare brought to the health care system and replaced it with the unrelenting risk that defined a past American health care system that had far fewer "gig economy independent contractor" types who needed to roll the dice.
The volatility of the individual health insurance market is an abstraction for the majority of Americans who work for an employer that offers group rates, but if the "gig economy" blossoms at its current pace and more workers from old-line industries get displaced by a changing economy, participation in the individual health insurance market will inevitably boom right along with it. Every other nation in the world recognized long ago that the concept of a "health care marketplace" simply doesn't function in the way that a "cereal marketplace", for example, does and that they have followed one of two models towards universal health care. Obamacare was a diluted version of Germany and Switzerland's health care model, except with far more conceits to a "marketplace" that leaves gaping coverage holes the likes of which we've witness leak like a sieve in the past several months. Rather than closing those loopholes, the United States House with the President's support has voted to revert back to the dysfunctional model of the 1950s that only worked then because just about everybody had coverage through employers in the post-World War II pax Americana.
Simply put, in a nation where fewer people get their insurance through employers and where fewer yet are likely to have it a generation from now, the "health care marketplace" that Congress just doubled down on is increasingly antithetical to the reality of the ground, and eventually there will be a price to pay for it. Some analysts said Obamacare succeeded in changing Americans' perception towards the liberal viewpoint that "health care is a human right", and that voters will now not accept, among other things, the notion of insurers denying people coverage based on pre-existing conditions. There's some truth to this, and as more people become foisted into the individual insurance market with less and less security and an insurance industry more likely to deny claims and discriminate based on more metrics than ever before, it seems like single-payer is inevitable.
I wouldn't have believed this even two years ago, and it still won't come easily with politicians dedicated to the preservation of a profit-driven insurance industry middleman in the health care market above all else whenever the topic of health care reform comes up. But the successful dark horse candidacies of both Bernie Sanders and Donald Trump last year proved that we have likely reached a tipping point where the central pillars of our system are vulnerable to change by a people who won't accept the status quo that our masters have resigned us to. And the health insurance "marketplace" that was a fiction to begin with is simply not sustainable in a nation of independent contractors.
It's hard to see much good coming from just about any trend in the American economy. But the sooner we can discard of the health care "marketplace" fantasy and move to a universal coverage scheme of some sort, the better off we'll be. There's no such thing as a painless health care coverage model. There are winners and losers to every approach, and we can be sure a vigorous debate would ensue before any transition to single-payer or even a more robust version of Obamacare like Germany has, but nothing could possibly work less for the American economy of tomorrow than the model that was crafted in the immediate aftermath of World War II. That economy is gone forever, as we're reminded every day we drive past shuttered factories and shuttered Sears stores, so the health care coverage that served that economy needs to go away too.
posted by Mark at 6:42 PM
2 Comments:
When I heard of brick-and-mortar retail places like Sears, Albertson's, RadioShack, Border's, and Blockbuster Video closing, I remembered my visits there as a kid, some of them enjoyable especially Sears. My husband also has fond memories of Richardson Square Mall, which closed in 2007.
This is anecdotal, but it seems the gig economy is also infecting the pharmaceutical industry. At my old employer, after I was hired in 2012, most of our new hires after that were independent contractors and most of them lasted less than a year. In fact, right before I left, one of them literally quit in the middle of his first day! Another quit on her third day, having found a better opportunity elsewhere.
The company had also been doing acquisitions like crazy after I was hired, and was known by 4 different names. I liked the company when it was Watson, but by the time it was acquired by Teva, which it is known as now, conditions went downhill fast, with the usual budget cuts and hiring freezes. Even some of the few newly-hired permanent employees began jumping ship and from what I heard, the situation is only getting worse.
Unlike most jobs in the 1950s, many jobs today, even high-skilled ones like lab techs, scientists, and IT professionals by their nature are harder to unionize because most of the time no two workers do the same exact work. I was one of only 2 or 3 out of 30 in my department that was trained on physical testing in the lab.
I would definitely be nervous about your industry falling prey to the "gig economy" too. And as I said in the writeup, this transformation in employment makes a stable health insurance market all the more vital, despite Congress's insistence we go the diametric opposite direction and introduce layer upon layer of new risk.
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