The importance of both universal basic income and universal health care in securing basic needs
On February 4th, 2017, I lost one of my closest friends I’ve ever had. Because I’ve always worked at home, we were together virtually 24 hours a day for almost 13 years. He felt like a part of me. His name was Stormy Waters and he was my dog. No other death in my life so far has left me feeling so empty as this one, and whereas it was his heart that failed him, I feel that in some ways, so did I, not because of lack of love, but because of lack of money.
If only I could have afforded to take him to the dentist, maybe he’d have lived longer. If only I could have afforded to take him to a heart specialist when I was first told he had a heart murmur, maybe he’d have lived longer. If only I could have afforded to go back to the vet over and over again for more tests and medicine, maybe he’d have lived longer. But I couldn’t do those things. I didn’t do those things. A lack of money proved too high an obstacle for those things.
The Great Unknown
I can’t help but think of all the parents out there trying to do the best they can for their children on the tightest of budgets, faced with similar decisions every day and never knowing for sure the full ramifications of those decisions, just as I don’t know now.
How many parents are buying foods high in fat, salt, and sugar, and turning to packaged dinners out of expediency instead of home-cooking healthier but more time-intensive meals? How many are frequently stopping at unhealthy but incredibly convenient drive-thrus on the way home or even between jobs due to lack of time? How many have insurance policies with high deductibles or even no insurance at all, and perform the mental math about hospital costs versus their kids being okay without that potentially entirely unnecessary trip to the ER? How many are living in neighborhoods they’d rather not live in, and sending their kids to schools they’d rather not send them to? How many of these decisions happen every single day, everywhere, because of lack of money?
It makes me sick to think of all the unnecessary pain and unknowing. For every parent who hears their child now has diabetes, how much does that hurt to know they could have been fed differently, albeit at a higher cost of both time and money, both of which weren’t really options? For every child who watches a parent die at the hands of an opiate overdose, how much does it hurt to know their lives could have been different if only they’d been more economically secure? For every sibling who watches their brother commit suicide or sister suffer chronic depression, how much does it hurt to wonder how much a lack of sufficient money played a role in that suffering, and how large that role may have played?
It pains me to think of what I could have done differently if only I could have afforded it. Unfortunately, I will never know the answer to that painful unknown. Fortunately, pain is also not the only thing on my mind right now. I’m happy that aside from over a decade of loving companionship, Stormy had a few final parting gifts that I will never forget, because that’s the kind of friend he was.
Gifts of Love
The moment he died in my arms, I immediately sobbed uncontrollably. I didn’t even recognize my own sounds. I didn’t know I could make them. They were reflexive. In that moment I had no control over myself. No amount of conscious effort could override the overwhelming tide of loss I felt in that chair in that moment with my friend’s newly lifeless body in my embrace.
For the next week, it was like traveling back and forth between two states of existence. My waves of grief were an automatic physiological response, like breathing, something done without thinking, the result of a biochemical cascading of neurotransmitters within my brain. Scientifically detached as this may sound, it was this observation that caused me to fully comprehend something to my core that before I only merely believed — we truly are a social species. Why else would it hurt in such a physically profound way to experience the loss of a loved one, if we weren’t biologically wired in such a way so as to love in the first place?
We as a species are entirely interdependent. It is a mass illusion to think any of us can go it alone. Adult humans put in solitary confinement experience hallucinations, anxiety, apathy, and even a loss of sense of self. It’s a form of torture. Baby humans provided the rest of their basic needs except for mere physical contact with other humans can actually die. Baby monkeys raised in isolation can only exist in such a state for a maximum of around three months before reaching a point that after release one in six stop eating and die five days later. We as primates need social bonds. We seek out connections with others. This need is biologically fundamental.
Our need for each other even goes beyond personal connections to a reliance on people we will never meet, thanks to the division of labor. It’s how we constructed this civilization of ours — on each other. Where once we were each required to do just about everything ourselves, we eventually decided it made more sense to allow each other to specialize. Instead of everyone needing to be somewhat proficient in many different things, we could each become incredibly proficient in just one thing, and through our combined efforts, for the centuries since, we’ve continually raised the bar of what’s possible through the power of specialization due to our division of labor.
Every single one of us was born into a world and handed everything it has to offer us, through the efforts of all those who walked on this world before us. The dead never asked us for anything in return. All civilization is a gift from the past. It is the absolute pinnacle of something for nothing. No amount of work done by any of the living can ever be enough to consider our debt to all of the dead, paid in full.
This is also something I viscerally felt with the loss of my friend. As part of my grieving process, I was able to look through hundreds of photos and videos I captured of him during his life. These recordings will never fade. I will always be able to look at them. Such technology did not exist just 200 years ago. Whereas now we are constantly all taking photos and videos with devices we keep with us at all times, back then it would have been considered magic. The earliest known photo of a person was in 1838. It took 7 minutes to capture . How many photos of loved ones existed prior to then? Zero.
Why am I so lucky so as to have images of those I love that take fractions of a second to capture forever in unlimited number? What did I ever do to deserve that ability where those hundreds of years ago without that ability did more hard work than I’ve probably ever done? The answer is I don’t deserve it because of anything I’ve ever done. None of us do. It’s a gift from the past freely given, along with many other gifts of knowledge and technology for which I for one am eternally grateful.
Basic Needs
I also consider myself extremely lucky that because of my crowdfunded basic income, I was able to control without any worry how my time was spent in the days directly following his death. He died on a Friday night and I realized on Monday how difficult it would be for someone to have no choice but to go to work, regardless of their emotional state. I certainly couldn’t think of anything else that day. Not only is that a nightmare to imagine how people are forced to work in such a state of grief, but I can only imagine how unproductive that would be anyway. Everyone needs time to grieve without feeling the taking of such time has the potential to end up impoverishing them.
My friend also taught me something else I will never forget: there is no true market for healthcare, and there never will be. When you are told someone you love is dying, there is no amount you won’t pay, if at all possible to pay it.
Last November, when I first rushed Stormy to the vet to save his life, the only reason he was able to live for the three extra months he did was through an approved credit line, which is money I didn’t and still don’t have. Repaying that, which I will likely be doing for months to come was only made more possible through the generosity of others through a GoFundMe campaign I set up, and that was just a veterinary bill. Health insurance for humans is an entirely different animal, and if some amount of money can bring years or even months of additional life for a loved one, we will say yes in a heartbeat if we’re covered for that amount.
It is absolutely absurd to think we can ever treat life itself like we do clothing and electronics. There is a point that something becomes too expensive, and where competition exists, there is someone who will try to meet that demand at a lower price, but when it comes to healthcare, that all goes right out the window. There is no limit to what we’d spend for those we love most. If you were told your child required a billion dollars in treatment and your insurance company offered to cover that, would you say no? Of course not, and so the cost of healthcare will continue to rise because no one cares how much everything costs to prevent profound loss. The patients don’t care. The families don’t care. The doctors don’t care. And thanks to competition not really existing where people shop around for the best deal when it comes to hospitals and insurance companies (which will never exist like it does for other goods and services) there’s no reason for anyone to care. All that matters is that those we love not be taken from us.
We must in the U.S. at some point achieve real universal healthcare. There is no reason aside from the combination of greed and stupidity that we should ever allow ourselves to continue spending more money than everyone else for worse outcomes. And if you think health insurance is the same thing, you obviously have never been in the position of being unable to afford co-pays or deductibles or prescriptions. Life is sacred, and we need to realize that and recognize that, by treating our health as something fundamentally different than everything else we obtain with money.
Source: Our World in Data
A Greater Society
It is for all of the above that I assert a demand for both universal basic income and universal healthcare as the two primary pillars of a Greater Society. We all need, without any conditions, sufficient income to meet our most basic needs. No one should have to choose between food and rent. No one should ever have to look back after the death of a loved one, and wonder how much a lack of insufficient money to cover basic needs played a role throughout their lives. The basics should be covered for everyone as a bare minimum, with everything we earn from employment being additional income to cover everything else we may want instead of need.
Furthermore, when it comes to meeting basic needs, simple cash can never function to achieve universal healthcare because free market private insurance within an unregulated healthcare market isn’t healthcare. It’s a license to take advantage of our inability to say no to any expense to save those we love most.
It makes no real sense to only have one or the other. If we only have universal healthcare, then we will spend more on that than we otherwise would on a population of healthier people with basic incomes. If we only have universal basic income, then the costs of healthcare will continue to rise (albeit more slowly), and people will continue needlessly suffering with a lack of fully universal coverage, or even no coverage at all. Together however, a basic income will create a healthier population, and universal healthcare will protect that population in ways money can’t.
I miss my friend. My heart goes out to everyone in this world without basic income and without real healthcare who has lost someone they loved, and will lose someone they love in the years ahead, until that day comes when we do finally achieve a Greater Society, and in so doing finally know that when death and suffering does happen, it wasn’t because basic needs weren’t met.
I would give anything for that knowledge, and will continue giving everything I can to make that world happen.
Will you?
Scott Santens writes about unconditional basic income on his blog and is crowdfunding basic incomes (including his own) on Patreon. You can follow him on Medium, on Twitter, on Facebook, or on Reddit where he been a moderator of the /r/BasicIncome subreddit since 2013.