Thursday, August 6, 2009

Garbage isn't healthy - but health care can be garbage-y

We have a private trash hauler system in Saint Paul. I understand those haulers have regulations on them, and taxes (solid waste fees - whatever) they pay to dispose of my non-recyclables. From what I read in the papers, there are more than a dozen residential trash haulers barreling down the streets of Our Fair City to remove the unusable stuff in our lives. Civilized places tend to have one truck doing this work, but I digress.

The Saint Paul City Council is considering maybe doing a study to maybe think about whether there is a better way to do this. Here's where some interesting parallels to health care can be uncovered - and I use the word "covered" intentionally here.
  1. People with money have coverage. If you are well off, you have health insurance and maybe think of the rest of us as annoying for whining all the time that we either pay *way* too much for it (as in the case of my family with no employer-based coverage and with people who actually have to see a doctor on occasion) or we just can't get it at all. Same thing with garbage collection. When the system is voluntary and based on private haulers, people with money call someone and get it taken care of, and can't imagine why some people who don't have money don't have a private hauler taking away their unnecessary items.
  2. People without coverage hurt the rest of the system. So, let's assume you are one of those folks who can't (or yes, in some cases won't) pay for private garbage hauling. Maybe you've spent every last dime on medical bills. Who knows. In any case, you don't have $20/month or more to pay for hauling. So, you maybe slip your garbage in with your neighbor's and hope they don't notice. Perhaps you take a bag with you when leave the house and walk by the dumpster at the local church and pitch it in (after all - it's a church - aren't they supposed to relieve you of your sins?). Maybe, just maybe, it gets real bad and you simply leave the stuff in the alley and hope for the best. If so, feral cats or squirrels or whatever are going to open the bags and now your old garbage is floating on the breeze into your neighbors yard, the public streets, or into our storm water run off systems and so into the Mississippi. Those of you thinking back to the "free rider" problem from PoliSci 101, you get a gold star.
  3. Private interests are vested in making money off the current system, so we don't get change. Yes, some of these people making money off the current system are very nice people. They are family businesses and they smile at you and they are not vampires. I get it. However, is the benefit those people get a good trade-off for the problems we have in the current system? This question is not rhetorical. If you really think so, please help me understand and perhaps I'll get on your side.
  4. People wanting to solve the problem are labeled as promoters of "big government" taking away "our freedoms". Me, personally, don't much care about the freedom to pick a garbage hauler. But sure, some people will lose some choice here. Is it enough of an issue to derail solving the problem? See number 3 again. I'm teachable (I hope). Tell me why this is more important than stopping free-riders from making churches pay for dumping and for having trash blowing in our streets.
  5. People without money need more from the system than those with money. I've been poor. Not abject poverty, and not for long periods, but I've maxed out a gas-station credit-card (the only card I had then) just so I could eat. Yes, I charged groceries at an Amoco station because that was the only way I was going to get them. Again, I digress.

    My point is when you are poor, you work with what you got. You take donated furniture and electronics. You buy second-hand clothes. If you buy new you're buying cheap, fiber-board stuff from discount stores. You know what happens to this stuff? It wears out. Fast. Then you have to dispose of it. And guess what? That costs money. Sorta like people without health insurance try to get by on the cheap until their bodies break down, and then it gets expensive. Fast.
So, City Councilmembers and my fellow Saint Paulites, let's consider these issues and get some more facts. Then perhaps we'll see if universal coverage makes sense in a much smaller universe than just health care.

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