Why Are We Getting Gay Marriage, But Not Universal Health Care?

Great Debates
1

In case it gets lost in what follows, I am for gay marriage.

But I would be dishonest if I didn’t admit to having been a homophobe most of my life, and I think most of my peers (I’m a male American in his 50’s) would have to say the same. It was just part of the culture, as evidenced by the fact that being gay would render you unfit for military service. Not that I or anybody I knew attacked gay people, but we certainly ridiculed them as teenagers (although we made exceptions for hot lesbians when viewing porn), and the question of whether they should be married like “normal” people was so ridiculous that we never even considered it.

Even now, as an unabashed liberal, my attitude toward gay marriage is just a matter of “live and let live, as long as you don’t hurt anyone,” but the thought of male homosex still kind of creeps me out. If that makes me a current homophobe rather than a former one, fine, I won’t dispute it, other than to note that I don’t think that my private thoughts hurt anyone, and my public actions are to vote for equal rights for gays.

On the other hand, I literally can’t understand people who don’t think that everyone should be entitled to health care, and that it shouldn’t drain your bank account when you get it.

So it seems like the US should achieve cheap or free universal health care long, long before it allows gay marriage.

And yet, even Rush Limbaugh has now conceded that gay marriage is a done deal. Even conservative Republicans have mostly thrown in the towel on fighting against the tide. But they are still fighting tooth and nail against the IMO disappointingly modest changes to our health care system from Obamacare, and true reform like a single payer system is regarded as too radical for even the most liberal Dems to fight for it.

Why is this? Depending on the study, 10% or less of the US population is gay, and legalizing gay marriage will result in an increase in costs to the taxpayers and corporations in the form of spousal benefits. But 100% of the US population needs health care, and getting our system more in line with other Western countries would reduce costs for everybody. Plus, a lot of people (at least of my generation) think gay sex is yucky, but nobody thinks health care is yucky.

So why has the battle for gay marriage been won, while the issue of universal health care seems to be more polarizing than ever?

2

The short answer is that gay marriage is about “live and let live”, and close to zero cost, whereas UHC is about a lot of healthy people subsidizing a small number of unhealthy people (who might be unhealthy because of personal choice).

Of course it’s not that simple in practice, which is why reasonable people can differ on both issues. UHC may be cheaper for most people, but there’s no actual proof of that until it’s implemented. And it will definitely be more expensive for some people.

3

Gay marriage is lots cheaper.

4

It has been implemented in many western democracies, and many, many studies have reported much lower costs with equal or better outcomes when compared with the US. The very top tier of specialist care for the very wealthy may (or may not) be better in the US, but there is no reason that has to change with UHC.

5

That’s not obvious to me at all. No matter how few gay people take advantage of spousal benefits, I can’t think of any way they will cost less. But a single payer health care system is almost guaranteed to cost less.

I understand that some people may end up paying more over their lifetimes if their premiums increase, and they die instantly in a car accident after a long and healthy life. But surely, for most people, the benefit of not having to worry about losing your life savings to medical costs should more than make up for that.

6

I think there truly is more resistance to Universal Health Care in the US. Not because I’ve looked at actual statistics, but because I’m on Facebook a lot. My newsfeed was red like the red sea over marriage equality, but even my skewed to liberal (but not exclusively so) Friends are decidedly mixed on UHC, on Obamacare and related issues. Some because it’s damn dirty socialism, others because they’re concerned about physician shortages, and still others because they think western medicine should be abolished entirely. It’s not just Conservatives that have reservations. It’s the Libertarians and the Anarchists and the HippieWoos, too. Not all of them, of course, but a much more diverse group than is against Gay Marriage. Plus, of course, almost the entirety of the crowd that is against Gay Marriage (because most of them are against Universal Health Care, too.)

7

What % of the economy is gay marriage?

8

That makes sense, although I’d be surprised if the latter two categories have much influence. I guess the Libertarians do, but as you implied, the people most against health care are hardly Libertarians when it comes to, say, abortion.

9

Since UHC is cheaper than the current health system in the US, that means that there are participants in the current system that make more money out of it than they would with UHC. That includes the insurance companies, which would lose a lot of their business, and have to change how they do the rest of their business. I suspect that it also includes hospitals and doctors. People who might lose a lot of their income would naturally be opposed to changes in the health system.

10

Simple. As others have noted, it’s all about the costs. Gay marriage, while distasteful to some, really in the end harms no one and is the right thing to do. Denying people the same rights and privileges that hetero couples get is just wrong and unjust, and it was only a matter of time before people realized that. Sort of like the civil rights movement of the 60’s, it was only a matter of time before a majority of Americans came to that realization.

UHC on the other hand is a whole 'nother animal. There is a perception, real or imagined, that it’s going to cost a lot, especially in the short term. And it’s a perception that’s easy enough to understand, regardless of your political motivation. If you currently have a health care system that costs $X for Y million people, and you intend to add Z more million users to the system that aren’t currently covered, then it’s pretty obviously going to cost a non-zero amount of money to do so. Pointing out that other countries have this and it doesn’t cost them more (presumably) for the same coverage really cuts no ice with most people, since most people grew up and understand our current system, and didn’t grow up or understand what someone in France does. Hell, I’m fairly old, and MY dad grew up with the current system, once he moved to this country. It’s been with us for a long, long time, and people understand it…and there are a lot of questions about how we would or could transition to a full blown UHC system without costing a lot of additional money and also a lot of pain in the transition. I’m fairly ambivalent about UHC and concede that once we get there it might actually be more efficient than our current system, but I still have a lot of reservation about how we get from here to there, and what it’s really going to cost, especially in the interim.

11

I don’t know, but I’d guess that unlike health care, it’s way too small to have many opportunities to save corporations and taxpayers a lot of money.

12

Also, most non-crazy people understand what same-sex marriage is - it’s just like the other kind of marriage, only between people of the same sex. But UHC comes in a whole variety of different forms, most of which are extremely complex to implement and maintain. Even people who want UHC may not want certain forms of it.

13

So you’re saying it’s a combination of the ignorance of the electorate, and the lack of communication from its advocates to counter the conservative demagogues? If so, I think that makes sense. It relates to another thing that puzzles me: Why has the internet made people dumber?

14

And they have very powerful lobbies. Yeah, that’s why the Republicans in Congress are so opposed to it, I’m sure. But for Joe Sixpack, it still seems to me that gay marriage should be a tougher sell than universal health care. Even if you’re not convinced it will save you money, the least educated people in the electorate are more likely to have been raised believing gay is bad, and helping the sick is good (WWJD?)

15

You are assuming that it’s equally obvious to everyone as it is to you that UHC is the answer to the problem. It’s not. Even people who are experts disagree on exactly what the answer is, and on what it will cost, and most importantly on how we get there from here. To most every day people it boils down to what they know and a big unknown. Since no one thus far has been able to conclusively demonstrate that what you take for granted is the reality and UHC will not only cost less but give the same or better levels of care to the people who currently have insurance, it’s that unknown that cuts into support from the voters. Sure, ask them in a poll if they want UHC for everyone and they are fine with that…it costs them nothing. But try and get them to vote for it, especially when there are those questions about what it will cost them both in terms of money and service, and they are less willing to vote as they polled.

At any rate, you asked a specific question and it’s been answered…we are getting Gay Marriage before we get UHC because Gay Marriage really costs us little and is pretty much categorically the right thing to do…it’s VERY unfair that homosexuals don’t get the same rights as hetrosexuals…while UHC is still a big unknown with a lot of questions still to be answered in the public’s collective mind. Calling the public ignorant (and blaming the internet) is militantly unhelpful if you really want to get UHC through. Setting out conclusive proofs and a road map on how we get from where we are to there, without the tiresome repetition that other countries who didn’t start were we are but have UHC today is the best way to get it through. If you lay out conclusive evidence and demonstrate with solid numbers how it will save AMERICANS money and add efficiency to OUR system, eventually even Republicans will come around…just like they were forced to by Gay Marriage.

16

Some people think UHC means they will have to pay more in taxes to fund other’s care while they themselves will receive inferior care (lower physician/patient ratios, rationing, higher cost).

Plus UHC involves expanding the government, gay marriage involves not letting the government prohibit people from using their freedom. You are using government for opposite things in those 2 situations. Libertarians, who are about 1/3 of the conservatives in this country, tend to be ok with gay marriage but anti-UHC. So there is a division in the conservative movement on this issue. I don’t think there is much of a division in conservatives about UHC, most are against it (except for those who have seen firsthand how expensive and poorly run our system is).

Not that I agree with those things, but there you go.

17

I’m aware of all this. Nevertheless, the US is not identical to other places, and so we won’t have proof until we try it. It may even be that entrenched interests ensure that we only ever get a broken, half-assed version of UHC, and so UHC does amount to a failure in the sense that we never actually get it. I generally support UHC, but it’s by no means certain to me that it will actually pan out, even if it does work elsewhere.

And as you point out, the top tier of specialist care won’t change, except that the users of such care will be paying more than they are now (the cost of the premium care plus the cost of the universal care they aren’t using). So on a purely selfish level, UHC is a negative for moderately wealthy people–people who are more likely to vote.

18

There is an increased cost, but it’s miniscule.

When gay marriage was implemented in Canada, people who study pension and benefits costs estimated that at most, it would increase the employers’ costs by something in the range of 1% to 1.5% - which is almost a rounding error.

By contrast, when pensions and benefits were previously expanded to include common-law couples, employers’ costs were estimated to go up something in the 20% range - and no-one batted an eye, because people living common law was becoming more and more common, and it was generally accepted that employees should have the right to have their common law partner included in their pensions and benefits. It was generally accepted as the right thing to do, even if it did cost the employers more money.

Once this contrast was pointed out, we didn’t hear many people trying to oppose same-sex marriage on the basis of costs to employers.

19

Good point. Especially Obamacare, which isn’t UHC, but an extension of the crazy employer-based health insurance system we have now with a gazillion exemptions including a fine for people who don’t want to have health insurance. People actually understand that last part OK, they just don’t like it.

20

UHC would cost some people money. The people currently making TONS of money in the current health care system.

They like making tons of money and they can use that money to influence politicians and elections and public opinion.