The Red Sox and the flu: Health care and the bottom of the pyramid

Sometime in the not-too-distant future, I'll have a post about Peter Diamandis and Steven Kotler's book Abundance. Until then, I just want to borrow their concept of the bottom of the pyramid — the four billion or so people who are the world's poorest but could mean big bucks for someone willing to go in with cheap products.

One of the things that happens is, if you can get this group of people clothes and food and water and electricity and cell phones, they can solve more of the world's problems. If you're worried about clean water and where your next meal's coming from, you could be the world's top engineer and you can't help anybody because you have to feed yourself first.

It's the same reason they tell you on airplanes to put your oxygen mask on first before you help anyone else with theirs: If you can't breathe, you're not of much use in making good decisions for someone else.

OK, so there's the bottom of the pyramid. Let's look near the top of the pyramid: professional athletes in the U.S.

The Boston Red Sox are off to a slow offensive start to the baseball season. A lot of that is due to the fact that the starting lineup has been decimated by the flu.

These are pro athletes, so they're generally in really good shape. They're also by and large wealthy — minimum salary for someone on a Major League roster all year is over a half-million dollars (approach that number without judgment — just recognize it as a statistic in relation to other incomes in the US).

While healthy people do tend to get rid of the flu more quickly than unhealthy people, the flu doesn't give a crap about your bank account.

Doctors and insurance companies, however, might.

Whether you're making $535,000 or $10,000,000 as a member of the Red Sox, if you feel like garbage and miss several days' work, at least your family is going to be well-cared for and it's hardly a matter of life or death.

If you're closer to the bottom of the pyramid, as far as US workers are concerned, several days with the flu might mean you miss several days' pay and perhaps you get fired. Maybe your job doesn't offer health insurance. Maybe your family isn't going to get to eat, or turn on the heat or lights this week, whatever you choose to forgo.

The thing about the flu: It spreads. If you have the flu, you risk your family getting the flu. If you go into work, you risk spreading it to their coworkers, and they to their families. If you work a bottom-of-the-pyramid type of job, say, at a department store, you might get a few dozen people sick. If you work in a restaurant or grocery store, there's a good chance you'll get some customers sick.

But if you work those bottom-of-the-pyramid jobs, it's hard to not go to work. You risk a lot.

Still inside the first few months of a new presidential administration, a lot of people are looking for a change in our health care system. Leadership royally botched its first attempt.

My congressman replied to my letter to him (see the post linked in the preceding paragraph), pointing out the Congressional Budget Office said the American Health Care Act would have saved the federal government money.

Yes, I responded, but they also said it would leave 24 million (more) people uninsured. Some people call that "patient choice." It's really not a "choice" if you have to decide between spending three-quarters of your paycheck on insurance and having a home and food and such.

So what do we do for those folks who, once the Affordable Care Act is replaced, won't be able to afford health insurance and won't be able to afford to miss work?

I don't know the answer. We have lots of smart people who could be working on it, but I'm not convinced any of them are.

In the words of President Donald Trump, "sad."


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