When you get a job that offers health benefits it is kind of a no-brainer that you are going to accept those benefits. The only sane reason to turn them down is if your life-partner has a job with better benefits. So, you fill out some forms for your human resources person, you select a primary care physician, you get a medical care card and a dental care card, and you’re done. Your company starts withholding money from your paycheck which you can track if you look at your pay-stub (not always something people bother with in this era of direct deposits). You probably don’t think about the fact that your company is matching some of the cost of your health care coverage. You don’t think about the fact that you’d be getting that money in salary or wages if you lived in a country that had some form of single-payer government provided (or subsidized) health care.

When your company’s health care costs double, you see some combination of reduced benefits and increased withholding. Maybe your co-pays go up. What you don’t notice is that your pay raises disappear or stagnate. Or, rather, you do notice that, but you don’t put two-and-two together and realize that your pay raise disappeared to help pay for the rising cost of providing your employer-based health care.

Your employer is more clear-eyed. They know how much you cost them in compensation. They look at the total cost, and they don’t care how much is direct pay and how much is part of your benefits package. When the cost of insuring you doubles, they can make it up in various ways. They can reduce the match on your 401(k). They can give you a 2% raise instead of a 4% raise. They can renegotiate a less generous health care plan for all their employees. They can withhold more from your paycheck.

All of this creates a situation where most Americans are constantly getting blasted by the rising cost of health insurance without understanding where that money is going. Maybe they think their company simply had a bad year and made few profits.

If you poll the people that have employer-based health care, they seem fairly happy with the deal they are getting. But they’re getting screwed. But they are not getting screwed half as hard as the people who have to buy individual coverage. They aren’t getting screwed half as hard as the people who have to go without health insurance because it is unaffordable for them.

What Baucus and his cohorts want to do is to force people to buy health insurance that they have already decided is not affordable. He wants them all to buy that insurance from the corporations that charge too much and deny too much care. That is not going to be popular. People are going to hate his plan. His plan is going to pauperize people who are barely getting by in this country.

It’s wrong. We all know that single-payer works, and works well. But if we aren’t going to go that route, we have to at least provide an option for people to buy government insurance at an affordable price. If we don’t do that, we are going to make enemies of the very people we most want to help.