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The Upper Middle Class Frustrates Health Care Reform

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The upper middle class is finally receiving the attention it deserves but probably doesn't want. The income inequality standoff between the 99% and the 1% that exploded after the 2008-09 Great Recession is moving downstream. About five years after the start of the recession, economists, social and public policy experts and intellectuals began to notice where the real growth in income was happening. Articles in the Wall Street Journal and Fortune both reference a study by Stephen Rose of the Urban Institute that claims that in 2014 the “upper middle class controls 52.1% of America’s income.”

But it’s not just rising income inequality between the upper middle class and the lower income classes that is getting attention, it’s their increasing political clout that is receiving bad reviews. Some public policy writers believe that the upper middle class is destroying America. Check out some of these headlines:

"The Upper Middle Class Is Ruining America And I want it to stop." written by Reihan Salam, 2015,
slate.com.

"The Dangerous Separation of the American Upper Middle Class," written by Richard V. Reeves, 2015, brookings.edu.

"Check Your Privilege, Upper Middle Class," written by Richard Reeves, 2016,
washingtonpost.com.

Personally, I never really thought about the status of the upper middle class until last month when I spent two weeks with about 100 of them on a cruise from Moscow to St. Petersburg, Russia. Now, I can't confirm that all of the people I met on the cruise were legitimately upper middle class, but I'm guessing many were.

Let me explain.
In his article in slate.com, Reihan Salam, said that “upper-middle-class is a state of mind. We’re talking about families that earn well into the six-figure range yet don’t feel rich, either because of their student loan debt or the enormous cost of the amenities they consider nonnegotiable: living in well-above-average school districts for those with children or living in “cool” neighborhoods for those without.”

So, if Reihan is correct that upper middle class is a state of mind, my cruise mates who casually compared the number of countries they visited, fit the bill. They also, according to every article I read about this group, and I’ve read a few dozen, possess all or most of the characteristics of the upper middle class: mostly white, educated, current or former professionals (doctors, lawyers, financial advisors, public-sector administrators, etc.) lifestyle-focused, with the ability to spend thousands of dollars on,
experiences, and segregated from the lower income classes.

Should We Care About The Upper Middle Class?

Why does a blogger dedicated to writing about health insurance and retirement saving public policy issues care about the upper middle class? Well, as a former workplace employee benefit professional, I know that workplace health insurance and retirement plans favor highly compensated workers. You know, those employees who make above the FICA tax limit and the ones who can afford to contribute the maximum amount to their 401(k) and whine that they are not able to contribute more, tax-free.

However, I never really thought about how these people got so lucky with the tax code. I never considered that they were making their own luck through voting and lobbying at all levels of government. What I’ve learned is that the upper middle class does not sit idly by and let change happen if that change will take away something they value, and they value their employment-based health insurance.

So now what? I can agree all day that the self-interested upper middle class is ruining America’s ability to institute health care reform, but what to do about it? Some social and public policy experts suggest appealing to this group’s sense of morality. Explain to them the greater good to be accomplished if we changed their benefits just a bit in order to improve access and costs for the lower income classes. Good luck with that strategy.

A recent
report about ColoradoCare put out by Mercer, a consulting firm with a main line of business in employment-based health and benefits, reported that,

“many employers don’t believe the goals of ColoradoCare are aligned with the goals of their organizations. While 80% say that slowing spending on health care in Colorado would be important to their organization, far fewer believe that either the goals of universal coverage (38%) or more streamlined administration (39%) would be important to their organization. And only about a third (31%) say that untying health insurance from employment would be important to their organization.”

The report also said, “According to Ryan Ramsey, Health & Benefits leader in Mercer’s Denver office,
“One reason that relatively few employers support ColoradoCare may be that a majority say they and their employees are satisfied with the status quo.”

And while not all members of the upper middle class get their health insurance from their workplace, many do and as the survey stated, they overwhelmingly like the health insurance status quo. There is no convincing them that they did not earn everything they have through hard work, intelligence and wise life decision-making. There is also no convincing them to share what they have. So option number one (consent to change for the greater good) is a NO.

Option two would be to elect politicians that are brave enough to enact health care reforms that change benefits for the upper middle class but help the lower income classes. This is also a difficult option because most politicians 1) are not brave, and 2) are members of the upper middle class.

What to do, what to do…?

Option three: inform the lower income classes of who is really standing in the way of health care reform—their bosses or bosses’ bosses. People needed to know who stands to lose the most if single payer becomes the law of the land, and it’s a lot more than the one percent. I wish Bernie Sanders would tweet this fact and not just focus on the 1% or super rich when he makes his case for single payer health care.

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