Like many Americans, I couldn’t break down a health care bill if I tried.
In response, I handed over the topic to our more-than-capable readers, professionals throughout the restaurant industry who have direct day-in and day-out experience with this lava-hot issue. We sent an email asking them to chime in and share their thoughts. The question was simple: What would you like to see happen with healthcare?
The responses were anything but, as you might imagine. Here are some select sound bites:
I believe for the restaurant industry as well as for all industries, both employers and workers, that the only solution and truly best solution for all parties involved (doctors, hospitals, patients, employers) is a Medicare for All Single Payer health insurance system, with a small deductible and co-pays for some services, like emergency room and doctor visits (to have skin in the game and not abuse it by patients). As well as the doctors getting a fair payment schedule (especially family doctors, but rein in excessive abuse by specialists). This could be funded primarily through a payroll tax (similar to social security) where employers match. This will greatly reduce costs for companies that offer insurance and will be only slightly more for those that currently do not. Say 3 percent seems like a reasonable amount, with higher incomes being taxed higher. America is a capitalist society (with rules and regulations, that we all hate but that we all cherish) and it’s what makes us great, however, health insurance for citizens IS NOT and CAN NOT be a market place product. It is just not possible as proof with pre-Obamacare, Obamacare, and now Trumpcare. Single payer for all.
As you know this is a complex problem without a simple solution, regardless of the sound bites from Washington.
As a global leader, we should lead the world in a number of areas, which we do not. Health care, education, etc. Unfortunately we lead the world in obesity and heart disease. These two items are directly related to the foodservice industry. Foodservice is at the end of the line when it comes to funding. Billions of dollars are spent on health care that never reach down to foodservice. Good nutrition is a silver bullet when it comes to health care. Unfortunately our approach to medicine is driven by the pharmaceutical companies, not the food companies.
—Ralph H. Goldbeck
My feelings on healthcare are pretty basic. If you want a boat or a house or a car buy your own insurance. When it comes to your health I want to be there for you and would hope the same in return. National healthcare is the obvious answer … it takes a village!
Although I consider myself a conservative, I think that to repeal the Affordable Care Act would be irresponsible. The Affordable Care Act allowed me to drop our group health care plan and by paying key employees more, they were able to enroll in health insurance at more affordable rates than through our employer provided plan. If the Affordable Care Act is repealed, there is no way the insurance rates will come down enough to make up for the tax credits currently being used to offset the insurance premiums. In the end, this could be a disaster for employers, as in the future, the Republicans will be voted out of office, and the liberals will be back in power. Then the $15 minimum wage will inevitably be passed, and small business will really suffer then.
Health care is a mess and unaffordable. It is not health care. It is catastrophe coverage. Premiums have increased over 100 percent. Deductibles to over $7,500 per person. No middle-income family can afford this and smaller companies are doing all they can to avoid offering coverage.
—John C Krebs
I have not had insurance since 2011. I am co-owner of a very small cafe/convenience store in rural Kansas. I also work 32—40 hours a week at our school as head cook. I bring home a paycheck from that job 10 months a year. It is just enough to make my house payment, utilities, car insurance, and put some groceries on the table. We have not taken a salary from the cafe since we opened in 2010.
Here’s my idea. The healthcare “reform” was a failure to people who were low income, self-employed, and trying to find coverage for their families. I am glad it forced insurance companies to cover people with pre-existing conditions. I am very disappointed that it is a requirement to have coverage for such things as pregnancy when the person who is being insured has taken measures to not become pregnant ever again. That is a complete abuse of power.
Secondly, I don’t see how paying $375 or more per month, a 20 percent co-insurance, and a $5,000 deductible is affordable. If you do the math, I would be paying over $950 per month (putting $2,000 for co-insurance and $5,000 for deductible in an account plus the premium) for “affordable health care.” I bring home about $1,100 dollars per month, 10 months a year.
I am 51 years old, I have no major health issues, I went to the doctor twice last year, both times for normal cold/flu issues, and I still have to follow all the “rules” if I were to find a policy. All I want is a major medical policy that would cover if I needed to go to the hospital if I fell and broke my leg, or something along those lines.
My husband will be covered under Medicare this fall. He is 64.
We are in the “gap” where my kids are on their own, my mother is still healthy and lives on her own, and we don’t make enough money to qualify for the tax credits, but can’t afford a real policy either.
My personal opinion is that insurance companies should be allowed to offer individual policies to people like us, with no government regulations, like were offered before ACA was implemented. If the government wants to force the insurance companies to provide a group policy to those that have pre-existing conditions, don’t make the average citizen pay for it with high deductibles and high premiums.
“I am very disappointed that it is a requirement to have coverage for such things as pregnancy when the person who is being insured has taken measures to not become pregnant ever again. That is a complete abuse of power.” — Wanda Waldeck
Health care shouldn’t be a business. Universal, government overseen health care is the only way to provide global care at a decent cost. Personal insurance can be added to get better and faster care. Hospitals can’t be a for-profit enterprise, period.
My thoughts quite simply on health care is that our government should stay out of a business that was and should continue to be privatized.
Having said that, I believe it is too late for such common sense to prevail. The example of the ACA being passed was the beginning of the end for privatization of health care in our country in my opinion. My best example of this was when our new leadership said that the ACA would be repealed, consequently town hall meetings erupted with many people pleading not to take away their health-care plans. I do not believe that there would have been so much push back from these people if they had not thought that they were already getting a great deal.
I can assure you that my wife and I are not getting a good health care deal, otherwise why would the costs of our health-care plans have increased from 2015 to 2016 by 28 percent and then again from 2016 to 2017 by another 33 percent.
I might also add that we currently make our health care cost choices by looking at a scale of only our age, with no consideration of healthy life choices that we have or have not made in our lives. Not to mention our current health status, weight, medications that we may be taking, etc.
My take may be long winded but people do not clearly understand the reality of the costs incurred in our health care system (saying that this is a system is a joke by the way). My example: I had an emergency appendectomy in 2012 with an immediate follow-up surgery to stop a bleeder caused by a staple hitting a vein.
I challenged the cost of the procedures because I had no insurance, and so I received an itemized bill. When you look at an itemized bill/receipt from grocery shopping, each item is scanned and costed out along with any discounts. Accuracy rates are near 100 percent, added up, you pay. My itemized bill from the hospital was seven pages long with multiple duplicate and triplicate charges along with suspect dates for the items I was charged for. I say this because the billing for each surgery shows the dates of those surgeries as the same day. They were on different days. There were numerous credits to the multiple charges but they were not organized. So you don’t know whether or not you were accurately charged. When we came to a conclusion on what to pay, five months had past.
What business bills for services and through its own inept bureaucracy, generates revenue five months after? Our wonderful health care system. Insurance companies rarely challenge certain costs and also take extensive time to pay out when they finally agree on costs. Pharmaceutical companies apply outrageous costs to their drugs claiming research is expensive. What they don’t tell you is that there methodology goes something like this:
Research department is doing work on a potential new drug and they decide they need a piece of equipment that will do a specific test that aids in determining feasibility. Let’s say this equipment will cost $30,000. The upper management of this drug company approves the purchase in the budget knowing full well the piece of equipment is only useful for that one test and will not be used for anything else. (I worked in the pharmaceutical and health care industry previously and witnessed this type of action routinely).
Bottom line is that our collective health care costs are grossly inflated because roughly 33 percent or more goes to administration/bureaucracy. Health care needs to be fixed from the inside before you can attempt any affordable health care act.
The reality is that truly 70 percent of Americans or more would love to have a single-payer system because health care should be a right, not something to be profited from. But no one really talks about that.
“Health care needs to be fixed from the inside before you can attempt any affordable health care act.” —K Campbell
The new health care bill (of which there are several proposals) does not propose taking away anyone’s access to health care. However, it does eliminate the mandate that everyone is required by the Government to buy health insurance or get fined. Liberty is what this great country is all about.
I have two points of view on this. As an entrepreneur, I rely on buying health insurance on the ACA marketplace. The fact that the costs have gone up is pretty bad, but the proposed AHCA seems not to seriously solve that anytime soon. It’ll be devastating to end up without health insurance, perhaps having to shut down my startup to get a job in corporate with full benefits.
As a member of the restaurant industry, I understand the drive toward keeping costs low, but there has to be a point where maintaining good and reliable employees makes more sense than just hiring at the lowest cost possible. I’d rather hire people who remain motivated and loyal than have a high turnover.
Also, it is infuriating and insulting to see the lack of political leadership we have in this area. While the ACA is/was not perfect, it is disgusting to learn that Republicans did not have a clear strategy to replace it. There shouldn’t be patience for this lack of preparation and vision at such high levels of government.
—Lucas E. Wall
The problem in this industry is that we employ many smokers, drinkers, and people who don’t necessarily plan ahead so it is a high-risk group. They want good coverage but don’t want to pay high premiums even though they may be high risk. Also, most servers in this business do not get a paycheck so you can’t deduct from their check and it is difficult to manage the monies. Perhaps offering a pre tax HSA so that all could participate. Offer incentives for non smokers and especially for those who agree to quit smoking.
It is a huge issue because many of these employees have family. Offer online tutorials on how to plan to save if their job is based on tips or an hourly rate of $10 per hour. The opportunities would be if they get tax breaks and monies back at the end of the year what they can do to plan for their future. If they do make tips, suggest ways that they can track their tips and save a portion in an account with their bank or within a plan.
“While the ACA is/was not perfect, it is disgusting to learn that Republicans did not have a clear strategy to replace it.” —Lucas E. Wall
I’d like for the state to stop enabling worker’s comp fraud. Every time we have an employee pursue a fraudulent claim our MOD still shoots up high. The MOD should be fraudulent-sensitive as well at-fault sensitive. We had a driver hit by an under-covered driver who ran a red light, and the insurance company, looking to recoup some of their costs, decided to put half his claim on our auto and half on workers comp. Even though we did nothing wrong there was no recourse we could take on the irresponsible driver and we paid unaffordable premiums for three years.
As far as personal health insurance goes, Obama lied to the public saying everyone should have affordable healthcare, yet Obamacare is anything but affordable. The first thing that needs to happen is return to people being responsible for themselves. Stop making employees’ private health concerns my responsibility to monitor, which just causes animosity and further tension in the work place.
If a person decides to take a job with us, we are very open about what benefits we cover and what we do not. When they accept our offer they are also saying that they will responsibly handle all we do not cover.
Costs and fees should not be passed onto the government or the people through any tax. If a person chooses to go to a hospital for a cold and has no insurance and cannot pay the fee then the hospital alone should be responsible for better enforcing payment receivables or their criteria for allowing admittance to their hospital. Our welfare programs should make it way harder for non citizens to get and it should not equal a minimum wage salary or everyone will keep choosing to stay on welfare. Childcare for working parents should be covered as well.
I have been thinking about healthcare quite often and the debate made me actually open the packet that I get every year from my insurance company, which is supposed to explain my policy. It is 138 pages long!
I have not read it as I also did not read the packet they sent last year either. But this debate did refresh my memory of visiting the hospital billing office in the 1990s. It was a large office with many desks and people working. It was explained to me that all those folks did day after day was figure out each patient’s insurance, then fill out the correct forms for each of the different companies and for the different policies that each patients had, and then send those off! Also then there would be claims that were returned because of an error or they required more paperwork to be attached. So for anyone to say that this is more complicated than anyone knew they haven’t bothered to try and read an insurance policy or visit a billing office ever. I recommend that every single member of Congress and the Senate and the President take a trip to a local doctors office, hospital, and/or a nursing home and visit their billing offices and have the workers explain to them what they do all day. Also our government officials can try reading insurance policies to see if they can make heads or tails out of them.
I was told back in the 1990s that all these different policies from all these different companies are one factor of what drives up the cost of health care. They should understand then why not every doctor or health care provider takes insurance from every single company. Insurance needs streamlining, that why many want single payer, it saves an enormous amount of paperwork, which in turn saves money. But there are other factors driving up costs as well. Greed is a big factor. There ought to be caps on the amount of profits these insurance companies and the drug companies are allowed to rake in as their profits are gauging consumers. Banks shouldn’t be allowed to gauge us and never should the healthcare industry. I keep reading about CEOs of these companies who make $10 to $20 million a year. Why? What do you do with that much money? Think how many people you could employ with $10 million dollars. It is obscene. I also feel there was a big mistake when they allowed drug companies to advertise prescription drugs directly to consumers, people who did not attend medical school don’t need to decide what drugs their doctors should be prescribing them. It alone will save the drug companies millions of dollars from their advertising budgets. Patients should go back to letting their doctors decide which medicines are correct for them.
I have been in the restaurant industry for 28 years. The last 11 years as an owner/operator. I have worked for large corporations and small mom-and-pop locations. In all of those 28 years I was covered by health care for a total of eight years. I think that the time has come for America to take care of its people. We should have universal health care. No matter what miss information or “fake news” the government and big corporations put out there. The people of this country should all have equal coverage. I have lost many employees that loved their jobs because of the cost of health care. So they go get a job they hate just so they don’t get fined for not having coverage. I pay the fine because it is cheaper than monthly payments of $800 to $1,000 with a $10,000 deductable. Every other modern country has it.
We all pay for healthcare, in the old system, in the current system, and whatever they come up with next. An uninsured person who enters an emergency room will be treated, even though they cannot pay. We pay that bill. That was the way it was, and it will continue to be that way. If you believe in the notion that an ounce of prevention is worth a pound of cure, we should support good health practices.
If we want to fundamentally reduce the cost of health care, we have to take basic research back into the 1970s. Prior to the 1980s, most research, basic and applied, was paid for by the U.S. government. In the 80s and 90s, a series of changes were made to reduce the growth in government support of research, and encourage the business investment. For example, the time protection on medical patents was extended to protect private companies’ intellectual property. Those changes have worked to create the Big Pharma companies we see today. Based on the most recently available data, most research is now conducted by the private sector with a profit motive:
“For the first time in the post–World War II era, the federal government no longer funds a majority of the basic research carried out in the United States. Data from ongoing surveys by the National Science Foundation (NSF) show that federal agencies provided only 44 percent of the $86 billion spent on basic research in 2015. The federal share, which topped 70 percent throughout the 1960s and ’70s, stood at 61 percent as recently as 2004 before falling below 50 percent in 2013.
The sharp drop in recent years is the result of two contrasting trends—a flattening of federal spending on basic research over the past decade and a significant rise in corporate funding of fundamental science since 2012. The first is a familiar story to most academic scientists, who face stiffening competition for federal grants.
But the second trend will probably surprise them. It certainly flies in the face of conventional wisdom, which paints U.S. companies as so focused on short-term profits that they have all but abandoned the pursuit of fundamental knowledge, an endeavor that may take decades to pay off. (This month, for example, Duke University’s Center for Innovation Policy will hold a conference entitled “The Decline in Corporate Research: Should We Worry?”)
“… Those private sector efforts are now the dominant form of research activity in the United States, with business spending $3 on research for every $1 invested by the U.S. government. In the 1960s the federal government outspent industry by a two-to-one margin, but the balance tipped in 1980.” Science Magazine, By Jeffrey MervisMar. 9, 2017, 1:15 PM
The justification offered by Big Pharma for the proverbial pill that costs $3,000 is that they risked a lot doing R&D, and deserve a return on that investment. So, If we want to fundamentally lower the cost of health care we should consider getting the government back into the research game and share the risks of research across the population instead of relying on private companies and extending patent protection periods.
“The truth is we live in a society awash in drugs.”—George Schenk
1. The health care goal, it seems to me, is to provide high quality health care that is affordable and available to everyone who truly needs it.
2. Modern health care is very good but it is very expensive.
3. Given the truth of point 2, the way to achieve the goal stated in point 1 is, a) we need to continue to work on delivering high quality health care smarter and more efficiently, and most importantly b) our society needs to become, on average, healthier. We need to become more thoughtful about our life style choices and take more seriously preventative health care.
4. In my view both sides of this argument have been disingenuous. The current proposal will leave a lot of people out of the system many of whom when faced with a medical condition will be thrown into bankruptcy and/or create medical bills that will have to be picked up, one way or the other, by government. Additionally, although it has been projected that the current proposal will cost the Federal government less than the ACA a substantial amount of the cost will still be unsupported by taxes and therefor contribute to the national debt.
The current ACA is imperfect in many ways, but so was the system it replaced. My principle concerns are that the ACA does not seem to have slowed the rising cost of health care and that the total cost is not fully supported by premiums and taxes, and so it too is adding to the national debt.
Neither approach is sustainable.
5. So, what to do? First, it must be recognized that it has taken us three generations to get into this mess and it is going to take both time and money to work ourselves out of it. In the short term I do not see how we have any choice but to cover as many Americans as possible with some form of subsidies more or less as the ACA is doing. To do this without adding to the national debt we will all have to pay more taxes. That said, taxes are a drag on the economy and the current rate of change in the cost of health care is unsustainable and if left unaddressed risks bankrupting the country. Therefore, it is in the self-interest of all levels of government and the private sector to find ways to help people become healthier.
6. So how do we move toward a healthier society? There is wide consensus within the medical community that people can proactively support their personal health with diet, exercise, managing their weight, abstaining from using tobacco, and not excessively using alcohol or drugs.
a) Diet: We need to move toward a national food supply that is cleaner, more nutritious, and far more transparent. Foods that have residues of pesticides, contain GMO’s, have been irradiated, etc. need to be clearly labeled. Although I am not a big fan of higher taxes we know that tax policy can shift consumption patterns. In support of the nation’s health I believe it is justifiable to increase taxes on sugar, salt, and saturated fats, and decrease subsidies on grains. In conjunction with these changes in the food supply we need a major educational effort in our schools and in varied media about the role of diet in health and how to make health-affirming meals.
b) Exercise: A recent study in a major medical journal reported that sitting too much was practically as bad for human health as smoking a pack of cigarettes a day. We need a broad educational effort on the importance of lifelong exercise. Physical education should be a daily requirement for all schools K-12. We need to build more bike and walking paths. We could encourage gardening as an excellent form of exercise and a source of delicious and nutritious food. Finally, it would help, I believe, if we elevated the value of physical work. Our bodies have been evolutionarily adapted to lift and pull and walk and run and stretch and carry. It is good for our health to do physical work.
c) Weight Management: Obesity is an important contributor to human health problems. The restaurant industry holds some responsibility here. Heaping plates of fries and a half-pound burger may seem like a good deal but in any true measure they are not good for our customers’ health. In 2014 I wrote on a chalkboard in a prominent location at American Flatbread at Lareau Farm “Eat less, eat better.” The sign is still there. It may seem counter intuitive for a restaurant to encourage its customers to eat less but it is my view that the best thing I can do for my business is to be respectful of my customers well being.
d) Alcohol and Drugs: The truth is we live in a society awash in drugs. From chocolate and coffee to morphine, from a cold beer to the little prescription pill so easily abused, drugs are everywhere and part of almost everyone’s life. The goal, it seems to me, is to understand the drugs we choose to use and to appreciate that their misuse can cause much unnecessary illness.
e) Tobacco: After 50 years of anti-smoking education we still loose one in five High School kids to the addiction of tobacco. We can do better. We have to do better. We literally cannot afford to fail. Tobacco taxes are already high, I would advocate for making then higher. Tobacco should pay for the illness it causes.
I WAS INSURED BEFORE OBAMACARE
I am one of the elderly persons who lost my healthcare due to the so-called “Affordable Care Act.” While our health care system was getting out of control before the ACA, it has now been totally decimated by the Obama administration.
NOW, I PAY MORE IN PENALTIES THAN I USED TO PAY FOR INSURANCE
Before Obamacare, I was able to afford a catastrophic health policy for LESS per year than the PENALTY I now have to pay … and I at least knew that my family would not lose our home, our business and dignity if something happened to me. Like performing routine maintenance on my cars, on my home or business. … I don’t mind paying for that maintenance out of pocket as long as I know that major repairs, accidents, acts of God are covered.
NOT FAIR THAT I SUBSIDIZE COVERAGE FOR OTHERS, BUT CAN’T AFFORD TO BUY COVERAGE FOR MYSELF
I certainly don’t think it’s fair that I am forced to pay penalties that subsidize insurance for others, but can’t afford to buy insurance for myself. Fortunately, my wife is on Medicare or I wouldn’t have any coverage for her either.
I DON’T NEED OR WANT A COMPREHENSIVE HEALTH CARE PLAN WITH COVERAGE I’LL NEVER NEED
I don’t want to pay for birth control, pregnancy-maternity coverage. I don’t want to pay for mental illness or drug/alcohol addition coverage—I’m male so I won’t be getting pregnant and AA or NA will be fine if I go off the deep end and start drinking ethanol.
I ONLY WANT CATASTROPHIC COVERAGE, BUT CAN’T PURCHASE IT BECAUSE I’M OVER 30
Naturally, catastrophic coverage is only available to those who are 30 or under because they’re the very least likely to ever use it.
THE PROPOSED AHCA IS A STEP IN THE RIGHT DIRECTION.
There are only 9.6 million people signed up on the Health Exchanges who receive subsidies.
There are 20 million people who either can’t afford their new choices or have elected to pay the penalty.
It’s estimated that approximately 50 percent of the 20 million lost the coverage they had before Obamacare.
So, 10 million middle class working people had to give up their insurance so 9.5 million who make less money could have it instead.
We already know that the 9.5 million people on the exchanges won’t lose their healthcare, unless they choose not to be proactive.
People like me will more likely PURCHASE insurance with the proposed AHCA, because INS companies will be able to once again offer policies that are not bloated with coverage I don’t want or need. Some coverage is better than none.
If nothing is done, Obamacare will implode on it’s own. It is unsustainable as is.
The proposed AHCA is STEP ONE and MUST be passed via rules of Reconciliation. I support it. It’s not perfect.
Tax Credits should probably be reduced for higher incomes brackets than proposed and that money used for the elderly and low-income brackets.
The Government should not directly invest in medical R&D. Private investment has always done a better job. We’re 20 Trillion in debt. If citizens believe they want to invest in R&D and public health, they can donate to foundations that do the best work.
NO FREE PERSON IN THE UNITED STATES SHOULD BE REQUIRED TO PURCHASE HEALTHCARE THEY DON’T WANT OR CAN’T AFFORD
Phase One: REPEALS but still provides a safety net for the most vulnerable and a viable TRANSITION to Free Market Healthcare Competition.
Phase Two and Three will provide the market conditions for Healthcare Providers, Insurance Companies and the industry at large to align, products, services, strategies and systems to provide better care at much more competitive rates.
“Life, Liberty and the pursuit of Happiness” isn’t even granted in the Constitution (that was the Declaration of Independence) and being provided Healthcare or even access to healthcare IS NOT provided for in either the Constitution or the Bill of Rights. So when did it become a “RIGHT?”
HAVING ACCESS TO A CAR IS NOT A RIGHT, IT’S A PRIVILEGE
DRIVING A CAR IS NOT A RIGHT, IT’S A PRIVILEGE
DRIVING A WELL MAINTAINED CAR IS NOT A RIGHT … IT IS THE RESULT OF A RESPONSIBLE OWNER WHO MAKES THE INVESTMENT TO MAINTAIN IT
OWNING A HOME IS NOT A RIGHT, IT’S A PRIVILEGE
OWNING A WELL MAINTAINED HOME IS NOT A RIGHT, IT IS THE RESULT OF A RESPONSIBLE OWNER WHO MAKES THE INVESTMENT TO MAINTAIN IT
HEALTHCARE IS NOT A RIGHT, IT TOO, IS A PRIVILEGE.
ACA HAS CRUSHED BUSINESS GROWTH AND FULL TIME JOBS
With the ACA enacted, small businesses (the real economic engine of the country were forced to stay small to avoid reaching the 50 employee level or if they had more than 50 employees were forced to restructure jobs so that as many employees as possible would be classified as “part time” so that they would not be required to provide healthcare benefits to these employees. This ONE RULE alone has been the biggest factor in reducing income for struggling individuals, actually making them even more reliant on government subsidies for healthcare, as well as, other government assistance programs. Of course, the moronic answer to this is the $15 per hour minimum wage
HOSPITALS AND DOCTORS HATE OBAMACARE
I am very good friends with someone who sits on the board of a very large Florida Hospital. THEY HATE OBAMACARE, it has greatly impacted the level of quality they can provide. They have lost 17 percent of their senior staff of doctors due to Obamacare. These doctors predominantly have decided to retire earlier than planned or have moved to private practice and become more selective in their patient base.
MEDICAL TOURISM DECIMATED
Before Obamacare, Medical Tourism was a booming business in the United States. Those in other countries with government run/provided healthcare systems who could afford to travel and seek out the best services available were flocking to the United States for treatments. Canadians, British, French, South Americans and more. The biggest reasons to seek US Medical Treatment were (1) patients could not wait the amount of time required in their country (2) the procedure they required was denied in their country (3) the type of care patients required was sub-standard in their own country (4) the choice of DR or Facility was not perceived as suitable in their country
Opponents of repeal are in denial or making too much money off of everyone else’s misery.