A GOP lawmaker is selling his party's vision for the U.S. health care system by presenting Americans with a decision: Your iPhone or your health.
“Americans have choices, and they've got to make a choice,” said Rep. Jason Chaffetz (R-Utah) on CNN Tuesday. “So rather than getting that new iPhone that they just love and want to go spend hundreds of dollars on that, maybe they should invest in their own health care.”
While Chaffetz's remarks reflect a sentiment that people should make financially responsible decisions, there are two things out of place here. First, if you run the numbers as my colleague Christopher Ingraham did, you quickly find it's an apples-to-oranges comparison. Even the most expensive iPhone is a tiny fraction of what most people pay for health care every year. Giving up a $769 iPhone would not make health care any more affordable in a meaningful sense. To truly cover medical costs, a typical American would need to give up 23 iPhone 7 Pluses, every two years.
Even if you believe scaling back on iPhones and other expenses such as movies or dinners out could make health care more affordable, Chaffetz's choice to highlight iPhones as an extravagance speaks to a certain relationship to technology that research tells us is dramatically at odds with the economic realities of millions of other Americans.
“Smartphones are no longer a luxury,” said Michael Calabrese, director of the Wireless Future program at the New America Foundation. “Surveys show that lower-income and minority people increasingly rely on smartphones for Internet access, since they can't afford both home and mobile broadband subscriptions.”
The Pew Research Center has done extensive study on American cellphone users. It has found that 62 percent have used their smartphones to get information about a health condition. Fifty-seven percent have used a smartphone to do online banking. Forty-three percent have used one to look for jobs. Moreover, roughly half of Americans say they couldn't live without their phones, according to the same research.
For many lower-income Americans, smartphones are the only realistic way to get online. As many as 10 percent of U.S. adults — more than 24 million — pinch pennies by paying for a smartphone plan only. This is both a credit to the growing capabilities of modern cellphone networks, but it also reflects the inability of many consumers to afford both wired and wireless Internet.
It's this same dynamic that forces some schoolchildren to do their homework from McDonald's, or to stand outside their school grounds after dark hoping to catch a bit of WiFi from the hotspot inside. As many as 7 in 10 teachers assigns homework that requires the Internet today, according to the Federal Communications Commission. For a family whose only connection to the Internet is through a smartphone, giving up that technological lifeline is not an option if the goal is to succeed and flourish in a society that runs on information technology.
Let's map this onto something familiar. Perhaps you've heard of Maslow's hierarchy of needs, the pyramidal chart that describes all the key things humans need to live happily and comfortably. At the bottom are physiological needs, such as breathing and eating. Once you have those squared away, you can start to worry about things like physical security, and then emotional security, and onward and upward until you reach the apex of the pyramid. The stuff at the top is generally thought to be less fundamental than the stuff at the bottom, because without the stuff at the bottom you won't be around to experience the stuff at the top.
In Chaffetz's view, health care seems to be lower down on the pyramid than cellphones. It makes a certain amount of sense: You can't live without your health, after all.
But that doesn't make smartphones a superfluous or excessive good. While this technology does provide access to fun and entertainment, they also give millions of Americans the tools to take the “personal responsibility” for their lives that society often chastises people for not taking. The truth is, smartphones aren't at the tippy top of Maslow's hierarchy. They're much closer to the bottom than many people think.
A spokeswoman for Chaffetz declined to comment.