Health care

By mollydb

One of the most important issues for free software within the US is one we rarely talk about: healthcare. That is why I am going to write about it.

These days, sustainability in FOSS is a hot topic. In my experience, for many years this conversation focused nearly exclusively on making FOSS -profitable- for companies, in order to create jobs. Now, the conversation is shifting to ask: what conditions do we need to create so that everyone who wants to work in FOSS can do so?

The answer is not the same for everyone, nor is it the same in every country. Someone supporting a family of two, three, four, or however many has greater income needs than I do, as my biggest financial responsibilities are debt and a cat. However, I also have a condition with a mortality rate estimated at 15%. Access to affordable, comprehensive health care is not just a nice perk, but crucial for my continued survival.

Access to health insurance has been the primary factor in all of my professional decisions: staying places where I was miserable, doing work I hated, even choosing where to apply. Access to health insurance was a major factor in my moving to Massachusetts, which offers health insurance to all residents.

While my free software career has been amazing — I am extremely lucky that I was able to cultivate a skill set and social network that enabled me to work in the greater sphere of FOSS (and previously open ed) — I would have made different decisions had I not been reliant on employers to provide me with health insurance.

In the United States (and many, many other places), access to affordable, comprehensive healthcare (from here on: healthcare) is a major factor holding people back from FOSS contribution. When your access to health care is tied to your employer, your time — and literally your life — is dependent on your employer. This seriously impacts your ability to even have free time, let alone using that time to build FOSS.

Since the creation of software largely relies on people’s professional skill sets, we’re asking people to do in their free time what they do in their paid time — design, develop software, plan architecture, organize events, maintain systems and infrastructure, be a lawyer, manage finances, and everything else that strengthens FOSS and FOSS communities. In asking someone to take on a leadership role in a FOSS project or community, you’re asking them to take on another job — one that comes with neither pay nor benefits.

When people face constant threats to their existence due to fearing for their lives (i.e. their health), it can be hard, if not impossible to spend their time contributing to FOSS, or indeed to any activist project.

People who live in societies that rise to meet the basic material needs of all citizens are able to spend time contributing to the greater good. Those of us struggling to survive, however, must forgo opportunities to become participating members of communities that are trying to change the world. Instead, we look to our employers (usually with commercial interests) to meet our needs.

When you work in tech, meeting our basic material needs through employer-sponsored insurance comes at a steep price: non-compete agreements, signing away patent and intellectual property rights, fights to ensure your work is available under a free and/or open source license, and giving up more than 8 hours a day/40 hours a week. When we try to create good FOSS in addition to that, we burn out, we become miserable, and we’re trapped.

People are incapable of creating FOSS when they’re sick, burnt out, worried about their health, struggling with an ongoing condition or disability, or dead. It’s that simple. [powerful]

People fighting for access to healthcare should care about free software for many reasons, but we as a free software community also need to care about access to health care. This is for the sake of ourselves and the sake of our communities. We cannot build the tools and resources the world needs when we are struggling simply to live.

If you accept the notion that lack of access to comprehensive healthcare impacts our ability to have the resources necessary to create something like free software, then we can acknowledge that, by providing health care to everyone, everyone will then be in a better, more equitable position from which they can contribute to FOSS and lead safer, happier lives.

According to the KHN, 8.5% of U.S. Americans didn’t have health insurance in 2018. Un-insurance rates are even higher among non-white populations according to HHS. As a community, we’ve accepted that the lack of diversity and the over-representation of cis white folks is a problem. We need to create more equitable conditions — so that people come to FOSS from similar places of privilege, rather than having a huge disparity in privilege and oppression. Providing health care to everyone will help alleviate this, and will enable more people to do the things they are passionate about — or things they will become passionate about once they have the chance to do so.

If we are to create a world where FOSS is successful, access to health care is paramount and we need to take it seriously.