Imagine waking up with chest pain, or getting hit by a drunk driver, or being diagnosed with cancer–and also still having to worry about whether your boss will still employ you next week so you can afford to stay alive.

Welcome to the great U S of A! Where your right to life is tied to your productivity.

We’ve normalized a system where healthcare is a perk, not a right. Like a company-branded tote bag or pizza in the breakroom. Need insulin to live? Better hope your employer hasn’t “restructured.” Broke your leg? You better not be unemployed–or you’ll be crawling to the E.R. and then into debt.

It’s cartoonishly dystopian when you think about it. We don’t tie firefighters to employment status. If your house is on fire, they don’t ask if you have a job before putting it out. But if your body is actually on fucking fire? Well, if you don’t have employer-sponsored insurance then best of fucking luck to you!

It’s also a massive scam. Tying healthcare to employment keeps people terrified of quitting, terrified of organizing, and terrified of speaking out. It’s wage-slavery dressed in HR-approved language. “We’re like a family” they’ll say. I’ve heard that one a few times in my life at work. Sure, a family that charges you $600 a month to maybe see a doctor if you’re lucky.

And don’t get me started on COBRA, the cruel joke of a system where you can keep your insurance after being laid off–by paying both your premium and the employer’s. As if anyone newly unemployed has a few extra grand lying around for monthly premiums. That’s not a bridge, it’s a toll road to bankruptcy.

Other countries keep healthcare as a basic human right. The USA treats it like a prize you can earn for being useful to capitalism.

Sick? Get a job. Too sick to work? Die quietly.

Let’s stop pretending this is normal. Let’s stop congratulating companies for offering healthcare, as if that makes them moral. The bare minimum shouldn’t feel like a gift.

Healthcare shouldn’t be a reward for surviving capitalism.

It should be a fucking right.