Thursday, June 11, 2009
Congress / Kotz / Law and Order / Politics Should Government Force People to Buy Health Insurance?
Posted by Pete Kotz on Thu, Jun 11, 2009 at 12:00 PM
But if you listen to the debate among reformers, it's an idea that's time may have arrived. Insurers are pushing hard for the measure. High costs have bled down their customers rolls throughout the decade. And reform will likely mean less gouging on premiums. As a general rule, what big insurance wants, big insurance gets, lest its bottom line be displeased.
Yet there's also a compelling public interest argument here. If we continue to have millions of uninsured, we'll continue to have a bloated, inefficient medical system. Go to any city emergency room these days, and you'll find what's basically a free clinic. The uninsured arrive for treatment for everything from coughs to the flu, knowing emergency rooms can't turn them away. Which leaves us paying for minor ailments in the most expensive way possible. And hospitals, of course, naturally pawn all these costs off on their paying customers.
It's hard to say how you can force someone with no money to buy something. And the heat will be intense. Conservatives will hate it because it's a government mandate. Liberals will hate it because it seems cruel. But after all these years of doing nothing, is it now time for a radical approach like this? Even if it means pissing everyone off?
Comments (14)
Showing 1-14 of 14
The same system has already been tried in Massachusetts and been proven to be an abject failure in short order.
And that's no surprise at all.
http://online.wsj.com/article/SB123811121310853037.html
like
dislike
The fact is that not everyone who is uninsured is that way because they can't afford it. Sometimes people who are not insured through work, but have ample earnings, simply choose to spend their money on something other than health insurance. It's estimated there are 10-15 million such people, which mean's that's the solution to 1/3 or so of the famous 43 million unemployed.
Of course we wouldn't have to force anyone to buy anything from a private company (think about this-does government ever require us to buy something from a private vendor? This will be a first.) if we had a single-payor system. We would simply have health care supplied directly by publicly-paid docs with no private corporate middle-man. But the industry is too big to simply unplug, so it will have its share - even if we have to ration actual healthcare services in order to pay those middlemen.
Americans spend more on health care than any other post-industrial country in the world. And yet we are among the least healthy. What we're doing now is not working. Time to try something else.
Singlepayor? Do you drive a car? As a condition of your license are you not required to have insurance on that vehicle? I admit it's slightly wonky metaphor, because you have the option of not owning a car, but you don't have the option of not owning a body, but it's a government mandated insurance purchase just the same, and one that has a pretty high rate of compliance. Ask the gekko
Man, Joaquin, you are one tough Dominican! And of course you are absolutely right. A lot of people simply choose not to buy health insurance. A significant number of these are young adults who are healthy, perhaps burdened with student-loan debt and decide to take their chances they won't be in an accident or get cancer.
For every person who is pissed off that they have to buy coverage, there will be another person who is happy that they no longer indirectly have to subsidize those who don't carry insurance. The precedent for such a law is already set. Think about your auto insurance. You don't have to carry a Cadillac policy, but you do at least have to carry liability insurance. Same principle here.
At the same time, mandatory coverage is not a panacea. It does nothing to fix one of the other big problems in the system: the millions of people who DO have insurance but still have trouble getting their insurors to pay for necessary care, or who are stuck in their jobs because of a pre-existing condition. And it does nothing about the OTHER huge problem -- continually rising costs created by a combination of new technologies and treatments and by a system in which incentives are completely misaligned if the goal is to deliver more cost-effective care.
"Think about your auto insurance. You don't have to carry a Cadillac policy, but you do at least have to carry liability insurance. Same principle here.'
Uh huh. Isn't the mandatory limit $25,000? That won't buy many days in intensive care and chances are the person with minimum coverage has no other assets so the injured party still ends up with the bills.
You're right, Emmett. It doesn't cure everything. But Joaquin's got a pretty good idea with the auto insurance analogy. It's likely that the basic policies will only cover catastrophic illnesses, which means deductibles will still go unpaid. But I'm guessing that's still much better than we have now.
Employers should not be the supplier of health care. We are the only country that does this. It is a trickle down effect of labor unions that got us here.
Health insurance ought to be available and affordable as a , um, retail type service.
NOTE that I said *affordable*
I swear I would leave my 6 figure salary job if it were not for the health insurance that already cost me $400+ a month before my company's contribution
"It's likely that the basic policies will only cover catastrophic illnesses, which means deductibles will still go unpaid. But I'm guessing that's still much better than we have now. "
And guess why it is that such policies are not available now.
It's because of thousands of federal and state government mandates that any and all insurance cover all sorts of things that are NOT catastrophic illnesses - or even actual illnesses at all - like marriage counseling.
"Of course we wouldn't have to force anyone to buy anything from a private company (think about this-does government ever require us to buy something from a private vendor? This will be a first.) if we had a single-payor system"
No, you would be forcing people to participate in and pay for the single payer system by paying taxes.
And that is a distinction without a difference.
Forcing people to pay one way is no different than forcing them to pay some other way. It's still force.
Kotz wrote: "It's likely that the basic policies will only cover catastrophic illnesses, which means deductibles will still go unpaid. But I'm guessing that's still much better than we have now."
You need to do some basic research into CoverTN the plan the governor touts. Unlike what you envision, it is not catastrophic coverage but has a $25,000 annual cap, if memory serves. You, being the journalist might have a look.
You can either have basic coverage and a low annual cap on benefits or high limit catastrophic coverage which requires a high deductible...but you can't have both at an "affordable price".
Sorry, Emmett, I probably wasn't making myself clear. I was talking about the various federal plans being bandied about. I don't think anyone --except maybe the governor--is looking to the governor for health care plans. That's kinda like asking Bob Corker to negotiate your next union contract, isn't it?
