Should healthy people be forced to buy health insurance?

[MartialDev]

The Senate is debating a plan whereby anyone who declines to purchase health insurance is assessed a penalty tax, of $2000 or more.

Do you agree or disagree with this proposal?

[ginkgo]

That is a good question but who determines if someone is in good health. Was Michael Jackson in good health when he died? I read that the doctor told him that he was in good enough health to do his tour. If the person who is in good health has a stroke or something and they are poor, then someone else has to pay for it. It is a complex issue.

That site above is a fine looking website.

[Xanafax]

Just think about the ramifications of such an idea.

What about those who actually can't afford it?

Will they be fined? Or will the Government set up a scheme to give them "free" Healthcare insurance, and where would the money for that come from? Taxes.

I believe it's an individuals choice as to whether or not to have insurance, as so far as they can afford. It's not within the Governments moral baliwick to tell people what they should and should not buy.

[Dreamline]

Insurance is, technically, a plan for unforseen issues. Health insurance has been changed to also include pre-emptive care, checkups, routine screenings, etc.

The problem is, someone pays for you to be sick when you have no insurance. Usually that is taxpayers and/or the hospital itself. As in..they eat the bill. Since it is against the law for hospitals to refuse to care for people and still accept government reimbursement (Ie: medicare and medicaid) they are obligated to take you even if you don't have money, a job or insurance. (Trust me when I tell you, you do NOT want to bankrupt your local hospital.)

Whether you are healthy or not doesn't keep you from getting in that car accident where you are left paraplegic and in a constant care facility for the rest of your natural, or unnatural life.

It doesn't stop the unexpected cancer diagnosis which happens to even seemingly healthy people too. Old and young.

It doesn't stop the appendicitis with emergency surgery.

The unexpected pregnancy.

The stepping on glass at the beach requiring 60 stitches.

Yes, I believe the only caveat for not buying insurance is if one is independently wealthy. Not healthy.


Jennifer

[funchy]

They need to solve the bigger problem first: the fact that right now people who WANT to buy it may be turned down for any pre-existing condition. Or people paying for coverage who go to use it and find out it doesn't cover anything remotely relating to any pre-existing condition. What kind of a market is this when some people cannot buy insurance for any price??

[floslib]

I'm of two minds on this, but I think the government should offer a public option, but not force people to have health insurance.

The problem with forcing people to buy health insurance is simple: some people can't afford it. If someone can't afford health insurance, then you slap a fine on them for not having it, you're only keeping them down, and you're actually preventing them from getting to the point where they can afford it.

Even if you have a program to determine that some people get free and reduced cost health care, programs that assess people's needs are very much out of touch with what people actually do need and can afford. If we could have a system which absolutely, with 100% perfection, could tell who needed assistance and who didn't, then I would say it would be ok to do this. As it is, it's a bad idea, and will hurt the people it's supposed to help.

I do understand that no one wants to subsidize someone else's health care. However, trying to force someone to pay money they don't have isn't going to make things better for anyone.

Edit: Also, right on funchy. That is definitely the bigger issue right now.

[Inthon]

Disagree. Forcing people to own their health/wealth is the key to a strong society.

We've turned over health care to the government, our money to the government (fiat currency versus gold), and our food supply is becoming more centralized by the day.

Keep your power, keep your wealth and don't believe the promises of politicians.

A strong society is made of self-reliant individuals; not those who think that government can make people eat their vegetables or live healthy lives.

The more we rely on governments to get us out of jams of our own creation, the more power/wealth they will take.

[jeff3]

The Govt should not be able to force anyone to buy anything.

[spirit4711]

Originally Posted by funchy

They need to solve the bigger problem first: the fact that right now people who WANT to buy it may be turned down for any pre-existing condition. Or people paying for coverage who go to use it and find out it doesn't cover anything remotely relating to any pre-existing condition. What kind of a market is this when some people cannot buy insurance for any price??

That is the problem as I see it in the USA. There is no centralized basic health insurance package for everyone. Personally I think that would be a good thing (most civilized countries agree with me on this one ). Insurance basically spreads individual risks (and costs) over many.

But a central package also means there is a 'force' aspect. For me that is no big deal. But for people who are opposed to that I wonder what they do when they get sick and they have no insurance? But hey it's their choice.

A deeper issue that I see is that (many?) people cannot afford basic health care. That says a lot about the poverty level of the USA. If it is so hard to have decent housing, decent schooling, decent food, decent roads and decent health care on a regular salary then there is a lot more wrong in my opinion than the 'force' aspect of a centralized health insurance. I live in the Netherlands and everybody can have this basic minimum and no, we as a country are not richer than the USA.

[JRhodes]

Originally Posted by jeff3

The Govt should not be able to force anyone to buy anything.

I've been edging towards Libertarianism for a year or so and I don't believe the government should be able to force people to buy health insurance. However this also means that those same people shouldn't then be able to hold out their hands and expect aid if they do develop health problems. It's a really a tough call though, both sides have a reasonable argument on this issue.

[emeadow]

Check out information on Massachusetts health care reform for the last couple years. I highly suspect this is an active trial in place to see what can be implemented around the country in regards to universal healthcare. Here is a quick summary, but sure you could find more. Massachusetts health care reform - Wikipedia, the free encyclopedia

Its interesting, because you pay for your mandatory health coverage based on a sliding scale determined by your income and poverty level. It also has implented some minimum requirements for coverage....so say you had employer based health insurance, your benefits need to meet a minimum standard to qualify, otherwise you paid a tax penalty, or needed to get supplemental insurance through the state. Many employers just amended their insurance plans so that all plans complied.
________

I personally have mixed feelings on the whole subject of universal healthcare. There are good and bads to both sides, and while it would not be great to be forced to buy a plan you do not use in order to subsidize for other people, it may in the end be the only way to stabalize the costs longterm.

Lets look at employer based insurance as an example....but this can be compared to individual insurance, since any given region is rated very similar (just a larger scale).

100 employees at your company, and the employer covers 100% of the health care costs (so all 100 participate in the plan). Of those 100 employees, 90% of your healthcare claims will be created by only about 10% of your employee population (trying to link reference on this....but know from experience on this one).

So in one year, your company had $500,000 in total medical claims, with the majority of the dollars created by 10 employees.

$500,000/100 EE's/12 months = $417 per EE cost

+ Admin expenses, trend, insurance cost for catastrophic claims

=your rate would be about $550 next year (hypothetically)


Now, lets take a similar company, and lets say they decide to only cover 50% of your healthcare premium because they are financially struggling. So now 100 employees don't stay on the plan, instead only 60 elect coverage, and of couse of those 40 who do not take the plan, a good deal are the 'healthy' folks who don't create claims in the first place.

Claims for company #2 end up being almost the same as company #1, $450,000. The majority of the people who are unhealthy or already expect claims had stayed on the plan. So claims are not going to be much different from company #1.

$450,000/60 EE's/12 months = $625 per EE cost

+Admin expenses, trend, insurance cost

= $825 rate next year (50% higher then company #1)

The effect of this high cost difference, is that the company will continue to reduce benefits, and reduce their contributions, just putting this groups claims into a downward spiral.

The compounding effect of dropping members off the plan who thought they were healthy, is that a few will have some unexpected claims hit, that they will not be able to pay. The hospital does not 'eat' these costs....they pass them on as increased costs to other patients/insurance companies. So based on this concept, the less people with insurance and the ability to pay for their catastrophic unexpected claims events, medical costs will increase faster.


So the question being, if everyone was 'insured', including the healthy folks, what 'rate' would everyone pay across the country? My biggest question though, is what effect would it have on the providers, who have pretty much run will nilly with their expenses and higher end medical treatments because insured members were out of the loop of the cost of their medical claims?
______

I think there are also some alternatives for those who are low utilizers of medical coverage. Discounts for healthy lifestyles and participation in wellness programs is one direction. Another would be to implement higher deductibles and out of pocket expenses, but tie them with an HRA or HSA type account. Each year you get money towards that out of pocket expense. If you don't spend it, it gets tucked away into the account. In a few years, if you haven't used your plan (keeping in mind preventative care is usually covered at 100%), suddenly you have enough money in your account to cover all out of pocket expenses. You will spend that money smartly, use it only when necessary. This has a few complications behind it, like for example, providers are not very forthcoming with their costs and bills, making it hard to shop smartly, but it is a positive direction all the same.

_________

Additional links
Medical Trend (the cost of how much the same procedures will run next year over this year...dictated by providers, pharmacies, and hospitals, not insurance companies)

In 2007 62% of filed bankrupties were caused by medical bills (3/4 had medical insurance at the onset of their illness...many lost it when they were unable to work)


Interesting commentary on the problems in our healthcare costs now

[YourHumbleNarrator]

It's ludicrous. It limits personal choice and it doesn't address the problem.

If we're going to have universal healthcare, let's have universal healthcare. Every taxpayer has access to the care they need. If we're going to stick to a private system, revise the law so it's legal to turn away people without insurance so we don't have to foot the bill (hospitals have to recoup the cost somehow). We have a system that's made too many compromises and we've been reluctant to choose a new direction. Because of that people on both sides of the issue are suffering needlessly.

With that said, healthcare is a "right" in the way education is a "right"- under the government's rule you'll get it whether you want it or not. It doesn't matter if you disagree with the methods of modern medicine and you'd prefer to pursue alternative healing all down the line, you're supposed to have insurance and it's a travesty if you don't. This debate is so emotionally charged that it feels like nobody is thinking clearly.

In a free country I don't have to pay for something I don't want. If such a bill gets passed it should be amended so that there's a box on each tax form that says, "thanks but no thanks, I'd rather be on my own." Stop babying us, America.

[WelfarestateChild]

No one should be forced to do anything, right? Where has tyranny ever gotten us

[Dreamline]

Ok, all the naysayers have ignored my comment: If you can't afford to carry insurance, then who pays for you when you get sick, hurt, chronically ill? Because obviously you cannot afford those payments either.

Anyone with a magical answer that don't FORCE anyone to do anything? (Except force taxpayers, medical facilities, MDs and others to assume the payments you can't make?)

Jennifer

[WelfarestateChild]

I think if the burden of tax is removed, people will be more charitable. People will then, out of their own desire to be cared for, care for others.

[Dreamline]

ANyone else?

Jennifer

[Xanafax]

The answer is no one pays, you just don't get any medical care.

[Acting Like Godot]

Originally Posted by WelfarestateChild

I think if the burden of tax is removed, people will be more charitable. People will then, out of their own desire to be cared for, care for others.

Errrr, I don't think so. You don't see this happening in the tax havens of the world.

[Acting Like Godot]

Originally Posted by funchy

They need to solve the bigger problem first: the fact that right now people who WANT to buy it may be turned down for any pre-existing condition. Or people paying for coverage who go to use it and find out it doesn't cover anything remotely relating to any pre-existing condition. What kind of a market is this when some people cannot buy insurance for any price??

But what kind of a market would be, if an insurance company will sell you medical insurance no matter how many severe pre-existing conditions you have?

[WelfarestateChild]

Originally Posted by Acting Like Godot

Errrr, I don't think so. You don't see this happening in the tax havens of the world.

I am talking about a society where voluntary contribuition > coersion and taxation. That is not really the case today where people want to hide their property from the authorities, using so called "tax havens"

[Michelle]

Here in Switzerland it is mandatory to have health insurance and everyone has to pay for it themselves.

1. I am really glad to have this insurance. Having grown up in the US without any, and once breaking my foot and receiving such poor care there that my foot turned black ... yes, I am glad to have it. Also, my insurance here pays for psychotherapy (a big plus for us PD types), contributes a sum toward going to a gym, for Chinese Medicine such as acupuncture and for homeopathy. There is a 10% deductable, the rest is covered.

2. I am glad everyone here has insurance. It feels nice to live in a place where everyone can have their needs met, and I enjoy contributing to that type of society. It feels better than just having all of my own needs met among others who cannot. It is a good society's job to take care of the weaker, the sick, the underdogs and not to reject them and throw them out. By taking care of them, they get stronger, happier and are more able to contribute themselves. If you can make a contribution be happy you have something to give.

[WelfarestateChild]

If the state just kept its filthy hands away from people and let them make their own chioces then everyone would be better of. A much better healthcare system would exist.
The state keeping its hands off of individuals means everyone. Also the ones trying to run a hospital.


When the state forces hospitals to treat everyone you set up a moral hazzard. I wouldnt pay for any health insurance if i knew the hospitals were obligated to treat me, regardless. And i sure didnt want to donate any kind of money to any organisation claiming to help unlucky people that fall ill.
And if the state suddenly decided health insurance is mandatory, everyone has to have one, that doesent mean everyone will suddenly get one.

There is nothing the state can do to advance healthcare to everybody, and improve quality.
So just leave hospitals and individuals alone. We are perfectly capable if figuring things out among our selves.

//Rant off

[Michelle]

Originally Posted by WelfarestateChild

And if the state suddenly decided health insurance is mandatory, everyone has to have one, that doesent mean everyone will suddenly get one.

Yes, they will because insurance companies would no longer be able to turn anyone away for basic health insurance. They have to insure anyone and everyone who comes their way because it is the law.

So just leave hospitals and individuals alone. We are perfectly capable if figuring things out among our selves.

People have figured it out amongst themselves. They've figured out that they want insurance for everyone or this wouldn't even be an issue. Before too long all Americans will be insured and the system still won't be perfect, but it will be better.

You as a grown-up may have all the answers . But what about the kid with the idiotic parents who'd rather have a big screen tv than take their child to the doctor? Or the college student, (like I was) dependant on working to support herself during her studies who slipped, fell and broke her foot only to receive worse care than in some third world countries only to be billed for it!

[aggie]

i recently spoke to someone from germany who said you had affordable insurance and you could keep it affordable as long as you adhered to a wellness programs of sorts....not a bad plan.

after reading all the posts i am a little concerned and confused where everone stands.

health care should be affordable for everyone...most who don't have it can't afford it.

and yes, people can't be turned away from emergency rooms...but do we really want to say a child that has been injured with no insurance should be kicked to the curb. there is some responsibility for our fellow man.

if someone can afford and doesn't want insurance...there should be some kind of penalty tax...because as said...anything can happen and who is going to pay for it.

much, much bigger problem then insurance or no insurance....

[WelfarestateChild]

Seems like its a non-issue. People are moral, people care about the unlucky ones, most do anyway. So everything is fine. There is no need for the state to force people to be "good" and come up with all these programs, rules and regulations. In fact, i bet it is these very programs that has made everyone so much worse off.

[Dreamline]

Originally Posted by Xanafax

The answer is no one pays, you just don't get any medical care.

I was hoping for a real-world answer, frankly.

Jennifer

[Dreamline]

Originally Posted by WelfarestateChild

Seems like its a non-issue. People are moral, people care about the unlucky ones, most do anyway. So everything is fine. There is no need for the state to force people to be "good" and come up with all these programs, rules and regulations. In fact, i bet it is these very programs that has made everyone so much worse off.

Ditto.

Jennifer

[Dreamline]

The lack of cogent answers to my question is why most countries are adopting mandatory health insurance or some form of pseudo-nationalized medicine.

People blah, blah and rail against all this "socialist" nonsense and being "forced" into it but none of them, not one, has an alternative that is even semi-sucky, let alone decent.

The only people that have answers are people from countries that are alraedy doing it, haven't been turned into life sucking commie vampires in their sleep and whose countries enjoy an extremely high standard of living, to boot.

Just because some aspects of your economy work best on a "socialist" type system doesn't mean you can't have a capitalist economy with all the plusses that brings.

Either step up WITH REALITY, or shut up. One thing is certain: healthcare can't survive if nothing changes.

Stop fretting, stop trying to re-invent the wheel and get on a plane to a country where it is working. I'm sure you will hear the horror stories but listen to the success stories with equal interest.

It can and does work.



Jennifer

[Acting Like Godot]

Originally Posted by WelfarestateChild

I am talking about a society where voluntary contribuition > coersion and taxation. That is not really the case today where people want to hide their property from the authorities, using so called "tax havens"

Aha. I wasn't talking about foreigners who park their money in tax havens. I was talking about people who are actually the citizens in tax-haven countries.

[aggie]

i have one additional comment...watch the movie "sicko"

i too agree this whole equating socialized medicine with communism is ridiculous.