To those who oppose mandatory health coverage

[beefytee]

I have health insurance, but I bought it in case it is needed, not because it was required to have it. So, in my case, your mooch theory is 100% wrong.

Is there a "case" where people won't need it? The only case I can think of is the insanely wealthy... or the dead.

[Sleeping in EQ]

Why are you against it? To me, it's the one part of healthcare reform that seems like a no-brainer. Robin, don't bother answering this one, because I understand where you're coming from--you don't like the whole concept of private health insurance. But I'm really trying to understand the rest of you. I'm really hoping I'm wrong in assuming that you don't just want to free-ride the system. So convince me.

I should add the caveat that I'm assuming that there will be some subsidy for people who can't afford it (including students).

System? We don't have a health care system.

[ERCougar]

I brought this topic up because I just read an article about how something like 22 states are considering legislation banning mandated coverage. That puzzles me. This is the least objectionable part of health care reform to me and I had no idea that there was so much opposition to it.

I'd still buy it for my own protection. I just don't want the government telling me that I am required to have it, though I understand your position.

If you're for mandadted auto insurance, how can you be against the Honor Code? BYU forces kids to adhere to it, just as the state forces us to adhere to the law requiring auto insurance.

So you have health insurance, where premiums are artificially high due to subsidization of unpaid care, yet you're against this mandate because "ain't no one gonna tell me what to do!" Really? Sorry, IPU, I like you, but that seems a little juvenile.

This. We're already paying out taxes, social security, and auto insurance as just one slice of government comandeering my earned money. I would like some say on what I buy and don't buy.

But this is something that necessarily involves pools of people, and is terribly inefficient when we start allocating things individually. A little like firefighting--should this be privatized? Should we wait until your house burns down and then have some local company drive by and offer to save your house for the right price? Or defense spending--should we allow Robin to opt out of his portion of paying for national defense because he doesn't really like how the money's being "commandeered"?

My only problem with a mandate would be solved with incentives/refunds. You can avoid auto insurance by riding a bike or public transportation. You wouldn't be able to avoid insurance premiums even if you seek alternatives to traditional medicine and take preventive measures.

The person who exercises regularly and needs treatment every other year shouldn't have to pay the same as the person who visits the ER every other week.

I think this is the biggest problem with a coverage mandate. It doesn't address the access problem.

Your prevention and usage problems can easily be solved with mandatory insurance coverage depending on deductible setup, premiums, and copays.

It absolutely addresses the coverage mandate in two ways. First, it allows the government to require that insurance companies not deny people coverage based on pre-existing conditions. Second, it brings down the price of insurance plans because everyone (and not just those likely to use it) purchases insurance.

[CardiacCoug]

I'm in favor of mandating some type of catastrophic health insurance. Right now, we're all subsidizing people who could afford to buy health insruance but choose to spend their disposable income in other ways and to pass on the costs of their emergency health care to the rest of us.

Whenever there is a discussion like this, it strikes me that there are two fundamentally different types of "health care" that are often grouped together:

1. Outpatient care that can be scheduled and for which patients can shop online and compare cost and quality between different options.

2. Emergency care for life-threatening conditions (car accidents, heart attacks, acute abdomens) for which you are at the mercy of the nearest capable hospital and doctors.

Thee two fundamentally different types of health care are kind of like the difference between a home security system and a city police force. It wouldn't make sense for the government to install and maintain a security system in every home, and it wouldn't make sense for the police to send you an enormous bill for their services after you were the victim of a crime.

For the first type of health care, we should maximize the private, competitive environment that makes this country great. People should pay out of pocket (from health savings accounts, etc.) for these services and we will see costs decrease and quality improve.

For the second type of health care, the free market just doesn't work. You can't shop online for your heart attack care from the back of an ambulance. There need to be common sense regulations for this type of health care and mandating catastrophic health insurance is a good start.

[SeattleUte]

I have health insurance, but I bought it in case it is needed, not because it was required to have it. So, in my case, your mooch theory is 100% wrong.

As woot said, this isn't about you. It's always sad when significant numbers of our society don't get freedom or aren't up to its obligations and therefore government has to step in, ironically for the sake of freedom. The Civil Rights Act was a classic example.

[KillerDog]

I have read a lot of comments based on abstracts. I will speak from experience. I went without health insurance or car insurance for the better part of 3 years. I chose to do that because I wanted to allocate my money differently. I spent my money on a snowmobile, a motorcycle, and a boat. Not having insurance changed a lot of my behaviors. I drove more carefully, I didn't go to the doctor unless it was serious, and I had to figure out how to pay for medical advice given by the doctors I went to. The problem isn't having people without insurance, the problem is having people who aren't willing to pay.

In the time I was without insurance, I never got in a car accident but I did get hurt quite a few times. For example, I dislocated my ankle. The stupid thing has never been the same since and I was in excruciating pain for a long time afterward but I never went to the doctor. I also had a Christmas tree hit me on the head and split my scalp open. I went to the emergency room for treatment and was given 4 staples. Because of the cost of the anesthetic, I refused the drugs and got the staples without pain killers. I also refused to fill the prescription. I had no long term effects from those things. I also got really sick once after going to some natural hot springs and didn't go to the doctor until I was coughing up blood. I paid for my doctors visits through payment plans, interest, and in many cases, increased pain.

My point is, we are making an assumption that someone getting medical care and not having insurance doesn't have to pay. That is not the case. We are also ignoring the fact that there are a number of ways to pay for your decisions and we should allow individuals to choose which way they want to pay. I think too many people fail to look honestly at the medical field and the result is we have assumptions that government involvement is or isn't necessary based on the dishonest view of the health care environment. Personally, I think we need to stop propagandizing and start looking at the system with honesty.

How will mandatory health insurance affect medical care? Experience with car insurance prices indicate that it will drive up health insurance prices. What then are we willing to do to "fix" that problem. We got where we are by making decisions regarding taxes and health as though we were in a vacuum. We cannot continue along that path.

[CardiacCoug]

I have read a lot of comments based on abstracts. I will speak from experience. I went without health insurance or car insurance for the better part of 3 years. I chose to do that because I wanted to allocate my money differently. I spent my money on a snowmobile, a motorcycle, and a boat. Not having insurance changed a lot of my behaviors. I drove more carefully, I didn't go to the doctor unless it was serious, and I had to figure out how to pay for medical advice given by the doctors I went to. The problem isn't having people without insurance, the problem is having people who aren't willing to pay.

In the time I was without insurance, I never got in a car accident but I did get hurt quite a few times. For example, I dislocated my ankle. The stupid thing has never been the same since and I was in excruciating pain for a long time afterward but I never went to the doctor. I also had a Christmas tree hit me on the head and split my scalp open. I went to the emergency room for treatment and was given 4 staples. Because of the cost of the anesthetic, I refused the drugs and got the staples without pain killers. I also refused to fill the prescription. I had no long term effects from those things. I also got really sick once after going to some natural hot springs and didn't go to the doctor until I was coughing up blood. I paid for my doctors visits through payment plans, interest, and in many cases, increased pain.

My point is, we are making an assumption that someone getting medical care and not having insurance doesn't have to pay. That is not the case. We are also ignoring the fact that there are a number of ways to pay for your decisions and we should allow individuals to choose which way they want to pay. I think too many people fail to look honestly at the medical field and the result is we have assumptions that government involvement is or isn't necessary based on the dishonest view of the health care environment. Personally, I think we need to stop propagandizing and start looking at the system with honesty.

How will mandatory health insurance affect medical care? Experience with car insurance prices indicate that it will drive up health insurance prices. What then are we willing to do to "fix" that problem. We got where we are by making decisions regarding taxes and health as though we were in a vacuum. We cannot continue along that path.

I think you're correct that if the mandatory health insurance is all-inclusive (joint replacements, spine surgery, dermatology care, etc.) then the price of health insurance and health care generally will skyrocket.

Mandatory health insurance needs to only cover life-threatening conditions with clearly-defined (but at times very expensive) therapies.

[ERCougar]

I have read a lot of comments based on abstracts. I will speak from experience. I went without health insurance or car insurance for the better part of 3 years. I chose to do that because I wanted to allocate my money differently. I spent my money on a snowmobile, a motorcycle, and a boat. Not having insurance changed a lot of my behaviors. I drove more carefully, I didn't go to the doctor unless it was serious, and I had to figure out how to pay for medical advice given by the doctors I went to. The problem isn't having people without insurance, the problem is having people who aren't willing to pay.

In the time I was without insurance, I never got in a car accident but I did get hurt quite a few times. For example, I dislocated my ankle. The stupid thing has never been the same since and I was in excruciating pain for a long time afterward but I never went to the doctor. I also had a Christmas tree hit me on the head and split my scalp open. I went to the emergency room for treatment and was given 4 staples. Because of the cost of the anesthetic, I refused the drugs and got the staples without pain killers. I also refused to fill the prescription. I had no long term effects from those things. I also got really sick once after going to some natural hot springs and didn't go to the doctor until I was coughing up blood. I paid for my doctors visits through payment plans, interest, and in many cases, increased pain.

My point is, we are making an assumption that someone getting medical care and not having insurance doesn't have to pay. That is not the case. We are also ignoring the fact that there are a number of ways to pay for your decisions and we should allow individuals to choose which way they want to pay. I think too many people fail to look honestly at the medical field and the result is we have assumptions that government involvement is or isn't necessary based on the dishonest view of the health care environment. Personally, I think we need to stop propagandizing and start looking at the system with honesty.

How will mandatory health insurance affect medical care? Experience with car insurance prices indicate that it will drive up health insurance prices. What then are we willing to do to "fix" that problem. We got where we are by making decisions regarding taxes and health as though we were in a vacuum. We cannot continue along that path.

Ok...I'm going to try think and write rationally here, but this kind of thinking pisses me off. To buy a snowmobile, a motorcycle, and a boat instead of health insurance is unbelievably irresponsible. And as evidence of your responsibility, you cite a few minor injuries and how you either didn't care for them or did it on the cheap. Guess what? You were lucky. Many aren't. What happens when that tree falls down, hits you in the head, gives you a subdural hematoma, and you're in the ICU and rehab for a month (or permanently)? Yup, no worries--we got it. Meanwhile, it'd be nice if I could afford a snowmobile, a motorcycle, OR a boat--instead, I'm paying your bill or caring for you for free.

You're exhibit A on why we need mandatory coverage. Because despite your claim of not needing your insurance, you actually are reaping the benefits of an insurance policy mandated by EMTALA by virtue of your very existence--you're just not paying for it. You're a free-rider.

Oh, and by the way, I never give anesthetic for staples--even to kids. Because they don't hurt. Kudos on your bravery.

[ERCougar]

I'm in favor of mandating some type of catastrophic health insurance. Right now, we're all subsidizing people who could afford to buy health insruance but choose to spend their disposable income in other ways and to pass on the costs of their emergency health care to the rest of us.

Whenever there is a discussion like this, it strikes me that there are two fundamentally different types of "health care" that are often grouped together:

1. Outpatient care that can be scheduled and for which patients can shop online and compare cost and quality between different options.

2. Emergency care for life-threatening conditions (car accidents, heart attacks, acute abdomens) for which you are at the mercy of the nearest capable hospital and doctors.

Thee two fundamentally different types of health care are kind of like the difference between a home security system and a city police force. It wouldn't make sense for the government to install and maintain a security system in every home, and it wouldn't make sense for the police to send you an enormous bill for their services after you were the victim of a crime.

For the first type of health care, we should maximize the private, competitive environment that makes this country great. People should pay out of pocket (from health savings accounts, etc.) for these services and we will see costs decrease and quality improve.

For the second type of health care, the free market just doesn't work. You can't shop online for your heart attack care from the back of an ambulance. There need to be common sense regulations for this type of health care and mandating catastrophic health insurance is a good start.

Well-put.

[woot]

I'm in favor of mandating some type of catastrophic health insurance. Right now, we're all subsidizing people who could afford to buy health insruance but choose to spend their disposable income in other ways and to pass on the costs of their emergency health care to the rest of us.

Whenever there is a discussion like this, it strikes me that there are two fundamentally different types of "health care" that are often grouped together:

1. Outpatient care that can be scheduled and for which patients can shop online and compare cost and quality between different options.

2. Emergency care for life-threatening conditions (car accidents, heart attacks, acute abdomens) for which you are at the mercy of the nearest capable hospital and doctors.

Thee two fundamentally different types of health care are kind of like the difference between a home security system and a city police force. It wouldn't make sense for the government to install and maintain a security system in every home, and it wouldn't make sense for the police to send you an enormous bill for their services after you were the victim of a crime.

For the first type of health care, we should maximize the private, competitive environment that makes this country great. People should pay out of pocket (from health savings accounts, etc.) for these services and we will see costs decrease and quality improve.

For the second type of health care, the free market just doesn't work. You can't shop online for your heart attack care from the back of an ambulance. There need to be common sense regulations for this type of health care and mandating catastrophic health insurance is a good start.

While I think that mandatory catastrophic coverage would be a big step in the right direction and will significantly reduce the cost of coverage for everyone who currently has insurance, I think what would decrease the amount we pay even more would be an emphasis on preventive medicine, which will require more comprehensive insurance coverage. This is what I would like to see become mandatory. Even most people who already have coverage would benefit from this. The elimination of insurance companies' ability to drop your coverage for any reason will be a necessary requirement for this to work, which will also be a great benefit.

[SeattleUte]

BTW, I'm undecided on this issue. I just thought that Il Pad's reasoning was lacking.

[KillerDog]

I think you're correct that if the mandatory health insurance is all-inclusive (joint replacements, spine surgery, dermatology care, etc.) then the price of health insurance and health care generally will skyrocket.

Mandatory health insurance needs to only cover life-threatening conditions with clearly-defined (but at times very expensive) therapies.

It will still drive up the cost. Mandatory auto insurance is limited in what it covers and what the size of the coverage is but it still dramatically drove up the prices of car insurance. It is funny because, as previously stated in this thread, you can opt out of driving and thereby opt out of car insurance. What we've learned from the auto-insurance world is that anytime you increase the demand artificially, the price goes up. No matter how you slice it, mandatory health insurance will drive up prices. What should we do then?

In similar circumstances, the government has set price controls to strip monopoly profits. Is that what is proposed here or are people proposing only an increase in demand?

[ERCougar]

While I think that mandatory catastrophic coverage would be a big step in the right direction and will significantly reduce the cost of coverage for everyone who currently has insurance, I think what would decrease the amount we pay even more would be an emphasis on preventive medicine, which will require more comprehensive insurance coverage. This is what I would like to see become mandatory. Even most people who already have coverage would benefit from this. The elimination of insurance companies' ability to drop your coverage for any reason will be a necessary requirement for this to work, which will also be a great benefit.

There are a couple of ways to address this preventive medicine issue. The easiest would be for the government to cover or subsidize certain cost-effective preventive medicine procedures/therapies. Blood pressure medicines or diabetic supplies are a great start--these are relatively inexpensive and keep people of of dialysis (an extremely expensive therapy).

[ERCougar]

It will still drive up the cost. Mandatory auto insurance is limited in what it covers and what the size of the coverage is but it still dramatically drove up the prices of car insurance. It is funny because, as previously stated in this thread, you can opt out of driving and thereby opt out of car insurance. What we've learned from the auto-insurance world is that anytime you increase the demand artificially, the price goes up. No matter how you slice it, mandatory health insurance will drive up prices. What should we do then?

In similar circumstances, the government has set price controls to strip monopoly profits. Is that what is proposed here or are people proposing only an increase in demand?

You're not increasing demand artifically by mandating catastrophic coverage. The demand for catastrophic coverage (which has nothing to do with your examples, by the way) is already fixed, based on catastrophic emergencies. We're just more properly allocating things. In fact, by opening up a competitive private insurance market, which hardly exists now because of its small scale and prohibitive prices, you're expanding supply--driving down prices.

[KillerDog]

Ok...I'm going to try think and write rationally here, but this kind of thinking pisses me off. To buy a snowmobile, a motorcycle, and a boat instead of health insurance is unbelievably irresponsible. And as evidence of your responsibility, you cite a few minor injuries and how you either didn't care for them or did it on the cheap. Guess what? You were lucky. Many aren't. What happens when that tree falls down, hits you in the head, gives you a subdural hematoma, and you're in the ICU and rehab for a month (or permanently)? Yup, no worries--we got it. Meanwhile, it'd be nice if I could afford a snowmobile, a motorcycle, OR a boat--instead, I'm paying your bill or caring for you for free.

You're exhibit A on why we need mandatory coverage. Because despite your claim of not needing your insurance, you actually are reaping the benefits of an insurance policy mandated by EMTALA by virtue of your very existence--you're just not paying for it. You're a free-rider.

Oh, and by the way, I never give anesthetic for staples--even to kids. Because they don't hurt. Kudos on your bravery.

I paid my hospital bills. By definition, I'm not a free rider. Please explain how I am.

The point is, I had that choice to make. Explain to me why you believe my choice should be restricted. If I read your comments correctly, your discomfort comes because I "might have" been more seriously hurt and someone would be forced to care for me. Why is that? I assume that a law requires the assistance. IOW, a law was passed that transfered the risk from the party best able to deal with it to another party. You're doing the same thing now if you make health insurance mandatory. That's the problem here. Choice has been curbed and now we want to curb it further because we already curbed it once. That's fine as long as we understand there will be additional curbing required and the outcomes may not be pretty.

The point isn't to cite bravery and your emotion is making you sound like an ass. The point is that they offered to give me pain killers to put the staples in my head and I said "no" because of the cost. If you are to be believed on the level of pain for staples, it is insane that they even offered and I never would have made the correct choice without the experience of not having insurance.