Justus For All

I think the problem with trying to force everyone to get health insurance can be traced to where problems lie with auto insurance.

The two aren’t entirely comparable, but some things worth noting when comparing the two:

1. Driving is a privilege, not a right, so requiring auto insurance is essentially a responsibility people are told to take on if they want to enjoy the privilege of driving a car. Now, I suppose one could argue that, when it comes to health care, not every single treatment available should be available right away to whoever wants it (and there are some out there in which there’s no question they shouldn’t be, although most of them fall under the “cosmetic” category), but I’m sure everyone would agree that living is a right for every citizen (barring death penalty situations) so one could argue people have a right to health care if said care is necessary for the citizen to live.

2. I don’t really see how subsidies are going to suddenly help people who can’t afford health insurance suddenly be able to afford it. Sticking with auto insurance, to use my example, I pay a little more than $330 in a six-month period. For health insurance for work, the portion I pay is a little more than $53 per half-month, or $106 per month. Do the math, and my portion I pay for health insurance in six months is nearly double what I pay for auto insurance in that same span, and you can probably guess how much the full cost of health insurance would be for me in six months.

This follows with the general reason people say they don’t get auto insurance is “I can’t afford it.” I’m sure you’ll hear the same thing from these people if they’re told they have to get health insurance.

3. I read at least one article in which the argument was “we require auto insurance, so why not heath insurance” and a more specific argument about how health care costs are rising because not everyone has health insurance.

Auto and health insurance both serve essentially the same purpose: To help people pay for the costs of services that would be expensive and difficult for most to afford without insurance.

With auto insurance, two things that determine rates are driving habits and how many claims are filed with an insurance company. Driving habits can be based on individual habits or state statistics (in New Mexico where I live, the high rate for driving under the influence of alcohol citations is a factor in auto insurance rates). Claims are pretty simple, but typically, the more claims filed during a particular period, the more likely the company will raise rates.

So if you have a health insurance provider who suddenly has a large number of clients getting insurance because they’ve been ordered to do so by the federal government, they have potential for a larger number of claims filed. I don’t know all the details about how health insurance rates are determined, but it would not surprise me that rates can increase if more claims are filed.

If that is the case, a larger pool of clients that increase the potential for more claims means the potential for rate increases also go up.

I know the argument that health care costs will go down has more to do with the actual care itself, but since insurance is supposed to cover that part, it likely isn’t going to make a difference in the pocketbooks of people who have insurance. They might save a little on the portion they pay out of their pockets, but it’s possible that savings could be countered by an increase in their insurance rate.

So… I believe mandating health insurance to all Americans is a bad idea. The only real solution to the government being involved with health insurance is for the government to do what Canada does and I’m sure you would agree with me that isn’t going to happen in the United States any time soon.

I agree that what to do with regards to health care is a sticky situation, but I’m not entirely sold on Wyden’s proposal. He does seem to be making an effort to keep insurance rates from going up too much, but I’m still not certain if his proposal is workable.

One thing I will add after further reviewing Wyden’s proposal: I’m not clear if an employer could continue to provide insurance or not. If not, then that means I become responsible for the full premium. Additionally, my payment to the premium through my employer comes before taxes, so then I’d lose additional money to taxes because that pre-tax deduction no longer applies. So it would impact me negatively.

OK, one last post on this subject… essentially to say I didn’t read the part about employers being required to take what they spend on health care and give raises to employees. So you can ignore my second post. My apologies.

I think the best argument for mandatory insurance is that if someone gets sick, we treat them anyway. Theoretically, we could refuse to treat people who couldn’t pay for care, but in the real world that isn’t going to happen. Mandatory insurance therefore deals with the free-rider problem.

Another touted bonus of this system is that it would promote preventive care, which could reduce costs overall. As an example, I have a friend with a hernia without any insurance. Eventually it will repture and he will go to the emergency room and get it treated, but until then he cannot afford care. Care would be cheaper now then when it becomes an emergency, but he simply can’t afford it. When that finally does happen, the bulk of those costs will be passed on to other consumers.

While rates obviously increase if more claims are filed, they also decrease if more people are insured, especially healthy people. Adverse selection is a serious problem with health insurance, and this plan seems to deal with it in a reletively sensible manner.

Whether overall health care will increase more, stabilize, or even decrease under this plan is somewhat questionable. Given that health care costs have been rising quite rapidly under the current system, trying something else out doesn’t seem like a horrible idea to me. That said, there will almost certainly be winners and losers in the new system. Clearly, the poor who can’t afford insurance will win. Probably most of middle America will more or less break even, and the rich will probably still get the same gold-plated health care they get today. The ‘losers’ of the system will be young healthy people who could afford insurance, but chose to not to get it, especially those whose employers don’t provide health care now. Of course, some of them will end up being ‘winners’ as their bets against not getting sick sometimes don’t pay off.

One interesting aspect of this plan from a libertarian standpoint is that individuals, rather than corporations will be in charge of their insurance. This will allow for greater job mobility, especially for people who have a pre-existing condition and absolutely cannot afford to give up their existing health care. It will also remove a great deal of uncertainty about future health costs from employers projections, probably allowing for greater dynamicism and employment growth.

Like I said, I am not 100% sold on this idea, but I am much less than 100% on our current system.

Hey guys, great conversation here.

Bob said, I don’t really see how subsidies are going to suddenly help people who can’t afford health insurance suddenly be able to afford it.

Anybody who is under 400% of the poverty line (~$40,000 a year for a single person, double that for family) would be subsidized.

According to the independent cost analysis, anybody making under $40k/yr would be paying LESS than they are now.

so then I’d lose additional money to taxes because that pre-tax deduction no longer applies.

Keep digging in to the details. You would get a deduction on what you spend for your premium — I think it’s roughly 140% in order to help hold you close to harmless.

People making between $50,000 and $150,000 a year would net out about $300 more a year. Above that, the tax deduction fades out so that high-income people don’t get subsidized by the rest of us.

[Full disclosure - I’m helping Senator Wyden with the campaign-funded netroots organizing site, Stand Tall for America. I speak only for myself, and any errors are my own.]

Here’s my plug: C’mon down to Stand Tall for America and join the campaign. (The site is pretty barebones, but we’re moving fast…)

How many Americans will it take to make universal, portable, affordable health care a reality?

first, i thought poor people already had health insurance. I thought it was called medicare or medicad. Adjust those plans to accomdate, don’t give poor people more money and expect them to use it wisely (remember they are poor for a reason).

secondly, if i get paid more, i get taxed more and contribute more to retirement. Already a full 25 percent of my paycheck goes to the man, paying me more is only going to increase that amount. Higher tax braket and all. Basically, after taxes, there is a chance there will be less money to go around on health services. Overall, i don’t know how that will balance out.

Also, i don’t feel the line of though of what would happen if you did not have insuance and needed medical care has been fully explored. If you are sick, we save your life presently, that will not change as dave pointed out. So i don’t have insurance, what is going to happen when i get sick? They will still save your life under this plan, but probably give you a ticket or some such. Or maybe even though you in jail, where the healthcare is free, heh. Don’t really see how this plan is going to fix the problem with people not getting insurance.

I really like the fact it cuts the employer out of the healthcare situtaion. That could have potential far reaching benefits and increase the growth potneial of business. They can concentrat on makeing money and not buying healthinsurance. Time spent shopping for health insurance, is time not spent making money.

Like dave, i am for giving it a shot, if it does not work, oh well, are we really that much worse off.

“People making between $50,000 and $150,000 a year would net out about $300 more a year.”

At what cost to my time though, if it costs me over 300 dollars of my time…am i better off?