Why the individual mandate philosophically is right/ or wrong

[Ausm]

If the fed gov can tell you that you must engage in private commerce and that you must buy health insurance because it is in the nation's best interest, what is preventing them from telling you that you must engage in private commerce and buy a new US built car? It is, after all, in the nation's best interest. Oh, and you now have to buy a new US built TV...and a new US built microwave. Cannot afford it or do not want it? Too bad.

Oh, and if you do not do as we demand, we will fine you equal to the cost of the product we decided you have to buy.

What's the difference between the Fed saying you have to have Health Insurance and States demanding that everyone has Car insurance?

 

[Fern]

What's the difference between the Fed saying you have to have Health Insurance and States demanding that everyone has Car insurance?

1. It's not true that everyone needs to buy auto insurance. I went many years without buying auto insurance. I rode the subways or buses.

2. Driving is a privilege, not a right.

3. Living is a right, not a privilege. So, there's no valid comparison.

Fern

 

[nonlnear]

1. It's not true that everyone needs to buy auto insurance. I went many years without buying auto insurance. I rode the subways or buses.

2. Driving is a privilege, not a right.

3. Living is a right, not a privilege. So, there's no valid comparison.

Fern

But what's the difference between car insurance and health insurance? I just don't see it!

 

[fskimospy]

No, it doesn't.

For many, the prospect of major medical means they are disabled and can longer work. If you're not working you can't pay your home mortgage, car payment and other bills.

Not many have disability insurance outside of SS. IIRC, the maximum disability benefit under SS is about $900 a month. Good luck with that.

So, you may be correct that the medical bills themselves won't force you into bankruptcy but I'm afraid we'll find out that's rather meaningless when you're in bankruptcy anyway. Clearly, the real benefit here is for physicians and hospitals who now won't have to write off medical bills for those that go bankrupt. HI will pay them.

Fern

This is a specious dismissal of his point. There are huge numbers of injuries/maladies that can create enormous medical bills that do not leave you incapacitated long term. Medical costs are so high that even relatively minor hospital incidents can leave someone thousands of dollars in debt. Anything more serious and we're quickly talking 5 figures plus. Hell, my cancer diagnosis cost ~$200,000 in medical bills and I most certainly wasn't disabled long term.

Can you provide us with some factual basis for what you just wrote in terms of what percentage of high medical cost maladies also come with long term disability, or were you just pulling something out of your ass to justify a position you had already decided to take?

 

[BoberFett]

But what's the difference between car insurance and health insurance? I just don't see it!

Car insurance is voluntary and doesn't pay for oil changes?

 

[nonlnear]

Car insurance is voluntary and doesn't pay for oil changes?

But basically they are both insurance, and they both have mandates. So, you know, they are, like, the same.

 

[Fern]

-snip- what percentage of high medical cost maladies also come with long term disability

I don't know that the info you are demanding above is available.

I have seen data that suggest of those in a medically related bankruptcy, a little over 1 in 3 blamed loss of earnings capacity/disability.

From what I've read info on bankruptcy is a bit sketchy at best. E.g., approx 50% who been in bankruptcy won't even admit it. It seems therefore many studies rely on court data and haven't yet seen one correlates bankruptcies to disabilities.

I have seen a report that says 95% of disabilities are caused by illness, not accident. But that's not what you're looking for.

So, I don't think the data you're demanding is out there. If it is, I haven't yet found it.

But this issue weighs on me now. A friend of mine had a stroke about 2 weeks ago. He is a self-employed tax attorney who was making good money and lives in one of the ritzier places around NYC. He isn't expected to be able to work in the next 12 months, if ever again, at that capacity.

I've been trying to help his wife, but so far I see little-to-no hope of saving the home from foreclosure and bankruptcy is all but certain.

He is covered under an HI plan, but has no disability insurance.

Fern

 

[sixone]

But what's the difference between car insurance and health insurance? I just don't see it!

If you CHOOSE not to own and operate a car, you are not required to have car insurance. If you CHOOSE to do so, you are required to protect others, not only yourself.

 

[Dr. Zaus]

But basically they are both insurance, and they both have mandates. So, you know, they are, like, the same.

100% this, I looked into it.

 

[theeedude]

The philosophical argument ended when Reagan signed COBRA, which included EMTALA.
If it's right to require that a hospital treat anyone coming through the ER door, it's also right to require that those people carry insurance to repay the hospital for that treatment.

 

[HomerJS]

The mandate is correct as long as hospitals are required to treat people without proof of insurance or ability to pay.

 

[ohnoes]

there is a 100% certainty that 100% of the population will get sick and die. They will require healthcare and hospitals will be obligated to treat them. What's wrong with the individual mandate in that context?

 

[dank69]

Let's pretend that's true, and follow this logic, for shits and grins.

If you're sick or injured and not able to work for long enough, you won't be able to pay your rent or your mortgage or your car payment or your insurance, and then you'll be going bankrupt with full health coverage.

So then the government will mandate that everyone buy disability insurance, so that they will have an income while they're unable to work.

Except the poor won't be able to afford both health coverage and disability coverage. How are you going to solve this problem?

No, it doesn't.

For many, the prospect of major medical means they are disabled and can longer work. If you're not working you can't pay your home mortgage, car payment and other bills.

Not many have disability insurance outside of SS. IIRC, the maximum disability benefit under SS is about $900 a month. Good luck with that.

So, you may be correct that the medical bills themselves won't force you into bankruptcy but I'm afraid we'll find out that's rather meaningless when you're in bankruptcy anyway. Clearly, the real benefit here is for physicians and hospitals who now won't have to write off medical bills for those that go bankrupt. HI will pay them.

Fern

Yup, thats's why I said 'due to unforseen medical expenses' rather than unforseen medical conditions. And Fern, I'm sorry to hear about your friend, but I have to ask, why didn't he carry disability insurance when he had a good job?

 

[Sunburn74]

If you CHOOSE not to own and operate a car, you are not required to have car insurance. If you CHOOSE to do so, you are required to protect others, not only yourself.

The cost of driving without insurance is paid for by the individual. The cost of living without health insurance is paid for by the public. The mandate turns what was previously an externalized cost into an internalized cost.

If you really want to be absolutely fair, have hospitals literally throw people who don't have any insurance out on the streets to die 100% of the time by law. Then it'll make sense to not have a mandate, because then everyone assumes their own risk and costs.

 

[nonlnear]

If you CHOOSE not to own and operate a car, you are not required to have car insurance. If you CHOOSE to do so, you are required to protect others, not only yourself.

tap tap tap

 

[ky54]

We need single-payer as a better solution for the poor, though.

The very poor we already do - Medicaid. And has it lowered health care costs? No and a lot of doctors refuse to see them because the rate the government pays per visit is below the line where it's *GASP* profitable. Instead of single payer would you rather a nationalized health care where the government owns the hospitals and run all forms of health care? Isn't that the end we are looking for?

 

[Matt1970]

Many such things are already done. We are mandated to buy car insurance from any company we want lest we face arrests and fines. We are mandated to buy clothes from any company we want lest we face arrests and fines for public indecency. We are mandated to buy food for children from any company we want lest we face arrests and fines for neglect. Being mandated to engage in private commerce is a very common practice.

The implementation of this plan may be crappy, but the mandate philosophically is pretty sound to me. Its essentially a tax with a flowery name.

No, that is false. Those are provisions attached to privileges you can easily refuse. There are millions of Americans who don’t drive and therefore don’t need auto insurance. I am not required to feed any children because I don’t have any.

 

[soulcougher73]

If the fed gov can tell you that you must engage in private commerce and that you must buy health insurance because it is in the nation's best interest, what is preventing them from telling you that you must engage in private commerce and buy a new US built car? It is, after all, in the nation's best interest. Oh, and you now have to buy a new US built TV...and a new US built microwave. Cannot afford it or do not want it? Too bad.

Oh, and if you do not do as we demand, we will fine you equal to the cost of the product we decided you have to buy.

What are these US built things you speak of?

 

[soulcougher73]

This is a stupid reason to give the government the power to force people to purchase things from a private company.

Did you know new cars are safer than old cars? Using your own logic, the government should be able to force you to buy a new car to protect you from being hurt nearly as badly in accidents.

Accidents are something you have no control over, and you get hurt in them. How often should the government force you to buy a new car, since you say they should be allowed to force you to do it?

So you are ok with a state forcing you to do something but not the fed gov? How is that really any different in the grand scheme of things?

 

[soulcougher73]

Don't worry, the Food Safety Modernization Act and Consumer Product Safety Improvement Act are attempts at fixing those oversights.

I dont ever agree with you, but this did make me chuckle

 

[blankslate]

The very poor we already do - Medicaid. And has it lowered health care costs? No and a lot of doctors refuse to see them because the rate the government pays per visit is below the line where it's *GASP* profitable. Instead of single payer would you rather a nationalized health care where the government owns the hospitals and run all forms of health care? Isn't that the end we are looking for?

That's the thing If medicare covered closer to 100% of the population then it would start lowering health care costs, since it only covers the very very poor it is too small to pay out enough to doctors.

We're the only first world country that has not implemented some version of a Universal Health care system. There are almost as many versions of it as the countries who have it. One thing it does though is helps their industries be more competitive... The very poor is too small a pool.

This is an older story but it serves to illustrate what I mean when I say that other countries are helping their industries be more competitive..

http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2005/06/08/BUGKAD4U481.DTL

Addressing GM shareholders, Rick Wagoner said runaway health care costs are partly to blame for the world's largest automaker cutting at least 25,000 U.S. jobs as it closes more assembly and component plants.

GM is the nation's largest private purchaser of health care. The company expects to spend $5.6 billion this year on health benefits for workers and retirees -- more than it spends on steel for its vehicles.

GM says this cost translates to $1,500 for every car or truck produced.

"Our $1,500-per-unit health care expense represents a significant disadvantage versus our foreign-based competitors," Wagoner said. "Left unaddressed, this will make a big difference in our ability to compete in investment, technology and other key contributors to our future success."

He added: "It is crystal clear that we need to achieve a significant reduction in our health care cost disadvantage, and to do so promptly."

GM isn't alone in facing this problem. It's a dilemma confronting virtually all U.S. industries as health care costs post double-digit growth year after year.

"Name any manufacturer in the United States, and this is an issue for them," said Steven Szakaly, an economist at the Center for Automotive Research in Michigan. "There's got to be some way to rein in health care costs."

In 2005 every foreign automaker it was able to have a $1,500 dollar competitive advantage on GM because they don't have to worry about health care costs aside from the part taxes they pay out on their revenues that goes to the health care system of their countries. Given the trend with inflation it's probably an even larger advantage 7 years later.

Since we won't adopt some form of Universal Health Care and have objections to mandates we'll continue to let it be more of a burden on our economy as other nations have to devote less of their GDP to the health care sector than the U.S. does.

 

[soulcougher73]

If you CHOOSE not to own and operate a car, you are not required to have car insurance. If you CHOOSE to do so, you are required to protect others, not only yourself.

Yeah but you CANT CHOOSE when/if you will get hurt/sick. So it sucks for the rest of us when you do get sick/hurt and you dont have health insurance because we have to pick up the bill for you. Thus mandated health insurance.

 

[nonlnear]

nm

 

[xBiffx]

Really wish people who stop with the blatant lying about the public picking up the bill for the uninsured. The public picks up nothing, or least a very very small portion of that bill. The hospitals and insurance companies get the brunt of that cost. Unless someone is comming in with Medicare/Medicaid, the public as a whole is paying none of that cost. Only people with health insurance currently get hit with some of it through increased premiums but is minor since its spread across the board. The hospitals will collect if you are capable of paying but for some reason don't have insurance.

Obamacare will change none of this by the way. You still will have uninsured freeloading albeit in smaller numbers, people will still be getting subsidized healthcare, and the public will still be picking up more than their individual share of healthcare. So please stop lying about Obamacare being the solution to this problem. It's not going to be a pay you own way or pay as you go solution, so just stop.

 

[Atreus21]

The government ought not be allowed to require us to buy a private product simply because we are alive.

If I want to protect myself, I should do it at my expense.

Although frankly, my biggest issue with UHC isn't the principle above, but the fact that we have an immigration problem. I think we should fix that before we talk about UHC.