How will making health insurance mandatory help?

[mortimer]

The fact that you think healthcare is limited to emergency procedures, and that therefore health insurace is a luxury that not everyone needs is as despicable as it is moronic.

Have fun beating on that strawman? Nowhere did I say that health insurance is a luxury.

I have a problem forcing people to buy health insurance when, in many cases, those people have already decided they don't want or need it.

 

[johnny karate]

Have fun beating on that strawman? Nowhere did I say that health insurance is a luxury.

So it's a "good thing" but not a necessity? Is there a better word than "luxury" to describe that?

I have a problem forcing people to buy health insurance when, in many cases, those people have already decided they don't want or need it.

I don't necessarily want or need automobile insurance. But guess what? The greater good has me trumped.

...in many cases, those people have already decided they don't want or need it.

I look forward to seeing the data you have to support such an assertion.

 

[mortimer]

So it's a "good thing" but not a necessity? Is there a better word than "luxury" to describe that?

A luxury is a swimming pool. A necessity is food. I consider health insurance closer to a necessity than a luxury, but I do think it falls well short of necessity.

I don't necessarily want or need automobile insurance. But guess what? The greater good has me trumped.

The federal government does not force anybody to buy automobile insurance.

I look forward to seeing the data you have to support such an assertion.

I thought this was fairly well known. Ah well, from a quick google:

Some scholars say the number of people who cannot afford insurance is overestimated. An Employment Policies Institute study found that 43 percent of the uninsured – about 20 million people - earn more than 2.5 times the federal poverty level, or $55,125 for a family of four. The authors – who include June O'Neill, the GOP-appointed head of the Congressional Budget Office from 1995 to 1999 - write "because most people at that income level are able to get insurance, (they) thus may be classified as 'voluntarily' uninsured."

http://www.kaiserhealthnews.org/Stories/2009/October/04/npr-voluntarily-uninsured-explainer.aspx

 

[Peephole]

The Employment Policies Institute (EPI) is one of several front groups created by Berman & Co., a Washington, DC public affairs firm owned by Rick Berman, who lobbies for the restaurant, hotel, alcoholic beverage and tobacco industries. While most commonly referred to as EPI, it is registered as a 501(c)(3) tax-exempt organization under the name of Employment Policies Institute Foundation. In its annual Internal Revenue Service return, EPI states that it "shares office space with Berman & Company on a cost pass through basis".

http://www.sourcewatch.org/index.php?title=Employment_Policies_Institute

 

[mortimer]

The Employment Policies Institute (EPI) is one of several front groups created by Berman & Co., a Washington, DC public affairs firm owned by Rick Berman, who lobbies for the restaurant, hotel, alcoholic beverage and tobacco industries. While most commonly referred to as EPI, it is registered as a 501(c)(3) tax-exempt organization under the name of Employment Policies Institute Foundation. In its annual Internal Revenue Service return, EPI states that it "shares office space with Berman & Company on a cost pass through basis".

http://www.sourcewatch.org/index.php?title=Employment_Policies_Institute

Mmmkay, and?

 

[johnny karate]

A luxury is a swimming pool. A necessity is food. I consider health insurance closer to a necessity than a luxury, but I do think it falls well short of necessity.

"Luxury" and "necessity" are antonyms. If there is a word for what you're describing, I am not aware of it.

The federal government does not force anybody to buy automobile insurance.

State governments do.

I thought this was fairly well known. Ah well, from a quick google:
http://www.kaiserhealthnews.org/Stories/2009/October/04/npr-voluntarily-uninsured-explainer.aspx

I thought you were going to give me actual statistics of people expressing a desire to not have health insurance, and not just assumptions based on a study by a right wing think tank.

Color me unconvinced.

 

[mortimer]

Twenty-five percent [of the uninsured] are eligible for public coverage… and 20 percent can afford coverage.

http://content.healthaffairs.org/cgi/content/abstract/hlthaff.26.1.w22

The broad picture that emerges from the authors’ tests is that between 25 percent and 75 percent of people who do not purchase coverage could afford to do so.

http://www.nber.org/cgi-bin/printit?uri=/digest/may03/w9281.html

• almost 35% of the uninsured have a family income exceeding $40,000.
• 25% of the uninsured have a family income exceeding $50,000.
• 40% of all uninsured Coloradans are between 19 and 34 years old.

http://www.patientpowernow.org/wp-c...isitics of the Uninsured - Lewin Colorado.pdf

 

[mortimer]

"Luxury" and "necessity" are antonyms. If there is a word for what you're describing, I am not aware of it.

Fair enough.

State governments do.

No, no they don't.

I thought you were going to give me actual statistics of people expressing a desire to not have health insurance, and not just assumptions based on a study by a right wing think tank.

Color me unconvinced.

You didn't actually read the article did you? Besides, how else would you characterize those who can afford health insurance but don't have health insurance? They have made a choice not to have insurance, but you now want to make that choice for them.

 

[johnny karate]

No, no they don't.

If you want to drive a car in their state, yes they do.

You didn't actually read the article did you? Besides, how else would you characterize those who can afford health insurance but don't have health insurance?

I'd characterize them as people who haven't provided a reason for not having health insurance.

They have made a choice not to have insurance, but you now want to make that choice for them.

And once again we have personal freedom butting up against the public good. But the illusion of completely unfettered personal freedom is just that.

If there are really people out there who can afford health insurance but absolutely refuse to get it, then I wish them well in taking on the government in defense of such a nonsensical stance.

 

[mortimer]

If you want to drive a car in their state, yes they do.



I'd characterize them as people who haven't provided a reason for not having health insurance.



And once again we have personal freedom butting up against the public good. But the illusion of completely unfettered personal freedom is just that.

If there are really people out there who can afford health insurance but absolutely refuse to get it, then I wish them well in taking on the government in defense of such a nonsensical stance.

Just to let you know where I stand: I wish we had a single payer healthcare system. I think that other countries that have single payer have proven that they work pretty well. I think this current plan of forcing people to buy private insurance is destined for failure. Spectacular failure.

I think we are arguing over definitions of "necessity" and "luxury". To me, the only "necessities" are food and shelter. Even the latter is debatable; there are areas of the country where one could conceivably live without shelter. But I don't know that I'd call everything else a "luxury", because the term in its common usage denotes opulence or extravagance. Shelter, clothing, education, transportation, health insurance... they just don't quite fit my definition for either. But you're right, there doesn't seem to be a good term for something in between necessity and luxury.

 

[johnny karate]

I would also prefer a single-payer system. But unfortunately severe partisanship will never allow such a thing.

Personally, I don't know if this healthcare reform bill will work, but I do believe the intention behind it is a valid and worthy one: to allow more people access to healthcare. And since that is an ideal I strongly believe in, I'm willing to give the benefit of the doubt until we see it up and running.

 

[WildCat]

• • almost 35% of the uninsured have a family income exceeding $40,000.
  • 25% of the uninsured have a family income exceeding $50,000.
  • 40% of all uninsured Coloradans are between 19 and 34 years old.

http://www.patientpowernow.org/wp-c...isitics of the Uninsured - Lewin Colorado.pdf

The average cost of health insurance premiums for a family of 4 is over $13,000. Do you really think this is affordable to a household earning $40,000 or $50,000? Not many people will stop paying the rent to buy health insurance.

 

[mortimer]

The average cost of health insurance premiums for a family of 4 is over $13,000. Do you really think this is affordable to a household earning $40,000 or $50,000? Not many people will stop paying the rent to buy health insurance.

I don't really know. Why would you take the lower limit of income and compare that to the average insurance cost? What is the lower limit of cost for insurance for a family of 4? Or do you think that those at the lower income range should be forced to get at least what is currently considerend an average insurance policy? Prices for all go up quite significantly if this is the case. And we are already paying more per insured capita than any other country in the world.

 

[mhaze]

Just to let you know where I stand: I wish we had a single payer healthcare system. I think that other countries that have single payer have proven that they work pretty well. I think this current plan of forcing people to buy private insurance is destined for failure. Spectacular failure.

I think we are arguing over definitions of "necessity" and "luxury". To me, the only "necessities" are food and shelter. Even the latter is debatable; there are areas of the country where one could conceivably live without shelter. But I don't know that I'd call everything else a "luxury", because the term in its common usage denotes opulence or extravagance. Shelter, clothing, education, transportation, health insurance... they just don't quite fit my definition for either. But you're right, there doesn't seem to be a good term for something in between necessity and luxury.

Tell ya what, I am certain all the hypochondriacs in the country are rooting for this bill, whatever it's got buried in it.

Constitutionality is obviously not a concern for many people.

http://volokh.com/2010/01/18/more-on-unconstitutionality-of-health-insurance-mandate/

 

[WildCat]

I don't really know. Why would you take the lower limit of income and compare that to the average insurance cost? What is the lower limit of cost for insurance for a family of 4? Or do you think that those at the lower income range should be forced to get at least what is currently considerend an average insurance policy? Prices for all go up quite significantly if this is the case. And we are already paying more per insured capita than any other country in the world.

I just went to esurance.com and got a quote for a hypothetical family of 4, 40 yo man, 37 yo woman, 2 children aged 6 and 4.

A high deductible ($3,500), 20% co-insurance, $6,000 annual out-of-pocket maximum (does not include deductible) plan from Blue Cross and Blue Shield is $6,768 a year for someone in my zip code (Chicago). That's a pretty crappy plan IMHO, and would be stretching the affordability limit for a household in the $40,000-$50,000 income range you cited as one which should be able to afford insurance. Bear in mind that a typical 3BR apartment in Chicago goes for $1,200/month, and that won't be in a great area.

A similar plan from the same provider with a $500 deductible will cost $13,652/year.

Get one with 0% coinsurance and you'll pay $17,100/year.

How many of these are really affordable for the family in the $40,000-$50,000 income range? The one with the affordable premium would likely bankrupt them if they ever had an expensive disease in which they'd have to cover the deductibles and coinsurance and out-of-pocket expenses. The plans with more coverage that wouldn't bankrupt them if they were unfortunate enough to need it have premiums they couldn't afford.

It could be worse, if I lived in Albany NY I'd be limited to 2 insurance companies, GHI and Empire. The GHI PPO plan would cost $15,321/year while the Empire HMO plan would cost an eye-popping $31,582/year. Now, there's an indemnity plan that costs just $4,273/year but as far as I can tell it doesn't actually cover anything, just gets you a discount???

 

[skeptifem]

OK, I confess that I have only a layman's understanding of economics and the health care debate, so I'm a little confused about the proposal to make purchasing health insurance mandatory. How exactly is it supposed to help?

It will make money for people who matter to politicians. Examining the record reveals the same pattern repeating itself over and over again. Crookedness is the norm, not the exception.

I predict that what constitutes 'health insurance' will become less meaningful. There are current insurance policies that only cover catastrophic injury. Will they count?

When last I checked, the primary problem with American health care is that health insurance is too expensive for most people to afford on their own. How are they going to be able to purchase something that they can't afford?

What am I missing?

That has been the primary problem LONG before any real reforms were proposed. The real problem is that other companies are getting mighty sick of paying their part for healthy workers, the costs rising is a problem for companies in addition to workers. You know this is the kind of problem that is being faced when companies like wal-mart are on board with reform (they have been making it easier for their employees to get on medicaid than on their health insurance for years now). They clearly do not care about the wellness of their workers outside of the cost to their company. What you see now is a compromise on the part of different business interests. This is why all the 'blue dog' democrats have some weird financial tie in to health insurance companies. The reform is not really meant to fix this for regular citizens, it is supposed to fix the problems of the business class. When you look at the rules (money is needed to get far in politics, representative democracy is the norm for major political issues, corporations have lots of money, corporations are responsible to shareholders to increase profits, etc) this is exactly how you would expect the system to behave.

 

[mortimer]

I just went to esurance.com and got a quote for a hypothetical family of 4, 40 yo man, 37 yo woman, 2 children aged 6 and 4.

A high deductible ($3,500), 20% co-insurance, $6,000 annual out-of-pocket maximum (does not include deductible) plan from Blue Cross and Blue Shield is $6,768 a year for someone in my zip code (Chicago). That's a pretty crappy plan IMHO, and would be stretching the affordability limit for a household in the $40,000-$50,000 income range you cited as one which should be able to afford insurance. Bear in mind that a typical 3BR apartment in Chicago goes for $1,200/month, and that won't be in a great area.

A similar plan from the same provider with a $500 deductible will cost $13,652/year.

Get one with 0% coinsurance and you'll pay $17,100/year.

How many of these are really affordable for the family in the $40,000-$50,000 income range? The one with the affordable premium would likely bankrupt them if they ever had an expensive disease in which they'd have to cover the deductibles and coinsurance and out-of-pocket expenses. The plans with more coverage that wouldn't bankrupt them if they were unfortunate enough to need it have premiums they couldn't afford.

It could be worse, if I lived in Albany NY I'd be limited to 2 insurance companies, GHI and Empire. The GHI PPO plan would cost $15,321/year while the Empire HMO plan would cost an eye-popping $31,582/year. Now, there's an indemnity plan that costs just $4,273/year but as far as I can tell it doesn't actually cover anything, just gets you a discount???

So you find only one policy that is below the national average? Perhaps you are not looking hard enough. My family plan (Aetna), which covers me, spouse, and all dependents is only about $7K/yr, and that plan is $30 copay for outpatient care, covers 80% on inpatient, with a $2K out of pocket max. $5/$25/$50 for prescriptions. I don't think you're looking hard enough.

ETA: My bad. It's about $13K/yr. I was thinking monthly, but my payment is bimonthly. Point still stands. My cost is average. There must be lower cost plans.

 

[WildCat]

So you find only one policy that is below the national average? Perhaps you are not looking hard enough. My family plan (Aetna), which covers me, spouse, and all dependents is only about $7K/yr, and that plan is $30 copay for outpatient care, covers 80% on inpatient, with a $2K out of pocket max. $5/$25/$50 for prescriptions. I don't think you're looking hard enough.

ETA: My bad. It's about $13K/yr. I was thinking monthly, but my payment is bimonthly. Point still stands. My cost is average. There must be lower cost plans.

See my point about lower cost plans. What's the point of having one if it still forces you into bankruptcy if you get sick? 60% of all people bankrupt due to medical reasons have insurance, they just don't have enough of it.

For some people, maybe a high deductible is no problem, and if needed they can tap into their savings and cover it. For others, a $5,000 deductible may as well be $50,000. Particularly those who would be living paycheck to paycheck.

Post #29 of this thread had a quote which defined medical bankruptcy as debts of $5,000 or 10% of income. I don't see how forcing all people in that group to purchase $13,000 or 25% of their income in insurance every year helps that situation. Hell, as far as I can tell the geniuses in Congress won't even let you deduct it from your taxable income.
Which brings me to my main criticism of the current bill - it does little to nothiong about addressing the costs of health care in the US. Why does everything cost twice as much here as it does elsewhere?

 

[Malerin]

I just went to esurance.com and got a quote for a hypothetical family of 4, 40 yo man, 37 yo woman, 2 children aged 6 and 4.

A high deductible ($3,500), 20% co-insurance, $6,000 annual out-of-pocket maximum (does not include deductible) plan from Blue Cross and Blue Shield is $6,768 a year for someone in my zip code (Chicago). That's a pretty crappy plan IMHO, and would be stretching the affordability limit for a household in the $40,000-$50,000 income range you cited as one which should be able to afford insurance. Bear in mind that a typical 3BR apartment in Chicago goes for $1,200/month, and that won't be in a great area.

A similar plan from the same provider with a $500 deductible will cost $13,652/year.

Get one with 0% coinsurance and you'll pay $17,100/year.

How many of these are really affordable for the family in the $40,000-$50,000 income range? The one with the affordable premium would likely bankrupt them if they ever had an expensive disease in which they'd have to cover the deductibles and coinsurance and out-of-pocket expenses. The plans with more coverage that wouldn't bankrupt them if they were unfortunate enough to need it have premiums they couldn't afford.

It could be worse, if I lived in Albany NY I'd be limited to 2 insurance companies, GHI and Empire. The GHI PPO plan would cost $15,321/year while the Empire HMO plan would cost an eye-popping $31,582/year. Now, there's an indemnity plan that costs just $4,273/year but as far as I can tell it doesn't actually cover anything, just gets you a discount???

Brief siderail: the Blue Cross plan I have for my family from my school district is much better coverage and costs $10,800 a year. There are multiple school districts in the coverage pool, so perhaps that keeps costs down a bit?

 

[Francesca R]

I have a problem forcing people to buy health insurance when, in many cases, those people have already decided they don't want or need it.

As I understand it, the present US system for health insurance is significantly compulsory anyway. I think that an employee can opt out of the cover linked to their employer, but they always lose a tax break, and in many (most?) cases they also fail to get any compensation for the net premiums either.

Hence, the cost of other people's health cover, in terms of the employer premium and the government subsidy, is charged to someone who demonstrably "doesn't want or need it" anyway. Which is why people usually don't opt out.

(Someone please correct me if I am wrong)

Aside from that, the reason why compulsion is part of health insurance almost everywhere is--again--because the voluntary mechanism for such a market suffers from failure (adverse selection, "death spiral" etc). In effect, therefore, you cannot choose between a totally voluntary freedom-respecting health insurance scheme and a compulsory one. You can only choose between usage fees and compulsory insurance.