How will making health insurance mandatory help?

[mortimer]

It is a necessity for millions of Americans with budgets too tight or other circumstances to afford to retain family doctors if they appear healthy, or to afford the cost of the current insurance costs.

This makes no sense. Health insurance is necessary for Americans who can't afford insurance? I'm not sure what you are trying to say here.

The guy with the bad liver may miss several signs of it going bad that his physician may have if he'd had health insurance. Or he may put off getting it checked until it gets far worse even if he suspects something--thus the early diagnosis (dependant on access to an affordable, regular PCP) won't happen. Thus his health care, if that's defined as caring for one's health, requires insurance.

Health insurance doesn't ensure health, your hypotheticals aside.

You need either insurance or money to get preventative care, and to get care from a single doctor who'll know all your ailments. A lot of people don't have the money and can't get or afford the insurance either, or are inbetween jobs, etc. Or don't think it's justified at the time, which causes health problems down the road.

If health care is a necessity, than so is health insurance for many people.

And for those who don't think it's justified at this point in time, you are in a better position to tell them what is necessary for them than they are? Are you also going to force them to see doctors on a regular basis to make sure they get preventative care?

Are there cases where people can take care of themselves and never have a serious health problem?

Look, I'm not arguing that health insurance is not a "good thing". Most everyone would benefit from having insurance. That doesn't, however, make it necessary, in that we must force everyone to have it.

 

[Dragoonster]

This makes no sense. Health insurance is necessary for Americans who can't afford insurance? I'm not sure what you are trying to say here.

"or to afford the cost of the current insurance costs." If someone can't afford health insurance it doesn't exist for him. Affordable health insurance is necessary, meaning people can actually use it.

Health insurance doesn't ensure health, your hypotheticals aside.

It ensures health care. You claim it doesn't.

And for those who don't think it's justified at this point in time, you are in a better position to tell them what is necessary for them than they are? Are you also going to force them to see doctors on a regular basis to make sure they get preventative care?

No, I'm going to give them the opportunity to see doctors on a regular basis if they want to, without it breaking their financial future or requiring a certain job or status, or level of wealth.

I'm pretty tepid on this particular bill though, so far I'm leaning to it being crap.

Are there cases where people can take care of themselves and never have a serious health problem?

Obviously. There are also cases where people die or suffer serious disability because they couldn't afford to get themselves checked out, where they would've otherwise. And there are cases where they go bankrupt trying to fix problems they knew needed fixing.

Look, I'm not arguing that health insurance is not a "good thing". Most everyone would benefit from having insurance. That doesn't, however, make it necessary, in that we must force everyone to have it.

Earlier you said health care was close to being a necessity, but your "close" seems pretty darned far. If it really is close to a necessity, how would you go about ensuring that everyone had it who merely wanted it, while not forcing it on them?

Or, if you don't want to provide it to them, do you think the government should provide for education and national park service and such to its people? Are those more "necessities" than health care?

 

[mhaze]

Incorrect, look again.

Incorrect, again.

Cheers.

Ah, I see that each of your two words links to a different document. I stand corrected yet right in my comments. You get credit for noting the error where I said "one" it should have been "two".

So what is your problem? You then know that these bills go to be merged in some yet uncertain fashion, with the resulting content not a subset, union, or junction of these documents in any known fashion, and with yet more new clauses to be added.

Get real, please.

 

[mhaze]

It is a necessity for millions of Americans with budgets too tight or other circumstances to afford to retain family doctors if they appear healthy, or to afford the cost of the current insurance costs. The guy with the bad liver may miss several signs of it going bad that his physician may have if he'd had health insurance. Or he may put off getting it checked until it gets far worse even if he suspects something--thus the early diagnosis (dependant on access to an affordable, regular PCP) won't happen. Thus his health care, if that's defined as caring for one's health, requires insurance.....

You certainly have a point. One of the most common findings in deaths in New Orleans is cirrosis of the liver.

With insurance all those bums could live to drink another day.

 

[Thunder]

Health insurance doesn't ensure health, your hypotheticals aside.

hmmm..i wonder what the statistics are on the health of people WITH health insurance, verses the people WITHOUT health insurance.

anyone?

 

[Francesca R]

So what is your problem?

?? I scarcely see where I have one. I have not had to tolerate your country's limping disaster of a health system except for a short period (without incident) when I lived there (although my insurance cost my company plenty). I will likely not have to settle for the somewhat inefficient attempt to fix it either (albeit better than any prior attempt). I'll be fine thanks.

You, on the other hand, first profess full ignorance about what the state of the reforms are, and now appear to believe that HR 3962 and the Senate act contain no information about what the resulting act will be. Still, help is at hand

 

[Thunder]

It has occurred to me that having soo many fellow citizens without health insurance is a form of "survival of the fittest". Perhaps Republicans are trying to weed out lesser species?

 

[applecorped]

Perhaps Republicans are trying to weed out lesser species?

Lesser species?

 

[mhaze]

?? I scarcely see where I have one. I have not had to tolerate your country's limping disaster of a health system except for a short period (without incident) when I lived there (although my insurance cost my company plenty). I will likely not have to settle for the somewhat inefficient attempt to fix it either (albeit better than any prior attempt). I'll be fine thanks.

You, on the other hand, first profess full ignorance about what the state of the reforms are, and now appear to believe that HR 3962 and the Senate act contain no information about what the resulting act will be. Still, help is at hand

Sure.

Government: We've got two versions of a bill, and they'll be combined and sorted out somehow, just go along with it, chump. See? Go along with it if you knows what's good for ya.

Citizen: Nope, let's see what you actually come up with. Right now you could change it any old way. You don't have a legal document yet, so you have nothing for me to agree to yet. And screw the tough guy Chicago style bs, punk.

That about sums up whats going on here in the US. By the way, your descent into ad homs was expected, since you have no argument left. Further this is a mis statement of my views:

and now appear to believe that HR 3962 and the Senate act contain no information about what the resulting act will be

Although in a legal and contractual basis your mis statement has some considerable merit. Changing one word can change the whole intent and purpose of a document.

 

[Thunder]

Lesser species?

you are right. I should have said human sub-species.



you know? the poor, blacks, Hispanics, etc etc. mandatory health insurance for all Americans will only lead to healthier and greater numbers of "those" people.

 

[mhaze]

you are right. I should have said human sub-species.



you know? the poor, blacks, Hispanics, etc etc. mandatory health insurance for all Americans will only lead to healthier and greater numbers of "those" people.

Not so sure that's a fair assessment. Does playing the race card work pretty well for you? I heard it was getting to be a tired and worn out argument that often backfired!

But those bums!

Those bums that use up a liver drinking, they'll be in line for another.

 

[applecorped]

you are right. I should have said human sub-species.



you know? the poor, blacks, Hispanics, etc etc. mandatory health insurance for all Americans will only lead to healthier and greater numbers of "those" people.

No, you got it right the first time.

 

[mortimer]

"or to afford the cost of the current insurance costs." If someone can't afford health insurance it doesn't exist for him. Affordable health insurance is necessary, meaning people can actually use it.

While I disagree that it is "necessary", I will accept that health insurance isn't particularly useful if it is not affordable.

It ensures health care. You claim it doesn't.

And I am correct. Unless you are going to require those with health insurance actually make use of it. Are you in favor of not only requiring health insurance, but also that people make full use of it?

No, I'm going to give them the opportunity to see doctors on a regular basis if they want to, without it breaking their financial future or requiring a certain job or status, or level of wealth.

No, you are going to require them the opportunity to see doctors on a regular basis, by making them pay for health insurance (or make others pay for their health insurance).

Obviously. There are also cases where people die or suffer serious disability because they couldn't afford to get themselves checked out, where they would've otherwise. And there are cases where they go bankrupt trying to fix problems they knew needed fixing.

Is this quantifiable? How many with health problems neglected seeking care because it would bankrupt them?

Earlier you said health care was close to being a necessity, but your "close" seems pretty darned far. If it really is close to a necessity, how would you go about ensuring that everyone had it who merely wanted it, while not forcing it on them?

Pretty much everyone has it now. It may not be the most efficient, or the highest quality, but health care is available to all, regardless of ability to pay.

Or, if you don't want to provide it to them, do you think the government should provide for education and national park service and such to its people? Are those more "necessities" than health care?

The Federal government does not provide for education. Nor does it require that all citizens purchase a yearly pass to access national parks.

 

[Peephole]

Here's Paul Krugman and Ezra Klein on the indiviual mandate:

Start with the proposition that we don’t want our fellow citizens denied coverage because of preexisting conditions — which is a very popular position, so much so that even conservatives generally share it, or at least pretend to.

So why not just impose community rating — no discrimination based on medical history?

Well, the answer, backed up by lots of real-world experience, is that this leads to an adverse-selection death spiral: healthy people choose to go uninsured until they get sick, leading to a poor risk pool, leading to high premiums, leading even more healthy people dropping out.

So you have to back community rating up with an individual mandate: people must be required to purchase insurance even if they don’t currently think they need it.

But what if they can’t afford insurance? Well, you have to have subsidies that cover part of premiums for lower-income Americans.

In short, you end up with the health care bill that’s about to get enacted. There’s hardly anything arbitrary about the structure: once the decision was made to rely on private insurers rather than a single-payer system — and look, single-payer wasn’t going to happen — it had to be more or less what we’re getting. It wasn’t about ideology, or greediness, it was about making the thing work.

http://krugman.blogs.nytimes.com/2010/01/08/one-health-care-reform-indivisible/

Right now, the insurer sets the rules. It collects background information on applicants and then varies the price and availability of insurance to discriminate against those who are likely to use it. Health-care reform is going to render those practices illegal. An insurer will have to offer insurance at the same price to a diabetic and a triathlete.

But if you remove the individual mandate, you're caught in the reverse of our current problem: The triathlete doesn't buy insurance. Fine, you might say. Let the insurer get gamed. They deserve it.

The insurers, however, are not the ones who will be gamed. The sick are. Imagine the triathlete's expected medical cost for a year is $200 and the diabetic's cost is $20,000. And imagine we have three more people who are normal risks, and their expected cost in $6,000. If they all purchase coverage, the cost of insurance is $7,640. Let the triathlete walk away and the cost is $9,500. Now, one of the younger folks at normal cost just can't afford that. He drops out. Now the average cost is $10,600. This prices out the diabetic, so now she's uninsured. Or maybe it prices out the next normal-cost person, so costs jump to $13,000.

This is called an insurance death spiral. If the people who think they're healthy now decide to wait until they need insurance to purchase it, the cost increases, which means the next healthiest group leaves, which jacks up costs again, and so forth.

Kill the individual mandate and you're probably killing the bill, too. The mandate is what keeps average premium costs low, because it keeps healthy people in the insurance pool. It's why costs have dropped in Massachusetts, not jumped. It's why every other country with a universal health-care system -- be it public or private -- uses either a mandate or the tax code. It's why the Obama administration flip-flopped.

But maybe you're willing to ditch universality. Add some subsidies, leave the mandate, and it's a step forward, right? At least until the project is consumed by an insurance death spiral? And Congress will surely do something to stop that, right? Well, maybe.

Kill the individual mandate and you make it easy for Congress to let the country backslide to its current condition. In a world with an individual mandate, insurance has to be affordable. If it's not, there's a huge political backlash. That gives Congress a direct incentive to focus on cost. Remove the individual mandate and ... eh. If insurance isn't affordable, people simply go uninsured. It's exactly what happens now. Same incentives, or lack thereof, to make the system better.

http://voices.washingtonpost.com/ezra-klein/2009/12/draft_1.html

 

[ponderingturtle]

Take California for example. If Blue Cross raises its rates, then people will switch to Kaiser or Pacificare. But if Blue Cross, Kaiser, and Pacificare are all having to deal with a flood of "Gilberts", and there aren't enough healthy young people to compensate, they'll all be forced to raise rates.

You forgot the easy solution to the problem, shoot gilbert.

 

[ponderingturtle]

how could anyone argue that a nation with 65% of its people with health insurance is better than a nation with 97% of its people insured?

more insured Americans, means less bankruptcies (which means more spending), less federal billed ER visits, means healthier Americans, etc etc etc.

Would it mean less bankruptcies though? Many medical bankruptcies are from middle class people with insurance.

 

[ponderingturtle]

How exactly is it a necessity? Certainly health care is close to being a necessity, but health care insurance?

So how you you pay for the care of the uninsured then?

 

[ponderingturtle]

Who do you know that needs a liver transplant, but has been denied one because of lack of insurance?

It makes sense, I mean why give the liver to someone who will not be able to get the anti rejection drugs needed to live with it?

So they need to not only be able to pay for the operation but a lifetime of medication.

 

[Francesca R]

Here's Paul Krugman and Ezra Klein on the indiviual mandate:

What they write makes sense. Not that they came up with it, of course. As per post 7 it is a feature of virtually all systems with universality. So a casual observer might have thought its necessity was completely bleedin' obvious.

 

[johnny karate]

Do those who do not have healthcare insurance not have access to healthcare? What a ludicrous position.

Who do you know that needs a liver transplant, but has been denied one because of lack of insurance?

Pretty much everyone has it now. It may not be the most efficient, or the highest quality, but health care is available to all, regardless of ability to pay.

Do you even know what "healthcare" is?

It's not restricted to getting a liver transplant once your liver fails. It's getting the preventive care that will allow the diagnosis and potential treatment of the liver before it fails.

And if you don't have insurance or the money to pay for it our of pocket, you cannot get that preventive care.

Tens of millions of American are currently without health insurance, or the means to pay for preventive healthcare.

45,000 die every year because they lack access to preventative healthcare due to their lack of health insurance.

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.