Forced to pay to live?

[kenandkids]

Today I was making my rounds of news and other sources and came across this article on NPR.
http://www.npr.org/2011/01/22/133141262/can-congress-mandate-health-insurance

It's primary question is whether or not the American congress can force all Americans to purchase health insurance. The entire debate on health insurance is not what I am addressing, just this one particular idea.

To declare that a person must pay or otherwise avail themselves of healthcare seems a bit of a stretch. One of the major problems with many people I know is that they do not qualify for free care and purchased care is literally costing as much as their mortgage and/or car payments, the two most costly expenditures for most middle class families.

Should congress be able to force them to continue spending money on something that they might literally not be able to afford? And what form of healthcare could/should be forced on people? The bare minimum?

 

[Lallapalalable]

I recently had to ponder this myself, as I got a new job and going through the benifits that I could sign up for made me think about what would be the most bang for my buck. I could cut the deduction and go with the minimum, but that would leave me with a high co-pay and very little flexibility, or I could go for broke so if anything happened to me I would be covered and wouldnt have to shell out much, or any, money at the time of my medical visit. I thought about people being forced to pay for something that either wouldnt help them at all in the event of a serious emergency or cost them more money than they could afford. These situations, latter especially, are concerning for any family who has a worker that gets laid off (still a strong possibility). They still have that mandatory expenditure, and if anything were to actually happen the cheapo plans could bankrupt them.

Even so, there has to be a way to do this. Theres the Canada approach, where everyone is taxed to hell and the coverage is subsidized, and the American approach, where you pay for it yourself (or your employer does) and you can choose what coverage you recieve and possibly other ways that arent currently implemented. I have a hypothetical system: there would have to be a revision of tax law that allows more tax for the government (possibly income based, with the poorer having a lower tax rate than those who make more) so they can afford to cover a decent portion of medical care; more rigorous monitoring of spending by the government so this new tax money doesnt get eaten up before its counted; and taxpayers pay a co-pay for whatever coverage you require (also income based). The only thing is, there will alway be those who, no matter how fair the system is, will abuse it and leech off of any public program.

Im getting close to rambling, so Ill wrap this up with saying that there is a way, but people should test their theories before implementing them on a national scale. Otherwise, it could just be a wast of everyone's time and money.

 

[Mapp]

If you want to own a car in this country, you are forced to buy car insurance. It's a non-negotiable fact of life. This is a particularly heavy burden for those of us living in D.C. or New York, where bad driving by others has drastically raised insurance rates. I can barely pay my rates every 6 months. It's something I have to save up for, yet it's still better than the alternative. This is because, when someone who is uninsured gets into a wreck, they rarely end up paying the full cost themselves. Much of it gets shouldered by parties who were not at fault. The taxpayers end up covering a great portion of the court costs in lengthy lawsuits that could have simply been settled by insurance adjusters otherwise. It's a measure of accountability.

With health insurance, we have millions of uninsured people in this country, and thousands of uninsured going to hospital emergency rooms everyday. This impacts us in two ways. First, because people don't have insurance they don't go to primary care physicians for checkups. Thus they usually wait till a problem gets really bad and end up in an emergency room. Once there, they can't be turned away, we can't simply turn injured or sick people out to die on the streets. Much of the burden is thus shouldered by the tax payers who end up covering a great deal of the expenditures of hugely expensive treatments, tests and bed stays. The remaining portion is usually enough to bankrupt a family. Thus, this is what people like Congressman Weiner mean when they point out that overtime the health care overhaul saves money. We pay for the health care of the uninsured. Period. Having everyone insured alleviates the strain by placing it on insurance companies who have the business model and capital to support it. Keep in mind that originally, this would have been done by a modestly priced public alternative, but that was stricken from the bill by morons. So now, people have to turn to private health care providers. Private health insurance companies have a long history of piratical practices in the U.S., but thankfully the health care overhaul also alleviates some of their most disgusting practices. While this is not the best alternative, it is far better than the system we have now, which is bankrupting health care in this country.

 

[ArthurWilborn]

This is, in part, an outgrowth of the idea of eliminating the denial of coverage for preexisting conditions. Given that alone, a reasonable person would wait until they actually had a serious condition to buy full coverage. This would create incredible obvious funding problems for the insurer. Since you can't have the glorious socialist system ruined by clever people, it becomes necessary to force people to buy insurance whether they need it at the moment or not.

 

[Andiferous]

After the election I was very hopeful when Obama seemed to try to reach out to find a political balance, but really, this answer seems a bit ridiculous and completely sabotaged by lobby groups and the political opposition, so it now benefits few but the insurance companies. If I'd to have an opinion, I'd say that maybe this proves that capitalism should have no role in government.

 

[ArthurWilborn]

After the election I was very hopeful when Obama seemed to try to reach out to find a political balance, but really, this answer seems a bit ridiculous and completely sabotaged by lobby groups and the political opposition, so it now benefits few but the insurance companies. If I'd to have an opinion, I'd say that maybe this proves that capitalism should have no role in government.

You mean the more power you give government over business, the more businesses corrupt government? I would have never guessed! (sarcasm) I agree, let's try to pull government and capitalism farther apart.

 

[Andiferous]

That's where you're confusing it though. Capitalism and Socialism are left and right of centre, if you look at the handy dandy diagram from political compass. Those two are independent of authoritarian and libertarian, which is the up down bit of the diagram. Being left doesn't mean authoritarian. One is about feelings of personal and social responsibility; one is about government control.

* I really have to organise tabs better and stop posting in the wrong threads...

 

[kenandkids]

If you want to own a car in this country, you are forced to buy car insurance. It's a non-negotiable fact of life. This is a particularly heavy burden for those of us living in D.C. or New York, where bad driving by others has drastically raised insurance rates. I can barely pay my rates every 6 months. It's something I have to save up for, yet it's still better than the alternative. This is because, when someone who is uninsured gets into a wreck, they rarely end up paying the full cost themselves. Much of it gets shouldered by parties who were not at fault. The taxpayers end up covering a great portion of the court costs in lengthy lawsuits that could have simply been settled by insurance adjusters otherwise. It's a measure of accountability.

With health insurance, we have millions of uninsured people in this country, and thousands of uninsured going to hospital emergency rooms everyday. This impacts us in two ways. First, because people don't have insurance they don't go to primary care physicians for checkups. Thus they usually wait till a problem gets really bad and end up in an emergency room. Once there, they can't be turned away, we can't simply turn injured or sick people out to die on the streets. Much of the burden is thus shouldered by the tax payers who end up covering a great deal of the expenditures of hugely expensive treatments, tests and bed stays. The remaining portion is usually enough to bankrupt a family. Thus, this is what people like Congressman Weiner mean when they point out that overtime the health care overhaul saves money. We pay for the health care of the uninsured. Period. Having everyone insured alleviates the strain by placing it on insurance companies who have the business model and capital to support it. Keep in mind that originally, this would have been done by a modestly priced public alternative, but that was stricken from the bill by morons. So now, people have to turn to private health care providers. Private health insurance companies have a long history of piratical practices in the U.S., but thankfully the health care overhaul also alleviates some of their most disgusting practices. While this is not the best alternative, it is far better than the system we have now, which is bankrupting health care in this country.

I really don't like the car example. One has a choice as to whether or not they drive or own cars. One has very little choice as to where they are born or can live.

It seems simply as if this plan will do nothing but keep the insurance companies in profit. As is already the case, services will get scaled down while premiums will rise. To specifically state in a law that we must purchase this item or get financially penalised (pay for it in punishment) or qualify for "free" care or... what...?... gtfo? I rarely agree with talking heads, but this particular concept really does seem to be a tax for breathing.

I had previously tried to come up with a workable public and private option, but the more I run down the concepts the more I see the worst doctors and services restricted to public and the better doctors and services will be only available to the private companies. This idea would only exacerbate this problem to a large degree imo.

 

[kenandkids]

After the election I was very hopeful when Obama seemed to try to reach out to find a political balance, but really, this answer seems a bit ridiculous and completely sabotaged by lobby groups and the political opposition, so it now benefits few but the insurance companies. If I'd to have an opinion, I'd say that maybe this proves that capitalism should have no role in government.

I think that the economic engine running a nation need not be infused into government. The reverse is not true. A government must maintain some controls on the economy and society, else it wouldn't be a government.
I think that this "insurance" issue is a good example. The industry has wormed its way into the government thought process and now officials cannot even contemplate a method of healthcare separate from the companies. The government should have kept itself separate, regulating not promoting. Then perhaps we would have a workable model that both maintains a basic health standard and doesn't waste time and money trying to figure out how to keep company reps employed.

 

[Andiferous]

I agree and I am sorry for being so glib in that. I mean to say that the government and democracy shouldn't really be seduced by money and motivations for capital in particular, when they aim to represent the people. It sounds pedantic, but it is suspect when democracy bows to money and lobby groups wanting money. I guess I said this because it's often assumed that authoritarianism and government control only exist in socialism, so capitalism often escapes the blame for problems in policy. I hope that made sense.

 

[Mapp]

I really don't like the car example. One has a choice as to whether or not they drive or own cars. One has very little choice as to where they are born or can live.

Then you completely missed the point of the example. It had nothing to do with choice of driving or with choice of living, it had to do with the requirement to purchase insurance to off-set a much larger cost to the public. Car insurance, like health insurance provides a method with which to cover expenses that is streamlined and does not burden the public with massive and unnecessary costs.

It seems simply as if this plan will do nothing but keep the insurance companies in profit. As is already the case, services will get scaled down while premiums will rise. To specifically state in a law that we must purchase this item or get financially penalised (pay for it in punishment) or qualify for "free" care or... what...?... gtfo? I rarely agree with talking heads, but this particular concept really does seem to be a tax for breathing.

The insurance companies were bringing in massive profits long before the health care reform bill. Some of the greatest opposition to the health care reform came from their lobbies. The hundreds of millions of dollars they dropped are part of the reason there is no public health option. They also made money through collecting premiums and then denying needed treatments, or by denying people with pre-existing conditions to maximize their intake, or by charging massive premiums to those same people. Most of these practices have been curtailed in the reform bill. While I would greatly prefer to have a low-cost public option, I'll take what I can get, it's still less expensive, and damaging to the public trust then paying out the cost of emergency treatment to the uninsured. I suggest you read my post again, because I'm not sure you understand who pays the cost when the uninsured go to the emergency room.

I had previously tried to come up with a workable public and private option, but the more I run down the concepts the more I see the worst doctors and services restricted to public and the better doctors and services will be only available to the private companies. This idea would only exacerbate this problem to a large degree imo.

Health care reform as it was initially proposed contained a workable public option. It was excised from the bill because the Democrats were too politically cowardly to get it through. I'm not sure how you came up with this fantasy "run-down" of yours. People with public health systems such as medicare routinely get the best care in this country, why? Because health care providers know the government will actually pay the medical bill. They don't have to pre-approve treatments, or go through lengthy pre-screening processes on the off chance that the insurance company will suddenly deny the claim or drop the patient, they can do the treatments as needed and charge the government later. Nobody is talking about taking over doctor's offices, forcing doctors to take unpaying patients, or setting quotas on doctors. In fact, having this system in place encourages doctors to help the poorest patients because they have a much better change of getting revenue.

 

[kenandkids]

Then you completely missed the point of the example. It had nothing to do with choice of driving or with choice of living, it had to do with the requirement to purchase insurance to off-set a much larger cost to the public. Car insurance, like health insurance provides a method with which to cover expenses that is streamlined and does not burden the public with massive and unnecessary costs.

I didn't miss the point at all. If car insurance were something that all people had to pay to offset the cost it would be a relevant example.



[quote}The insurance companies were bringing in massive profits long before the health care reform bill. Some of the greatest opposition to the health care reform came from their lobbies. The hundreds of millions of dollars they dropped are part of the reason there is no public health option. They also made money through collecting premiums and then denying needed treatments, or by denying people with pre-existing conditions to maximize their intake, or by charging massive premiums to those same people. Most of these practices have been curtailed in the reform bill. While I would greatly prefer to have a low-cost public option, I'll take what I can get, it's still less expensive, and damaging to the public trust then paying out the cost of emergency treatment to the uninsured. I suggest you read my post again, because I'm not sure you understand who pays the cost when the uninsured go to the emergency room.[/quote]

I suggest you reread, because I wasn't arguing with you. As I said earlier, I'm not addressing the whole of the healthcare topic, only this seemingly ill-conceived law. The reform bill had many positive aspects that nearly immediately hit the cutting room floor. Many of these would have helped alleviate the cost to the public.

Health care reform as it was initially proposed contained a workable public option. It was excised from the bill because the Democrats were too politically cowardly to get it through. I'm not sure how you came up with this fantasy "run-down" of yours. People with public health systems such as medicare routinely get the best care in this country, why? Because health care providers know the government will actually pay the medical bill. They don't have to pre-approve treatments, or go through lengthy pre-screening processes on the off chance that the insurance company will suddenly deny the claim or drop the patient, they can do the treatments as needed and charge the government later. Nobody is talking about taking over doctor's offices, forcing doctors to take unpaying patients, or setting quotas on doctors. In fact, having this system in place encourages doctors to help the poorest patients because they have a much better change of getting revenue.

And here you make it seem as if you intend to argue, whether or not someone is agreeing or disagreeing. I never made any claim that someone is taking over doctors offices. As for my "fantasy" it wasn't in regards to the current system, as it should have been obvious. You might want to read the news however, about such things as prescription costs and "part d" that are proving to not be anywhere near as helpful to people on medicare as you seem to think.

 

[Mapp]

I didn't miss the point at all. If car insurance were something that all people had to pay to offset the cost it would be a relevant example.

But everyone DOES pay to off-set the cost. That's exactly the point I was making in both cases. Your tax dollars go to paying the costs of court, the cost of road repair, and would likely go to pay the medical expenses of either or both drivers if they were not insured. That's why we make insurance mandatory for drivers. If you don't think you're invested, then you aren't checking your paycheck stubs. The reason we only charge car owners insurance is because they're the ones taking the risk of ownership, and because of the structure of liability that comes with that. In the case of health insurance, everyone uses the medical system, whether they have insurance or not. The burden is shared by everyone who could potentially incur a loss to the public health system, thus the need for a universal system to mediate the costs, provide for avenues to wellness through doctors visits, and coverage for long term care. In BOTH cases, everyone pays when the uninsured incurs damage, in the case of health everyone contributes on both sides of the equation.

I suggest you reread, because I wasn't arguing with you. As I said earlier, I'm not addressing the whole of the healthcare topic, only this seemingly ill-conceived law. The reform bill had many positive aspects that nearly immediately hit the cutting room floor. Many of these would have helped alleviate the cost to the public.

I read your post fully, you were making an ill-conceived argument that this law aided the insurance companies, here is the relevant quote:

It seems simply as if this plan will do nothing but keep the insurance companies in profit.

While it is certainly true that mandating insurance would give companies more clients, that is not the same as aiding them. Keep in mind that the business model of insurance companies has traditionally been to only cover the healthy and do whatever possible to avoid covering the sick. Forcing insurance companies to actually do what's in their mission statements and help the sick and injured cuts into their profits quite a bit. It means that insurance companies can no longer drop those with conditions that require long-term expensive care. It means that people with Diabetes for instance, aren't tied permanently to jobs they can't retire from, because the moment they do, they would lose their insurance plans, since private insurers don't make a profit by picking up someone with pre-existing conditions. It means that insurance agents don't go combing through your medical records for undeclared previous conditions, like chronic acne, for an excuse to drop your coverage if you need an operation. It's why they've opposed the legislation so vigorously. If you're arguing that a public option would be a better system than both the pre-reform system and the current system I can not agree more with you. Nonetheless, allowing people to get medical treatment while uninsured has caused a hemorrhaging of tax payer money that can not be allowed to continue.

And here you make it seem as if you intend to argue, whether or not someone is agreeing or disagreeing. I never made any claim that someone is taking over doctors offices. As for my "fantasy" it wasn't in regards to the current system, as it should have been obvious. You might want to read the news however, about such things as prescription costs and "part d" that are proving to not be anywhere near as helpful to people on medicare as you seem to think.

Your previous post was largely contentless so I was trying to head common arguments off at the pass. You made the fallacious statement that the worst doctors and services would restricted to the public sphere. That's not an accurate picture now, it wouldn't be the picture under a public system, and it's not even remotely true under the current, compromised bill. I suggest if you want the facts you stop watching the news, especially news whose sponsers include Glaxo Smith Kline or Pfizer and actually look at the data. Medicare rates consistently higher than any private insurance plan in the Consumer Assessment of Health Care Providers. Even in Part D, where the government is not allowed to negotiate prices with drug companies, thanks to the vigorous buying of Congressmen, the AARP reports an 85% satisfaction rate with the plan. The individual horror stories about Part D that play on the news don't portray an accurate picture of the vast majority of Americans experience with Part D. In fact, the "Donut Hole" problem of Plan D is just as common with basic private insurance plans, such as the one my wife is currently on.