Single Issue Voter: Mandate-Shmandate
Posted by seed @ 12:47 PM
With auto insurance, at least there is a reasonable argument that a well-enforced mandate could reduce insurance premiums. When many motorists are uninsured, those who do buy insurance need, and are sometimes required, to buy coverage for damage done to their vehicles by the uninsured. So when the uninsured become insured, others' premiums could fall. But this argument simply doesn't fly in the case of health insurance, because (as already noted) uncompensated care is such a small fraction of overall health spending. Furthermore, more than 85 percent of uncompensated care is paid for by governments, not by private insurance. That means less than 15 percent of uncompensated care -- less than half a percent of all health care spending -- contributes to higher private insurance premiums.
None of this means that the uninsured are not a problem. But the problem is not that they cost the rest of us too much. One reason uncompensated care is such a small fraction of health care spending is that uninsured people simply get less health care than others. (Though they do get some; health care and health insurance are not synonymous.) So if the real concern is making health insurance and health care available to those in need, we should focus on health care prices and insurance premiums.
You know, a federal mandate for ass-wiping isn't going to keep me fresh either... crap.
Comments
The probelem with your numbers is that it does not account for those who had to declare bankruptcy because they couldn't pay their outstanding healthcare bills. Of course, those numbers are out of date because thanks to Bush Co., health care debts are no longer relieved by bankruptcy,.
In addition, you have people--like me-- who have seen their health care costs baloon at a rate that far outstrips their earning power. 10 years ago, if my daughter had developed leukemia, it would have been a minor financial inconvenience. I would have been able to pay what was not covered by my insurance.
5 years ago, my deductables and coverages rose to the point where I would have had to declare bankruptcy because I would not have been able to make the co-pays.
Now, I would simply be fucked. I will lose my house, and my pension if I try to treat my daughter beacuase bankrupty is no longer an option. Hell, last winter I had to take both of my kids to the urgent car center because their pediatricians office was closed on that day and it cost me $150. They tried to bill me $5k, but I won the appeal. Luckily, I have a job that has enough fuckoff time to fight it.
Our healthcare system is fucked. When you have kids, you'll understand.
Posted by: ~Easy | September 19, 2007 8:30 PM
Easy,
You are absolutely correct, insurance premuims are through the roof. And, bullet-proof coverage is hard to come by. No arguments from this rider on any of that.
But that is exactly what's wrong with any mandate from Uncle Sam. If the goal is to reduce the premuims this will have little effect. The integral part is what type of coverage is required. Until that's decided this is feel-good campaign rhetoric. Of course, deciding the what will open the doors to even more special interest lobby in DC. Do you think chiropractors should be included in the mandate? How about optomologists? Invitro? Dentists? Accupuncture? Hair transplants? Viagra? Where does that end? What a mandate does is open the flood gates of Federal cash to the medical industry. Essentially, instead of a single-payer, you have a mega-payer. The difference is slim.
More to the point, what does this do to reduce the premiums? The mandate will require insurance companies to make larger payouts to the newly included mandated services. The Fed will make some of that up, but as it always does, the higher costs will be passed on to the consumer. Low risk patients, those that are healthy and have minimal health care costs, will be faced with a higher premium that isn't worth their investment. So, the mandate can encourage drop-outs. Which means the pool of payers that are intended to share the burden will shift closer to the upper end of the curve.
The issue with our healthcare is the fact that it's not in out control. As a by-product of previous legislation, wage controls, employers began to include benefits as incentives to employees. Employers got tax incentives, another layer of legislation, for paying part of the employees premuims. Now, you have a choice of whatever your employer can get you, or going it alone and footing a post tax premium. We've had this conversation before.
Now, in regards to your comment about the revisions to bankruptcy legislation and bushco... ehh, off topic. Not to be a dick, you don't fix healthcare buy adjusting who can and cannot throw in the financial towel. I know this shit's expensive. I just elected to have a six-foot garden hose shoved up my ass for about $2k, out of pocket. My wife has RA and, though she does benefit from prescription coverage, she meets our high family deductible in no time. If we could use an HSA to get a tax break on those routine expenses, now you're talking. If I could deduct my insurance premiums pre-tax, even better.
If the goal is to get more people into the loop, how about lifting state restrictions on insurance plans? Currently in IL, we are arguing about cable television broadcast restrictions. WTF? We want as many options as we can get in entertainment, but as far as healthcare goes - fuck it, sign me up for whatever Uncle Sam has on the menu. The difference is that TelCom is easy to gang-up on, while healthcare is impossible to vote down. See also: Pro-War Protesters.
My issue with this type of policy is that it's tee-shirt politics at it's best. Mandating healthcare for all sure makes people feel good. The silver of pie that it affects hardly lives up to it.
Posted by: seed | September 19, 2007 10:08 PM