Fred is 20 years old, healthy and uninsured. Should he have the right not to buy health insurance? This is the question that the courts first considered earlier this month, an issue that will ultimately decide our ongoing health care reform battle.
On its face, such a question seems easy. Of course, Fred should be allowed to do whatever he wants. It’s a free country, right? Anything that takes this choice out of his hands is a stripping of a freedom, a move toward “big government intrusion.” Much of America has expressed this feeling in regard to health care reform. And this is not something to trivialize. It’s an understandable feeling.
But Fred’s freedom deserves a little scrutiny, too, because it is without a doubt, his “freedom to freeload.” If Fred has the “right” to avoid paying for his own insurance, then he is guaranteed the freedom to transfer his future health burdens from himself to everyone else. He can tell the rest of us, “When I get hit by a bus, when I get sick, when I grow old and need help, I’ll expect you to pick up the bill. Because that’s my right.”
Now, if Fred was left in the mangled car and never transported to the hospital, if he was barred entrance into the emergency room when he was blue in the face and grabbing his chest, then his “freedom” would see its logical conclusion. He made his choice. Now live — or die — with it. Right?
That’s to say, if we choose not to pay for a product, then we don’t expect to enjoy that product. I don’t go to Walmart expecting to be warmed by a new space heater unless I pay for the new space heater.
But health care is different. Even the uninsured have some expectations of service. And unless you are morally lacking, you are OK with that, too, at least to some degree. Imagine the world in which uninsured Fred is left in the wrecked car by EMS as flames come out of the gas tank. Imagine the severely dehydrated 4-year-old of an uninsured single mom turned away from the emergency room because mama doesn’t have a Blue Cross Blue Shield card.
Should this country bar the uninsured from the hospital door? Undoubtedly, this is our only economically sensible position if we don’t have a mandate on insurance. Pay for the product or don’t get served. Simple as that.
However, we recognize that this health care transaction is not as simple as my Walmart space heater purchase. It’s morally wrong to deny care to the uninsured 4-year-old struggling to stay alive. At some point, humanity kicks in over money and politics. Nevertheless, this commitment to basic human rights presents a practical nightmare for hospitals and the health care system in general.
The irony of today’s “socialism” debate is that the American mandate on health insurance was proposed by Republicans in the 1990s in response to Hillary Clinton’s health care proposal. At the time, Republicans touted the mandate as a move toward personal responsibility. Now, they vilify it as a move away from personal freedom.
No real surprise there, because political positions often shift as partisan battles enter new phases. But the ugliness is a constant. We shout and bicker. We hate each other. It is depressing. With all the emotion, it’s easy to be distracted from the practical questions.
But leave the politics out for a minute. Just consider the outlook. Does it make sense for Fred and the millions like him to pay at least small premiums for catastrophic coverage, or should those who already fork over considerable money for insurance pay even higher premiums because Fred and others choose not to put any money down on services many already use and most all will surely need later?
Also, do you think a 2-year-old should be denied health insurance because she’s born with a terrible condition? It makes sense to ban insurance companies from denying children coverage due to God-given conditions. On the flip side, it’s also totally unfair to require insurance companies to accept everyone without first requiring all to have insurance. Otherwise, everyone would just wait until they got sick to get insurance.
We recognize insurance as a way to share financial risk. It is a form of collectivism, and, in essence, a politically acceptable form of “socialism” in America so long as the government isn’t involved. Even Tea Partiers prefer to be a part of a large collective, rather than a smaller one. Because being in a coverage group with 10 is cheaper than being self insured. Being with a group of 100 is better than being in a group with 10. A group of 1,000 is better than 100. You get the picture. So, by the basic economics of insurance, a national plan makes sense. Where does this logical risk-sharing break down? At some point, our politics outweigh the practical application of insurance, which is to divide risk with the biggest group possible. Would the country be OK with a national insurance plan if it was run by a corporation rather than the government? And if it’s “socialism” you truly hate, isn’t it logically consistent to have an individual insurance plan, rather than participating in any risk-sharing collective?
I suspect that it’s not the wide risk-sharing of national insurance — the true “socialism” aspect — that’s the problem for most. It’s the matter of who would be included. No one likes the thought of “freeloaders” getting a piece, even though our current arrangement provides the best deal for freeloaders and the worst deal for those struggling to get by.
It’s worth noting that those countries with national health plans are generally smaller and homogenous. A “melting pot” presents a much tougher political situation for the practical application of national insurance. That’s no indictment on any group. It’s just a political truth.
Anyway, all this will linger on beyond the November elections. A Michigan judge recently backed up the health care mandate as appropriate. But there will be many more such battles and much more gnashing of teeth.
Meanwhile, I’ll try to bite my tongue as I watch so many people who passionately hate freeloading scream for Fred’s right to continue freeloading.
Zach Mitcham is editor of The Madison County Journal
Once the precedence is established, theoretically, there is nothing that the government cannot require us to purchase. It is sophomoric to assume that the requirement to buy health insurance will stop there. If this stands, the proverbial Pandora's Box is now open.
Prepare for this stage setter to be exploited in our courts by the lawyers for many other mandates to come.
By law, you are not required to purchase Social Security "insurance" nor Medicare. These are FICA taxes which are collected from taxable income and your employer. In essence, if you did not work or drive you would not be forced to pay any of these taxes and still be eligible to collect SSI and Medicare upon retirement age or disability. Under NO circumstances could you be exempt from the Health Care "insurance".
The idea is that by the precedence that this mandate sets, the next proposed "good" program that you are required to buy may not be so good for you after all.
Back in the 1930’s we decided that letting elderly folks waste away and die of poor health, cold and malnutrition was unacceptable. We provided Social Security so as to cover those elderly who had no family or friends to care for them and to relieve families from the burden of trying to take care of so many of their own. Then in the 1960’s we decided to provide medical insurance to the elderly, mostly because private insurance companies had to charge so much to cover this group that they wouldn’t even offer coverage to them, so what were old folks to do? Now everyone takes care of everyone’s elderly; this is clearly the fair and moral thing to do.
When I was young, I struggled to make enough money to care for my child and myself. It was almost more than I could do to pay regular taxes, but I really resented money being taken out of my meager paycheck for social security and Medicare because I so needed every penny I was able to make at that time. I did, of course, get some tax breaks (head-of-household, low income, dependent deduction), so I guess it evened out.
At the age of 30 I took in my sweet grandmother, who could no longer live on her own, until she died. Though dealing with Medicare and Social Security is an overwhelmingly trying experience, I saw that it did help my Nanny, and therefore, me. Since then, I have never thought of my ‘payments’ to Social Security as insurance premiums for myself (as they are presented to the public). That money is my moral obligation to take care of elderly folks, as is my forced contribution to Medicare. I am happy to part with that money, especially as I approach a time when I may not be able to take care of myself. Though I have always been personally responsible, especially with my money, it is profoundly gratifying to know that I will get some help from my country in my old age.
So, if one thinks this moral obligation to the elderly is appropriate, then adequate health care for all should fall into a similar category. To think otherwise is simply immoral thinking. As more and more of us are priced out of the medical insurance market, coverage for those remaining gets more and more costly, which in turn, forces even more out to make premiums go up even more, etc., etc. We are nearly at the point where the elderly were in the 1960’s when our government came to the rescue.
For those who would shout “socialism” as if it was some sort of suffocating Boogey Man, I would call them greedy and selfish people who don’t want to do their part. They would prefer to “freeload” on the rest of us until they find themselves unable to pay for what they need. Most people are healthy, especially when they are young, so all these citizens tend to wonder what the big deal is about health care. Like me when I was young, they need their income for other things. They have not experienced the medical industry first hand. Once they do, they will quickly change their tune. It needs fixing big time.
I sincerely believe that very few of us would ask a person having a heart attack if they were able to pay for the immediate medical care they needed before doing something for them. Why would people not do this? Because it is basic human nature to take care of one another for the good of the group. We can solve this complex problem if everyone agrees, fundamentally, that everyone should have adequate health care. How we do it is the hard part, but our President has managed to at least get us started. We should all make an honest and good faith effort to see it through, as quickly and fairly as possible.
You brought up car insurance. Of course, you don't have to buy car insurance unless you get behind the wheel. But we all have to die. And in the process, we will all need health care, whether it's in the immediate or long-term. We really don't have a choice in the matter, because if we collapse on the side of the road, we are cared for, whether we choose it or not. If you want to use car insurance as an example, you can't deny that we are all "behind the wheel," as long as our hearts tick in our chests.
Therefore, the mandate deals with the inevitable followup question: who pays for your care? Can you lawfully shift that cost to me, or should you be required to pitch in? If the courts rule that everyone has the right to avoid personal responsibility and shift their own health care costs to me and others who already purchase insurance, then that is a pretty alarming precedent.
If the courts wipe out the health insurance mandate, I would then say that any mandate on car insurance should also be wiped out. Whether you hit me with your car or your emergency room bill, you're still bumping into me financially. If the courts rule that it's your right to pass the buck, well, so be it.
But I believe such a precedent would be a very sad affirmation of the unwritten "freeloading" precedent that we already have in our health care system, which is crippling us. We have a sick system which must be addressed with healthy diagnosis and care. Instead, our political environment rewards name-calling, political paranoia and paralysis, while punishing sincere collaboration, compromise and problem solving. So how can we fix this? I honestly want to know.
I don't think the Health Care Bill will remove freeloading it will only increase it thru entitlement. Who do we think is going to carry those who say they can't afford it?
Social Security was only supposed to be a temporary thing, until the Fed figured out what a cash cow it was.
Then it just began to spread like the plague.
Where does it end?
I thought Charity came from the Heart ,not the Government.
Aren't there plenty of Mega Church's and other Charity organization's out there?
What has killed the American Spirit?
Why are so many scared they will starve or die if the Government doesn't step in and help?
Granted the Health Care System is in shamble's in this country but before we rush to an Irrational decision shouldn't we exam the reason's why it's in shamble's.
Does anyone remember when Martha Stuart was convicted with insider trading charges.
I found out and interesting fact during that time I bet many don't know about.
That the Government passed Legislation that granted them the right to engage in insider trading with impunity.
Can you say conflict of interest ? Is it possible that they all have a vested interest in the Insurance Industry ?
Might be why they had to Bail out Wall Street and not Main Street.
More Government will never be the answer ,only more of the problem.
When will we ever learn?
Medical care is in shambles. If the private sector could solve the problem, it would have by now. So either we continue to ignore the problem with all its inequities or someone steps in to fix things. That can-do American Spirit has been eaten up with greed and bottom-line thinking. Government is all that is left.
This differs in extreme from the auto insurance issue. An individual is not required to purchase such insurance if they do not own an automobile. Should they purchase a car, they are obligated only to purchase liability insurance so as to pay for damages they may thrust upon others by collision with other vehicles. The individual is accountable for any and all repairs to his vehicle. This differs completely from the health care issue.
As cruel as it may seem, logic demands that an individual not be required to purchase health insurance with the caveat that they receive NO treatment that they do not pay for completely, promptly...with the exception of negotiated payment schedule with a medical facility. If this individual then sees the light and wished to purchase insurance they would have to pay a rate commensurate with their medical history. Insurance companies would be required to make public their offerings for these individuals to choose from. Failure to insure at this point would preclude further health care other than that paid in full at time of service. To do otherwise seriously compromises rational health care for the bulk of citizens.
This leaves those who cannot care for themselves, not only health care, but in day to day living. We see them panhandling on streets, living in shadows under abominable circumstances, and those requiring chronic health and personal care. Government should care for these people, however, their need must be documented and the resources budgeted from funds derived from general taxation.
I cannot see the people of this country accepting such a plan. Sadly, the consequence will be a logically flawed plan that is far more expensive than should be. I would probably lead the charge for such a system should I be unable to pay for a family member's care when necessary!
The problem remains that medical care is beyond the reach of a large portion of our citizens. Premiums are crippling! An aquaintance incurred $80,000 to get care for a badly broken leg. She has insurance (poor value as most policies are) and that money was her portion to pay. She can't work for a long time. She lost her job. Where is Government for her? She was not a freeloader. This does not work!
Public Safety - everyone pays; everyone benefits.
Roads - everyone pays; everyone benefits.
Schools - everyone pays; everyone benefits.
Why aren't some of you who are so concerned about paying for "freeloaders" screaming about paying for all these crazy wars that have bankrupted the good old U S of A? Why are you not willing to help with a fellow American's health care, but you are willing to pay for all these freeloading military contractors Rolex watches?
Healthcare - everyone should pay; everyone should benefit.
Let's stop lining the pockets of those insurance execs, y'all...public health care for ALL AMERICANS. Doggone it, we're worth it! Too many good American lives are being lost. We lose more American lives due to lack of access to affordable health care than we lost in 9/11 every day...EVERY DAY THOUSANDS DIE. Yet some think paying taxes to save lives is supporting freeloaders, but you are more than willing to pay 10 times as much money to support Halliburton's retirement Rolexes! Your "anger" is misplaced. Let's spend that money on HEALTH CARE like TRUE PATRIOTS.
I would sincerely appreciate somebody answering the above questions, in case I am missing something. I really do want to hear the other side of this issue.