Insurance mandate: Should the healthy pay for irresponsibility?

[The T]

Health care is not the same as insurance. It is possible to get decent routine & preventative care without an expensive health insurance policy.

Key.

 

[The T]

Hell yea....screw em

Not having healthcare is poor planning on their part. Blew the money they could have spent on healthcare on beer, cigs and chicken wings. Americans are soooooo dumb. Why didn't Obama think of that chicken wing thing to fund healthcare?

Hell yeah!
Let's reward poor planning by bailing out not just companies but individuals that engage in bad decision making and we'll punish the prudent by taxing them to pay for it all. That'll encourage people to act prudently. Right?

Right you are Rabbi

These morons shouldn't spend money for luxuries like rent, heat and food when they could be paying off a $15,000 doctors bill. Its poor planning on their part

You treat all healthcare as catostrophic. it isn't. Nice strawman though...

Sing with me now...

...if I only had a brain...

 

[The Rabbi]

Hell yea....screw em

Not having healthcare is poor planning on their part. Blew the money they could have spent on healthcare on beer, cigs and chicken wings. Americans are soooooo dumb. Why didn't Obama think of that chicken wing thing to fund healthcare?

Hell yeah!
Let's reward poor planning by bailing out not just companies but individuals that engage in bad decision making and we'll punish the prudent by taxing them to pay for it all. That'll encourage people to act prudently. Right?

Right you are Rabbi

These morons shouldn't spend money for luxuries like rent, heat and food when they could be paying off a $15,000 doctors bill. Its poor planning on their part

What kind of country makes poor people spend money on rent heat and food? Darn. We need programs to pay for those things. We can call them "Section 8" and "WIC" for starters.
Oh, wait a minute.

 

[rikules]

Many Democrats are arguing that an insurance mandate is necessary so that everyone will be forced to get health insurance. This is for the sake of cost sharing; nowadays, for instance, many consumers are looking to tighten their belts and find savings everywhere they can. One bet many poor healthy people have made is to not get health insurance because they won't need it enough to justify the cost. Insurance companies lose many of their healthy subscribers, so they lose profit; as a result, those who are too sick remain on the plan, but for the company to offset its losses, it has to increase premiums. This is probably what caused the recent 39% premium increase Anthem imposed in California (statehealthfacts.org/profileind.jsp?ind=346&cat=6&rgn=6). A mandate will prevent the possibility of this happening in the future; people will have to get insurance even if it would not be economically rational, and insurance companies get more profit.

I have two main disagreements with this:

• Healthy people should not have to pay for sick people directly because sickness is often caused by poor lifestyle behaviors. If some people make poor decisions about their health, others (the healthy who would be forced to get insurance for cost-sharing) should not be forced to pay for it. Call me heartless, but I think if you eat so much that you're 300 pounds and need coronary bypass surgery or something, you should be the one to pay for it. It's basic personal responsibility.
• The government has no imperative to force citizens to buy something simply so that an industry can make more profit. Without the mandate, the people in need will disproportionately desire health insurance more - but that's how it is for every single other good and service the market provides. It's not unfair to the companies, they're voluntarily providing a service (hopefully) and others are voluntarily choosing to purchase that service or not.

Firstly, the healthy should not have to pay for those who make bad decisions and make themselves sick or require expensive surgery or drugs. Of course, there are many ailments which are not caused by negligence, but many are. For instance, eating at McDonalds every other day, or taking the elevator up to the 2nd floor, or using a motorized lawn mower you ride on, or not exercising, etc. Recent advances in technology and manufacturing have increased our ability to stay inactive or to buy cheap, unhealthy goods. You can see the effects of thsese things today:

Obesity:
upload.wikimedia.org/wikipedia/commons/c/c1/USObesityRate1960-2004.gif
2/3 of all Americans are overweight.
1/3 of all Americans are obese.

In 2018, the cost of obesity at a national level is projected to be $1,425 per person. Source: americashealthrankings.org/2009/spotlight/cost.aspx"

($1425 per person * ~300 million people = $427,500 million, or $427.5 billion)

Diabetes:

If nothing is done, the number of Americans with diabetes will nearly double in the next 25 years and spending on the disease will nearly triple, a new study shows. ... By 2034, as many as 44 million Americans will have diabetes, up from 23 million today, according to the new projections, published in the November issue of the American Diabetes Association journal Diabetes Care.

The cost of caring for diabetes patients is projected to rise from $113 billion to $336 annually, before adjusting for inflation.
Source: medicinenet.com/script/main/art.asp?articlekey=108138
Medical Journal Source:care.diabetesjournals.org/content/32/12/2225.full

Alcoholism:

• Percent of adults who were current regular drinkers (at least 12 drinks in the past year): 50
• Number of alcoholic liver disease deaths: 13,050
• Number of alcohol-induced deaths, excluding accidents and homicides: 22,073

Source: cdc.gov/nchs/fastats/alcohol.htm

The bottom line is that poor lifestyle choices are a significant cause of much of our extravagant health care spending. These poor choices should not be subsidized by unrelated third-parties (the healthy) - it creates a moral hazard. People are more likely to make bad decisions if they know others would pay for potential consequences.

Secondly, even if the lack of a mandate gives a company greater cost pressures, that's no reason to interfere with the market simply for the sake of providing the company more profit. We don't force corporations to operate at a loss; why should we force some consumers to operate at a loss (be forced to buy insurance)? This would simply be a giveaway to the insurance companies. They're already making billions of dollars in profits; why should the government interfere simply to give them more, hurting healthy citizens in the process?

Of course, there is one caveat applicable to both of these, which is that some sicknesses are not caused by risky behaviors. It would be quite difficult to fairly and consistently separate those responsible, and given that reducing costs is one of the main reasons for health reform, I don't see a solution, other than the following:

There is also the idea that, whether or not one is responsible for one's ailment, the state nevertheless has a duty to help out financially. While this may have philosophical merit, I don't think it's workable here, given that personal freedom is supposed to be one of the main principles of the country, and that cost control is absolutely necessary.

One last argument for the mandate is that some will buy health insurance only when they get sick, decreasing the insurance industry's profits if they decide to carry you. A possible counter is that the firms may be free to deny your insurance application, which would incentivise getting insurance before you need it, for the sake of cost-sharing among the healthy.

What do you think?

"Insurance mandate: Should the healthy pay for irresponsibility? "


No.

in fact, NOBODY should be forced to pay for IRRESPONSIBILE behavior that leads to expensive doctor and hospital treatments.


so

any conservative
who mocks eating healthy as being "PC"
and stuffs himself on fatty foods

hardening his own arteries
getting fatter and fatter
developing heart, back, stomach, liver, kidney problems

or chooses to smoke tobacco and developes heart and/or lung problems or cancer


should NOT recieve ANY $ aid.


NO medicare
NO medicaid.

I do NOT want to pay for the irresponsible behavior and lifestyles of people TOO IRRESPONSIBLE to be responsible for their own health.

 

[RationalAltruis]

Because he's still going to get surgery for that crushed femur. His bill will never be paid, and the hospital will subsidize that cost by spreading it among paying customers.

Oh, I get what you're trying to say, you're assuming that he doesn't have the resources available to pay for the surgery. You are aware that hospitals reject patients because of a lack of insurance pretty often, right? Especially when there is a space availability problem as well?

Who would determine "high risk" behavior? Would insurance companies have to weigh and drug test people monthly to see if they are drinking, smoking, or using drugs? Would they monitor food choices or check to see if you mountain climb or do helicopter skiing? How about unprotected sex? That's irresponsible.

And who would pay the health and safety police?

Slippery slope...

I'm not trying to prove that certain behaviors are high-risk and others aren't. There wouldn't be a government panel or anything. All I'm trying to say is that there is a strong correlation between irresponsible health habits and low health; what those habits are and aren't is a different story, but one would imagine that there are a few obvious bad habits, like the ones I listed before, such as chain smoking, alcoholism, lack of exercise, fast food every day, etc.

No one is going to monitor people to see if they are being responsible with their health or not. I am simply trying to establish the fact that there is a correlation between health irresponsibility and low health. From this, even if we don't know what exactly are the precise causal mechanisms, we can conclude that many of those with expensive health conditions nowadays are the cause of their own bad health. I addressed this in the OP:

Of course, there is one caveat applicable to both of these, which is that some sicknesses are not caused by risky behaviors. It would be quite difficult to fairly and consistently separate those responsible, and given that reducing costs is one of the main reasons for health reform, I don't see a solution, other than the following:

As you can see, I'm not trying to separate the responsible from the irresponsible, because of the extreme cost and horrendous invasion of privacy it would require.

So you will allow people to go uninsured until some catastrophe strikes requring medical care. The providers will be required to supply this care. The uninsured will then be billed but because they dont have any money (which is why they dont have insurance to begin with) they can't pay it. SO the state picks up the tab.
And this differs from our current system, how?

Wouldn't they be required to pay what they can? Even someone without health insurance probably has some kind of savings, even if it's not very much.

Insurance companies are already prohibited from canceling coverage when people get sick. What really happens is that (some) people do not honestly fill out their application in the first place. Then they get sick, make a claim, and are found to have not been honest on their application; in that event they are cancelled. The key is to be honest in the first place when filling out the original application.

I was under the impression that many people denied coverage when they get sick usually did fill out their insurance application accurately, to the best of their ability. For instance, someone might not be aware that in some states they have to list domestic violence as a preexisting condition (mcclatchydc.com/2009/10/04/76477/domestic-violence-as-pre-existing.html ) . The legalese and intricate contracts make it not inconceivable to think that even a normal person could easily screw up on one or two lines, or omit something the company thinks they should have put there, and as a result have their claim denied when they get sick.

Blaming the sick.

How funny you assholes are.

I am not blaming the sick as a whole. I specifically disclaimed this when I said

Of course, there is one caveat applicable to both of these, which is that some sicknesses are not caused by risky behaviors. It would be quite difficult to fairly and consistently separate those responsible, and given that reducing costs is one of the main reasons for health reform, I don't see a solution

I still think a public option of some sort would be the best way to ensure everyone has access to health care, but unfortunately it seems to be pretty much dead.

Its just so funny to see all the Rs beat to hell the ideas of jesus.

FYI, I'm not a Republican, have never been, and never will be, at least until there's a major party reallignment. Don't associate me with them.

They could fix this easily. Allow people to exempt themselves from mandatory insurance on the condition that they will then not be covered by the new laws requiring insurance companies to insure anyone regardless of pre-existing conditions.

Government has no business in dictating anything on behalf of those that FAIL to preparethemselves for LIFE. Health Insurance isn't mandatory, and nor should it be. Especially by ANY law coming out of ANY Government entity.

Should bank accounts? Savings be mandatory by LAW? (Other than Socialist Security...which is a failure in it's own right)?

WHY do you hate your own Liberty? And what's up with the government 'Allowing' anything? It isn't NOR ever was theirs to 'Allow' to start with.

The government forces me to protect myself by taxing me to fund defense, law enforcement, the courts, food safety, workplace safety, clean water, clean air, truth in advertising, banking regulation, and on and on.

Let's not pretend that mandating something has suddenly appeared magically out of nowhere.

The difference is that mandating taxation for "defense, law enforcement, the courts, food safety, workplace safety, clean water, clean air, truth in advertising, banking regulation, and on and on" is for public goods. Everyone benefits from stuff like that. However, mandating personal insurance is personal; it's not a public good. That's why I think it should be primarily a personal responsibility, at least as long as the government is up to its ears in debt and can't afford to pay for much more.

Why should "I" pay for someone elses kid to be educated?

Shouldn't these ignorant lowlifes save up the money to educate their own kid? If they would rather spend their money on plasma TVs, Escalades and Ipods than their kids education, that is their problem not mine

If they don't have the money in the first place to educate their children, their children won't be educated, and as a result won't have a high-paying job, and as a result won't have money to pay for THEIR children's education. It's a self-perpetuating problem, and can only be resolved if they can get financial resources to pay for education or education itself.

 

[RationalAltruis]

There should be a declaration of an “open season” for applying. During this “open season” everyone gets insurance as a part of the whole pool with the same rates as the whole pool. There would be a 3 or 4 or 6 month sign-on period, say from January to April or January to June. Or there could be sign-on period dating from one’s birth-date, which might make more sense. If they signed up during their “open-season” they would have the same rate for any deductible as any other person in their group.

That would imply that someone who's physically fit, eats healthy food, and doesn't smoke or drink would be paying the same rate as someone who's fat, goes to McDonalds every day, and chain smokes and gets drunk every night. That doesn't sound like a fair distribution of costs, given the potential difference in responsibility.

Health care is not the same as insurance. It is possible to get decent routine & preventative care without an expensive health insurance policy.

This too is a very important concept few have wrapped their minds around. Many people think that they should get comprehensive health insurance coverage if they can afford it at all; this is untrue, especially for those in good health. High deductible policies are often cheaper and more economically rational for some people.

 

[Cuyo]

Healthcare is a life and death issue , why do some LIE to pretend its a luxury?

It's a responsibility of the INDIVIDUAL. NOT the rest of Society.

Some of you need to get up off yer asses and learn this.

So do you condone denying care, including emergency care, to non-payers?

Lets hear someone who does. If not, STFU and get on board with single payer.

 

[The T]

Healthcare is a life and death issue , why do some LIE to pretend its a luxury?

It's a responsibility of the INDIVIDUAL. NOT the rest of Society.

Some of you need to get up off yer asses and learn this.

So do you condone denying care, including emergency care, to non-payers?

Lets hear someone who does. If not, STFU and get on board with single payer.

Right Now the LAW says that no one is denied asswipe. And it isn't what I said shithead.

 

[Cuyo]

It's a responsibility of the INDIVIDUAL. NOT the rest of Society.

Some of you need to get up off yer asses and learn this.

So do you condone denying care, including emergency care, to non-payers?

Lets hear someone who does. If not, STFU and get on board with single payer.

Right Now the LAW says that no one is denied asswipe. And it isn't what I said shithead.

I know. That's the point everyone seems to be missing. You agree with me, yet you call me names.

Prices will not come down until you either get the non-payers insured somehow, or get them off the teat.

Sure there's a few things you could do here and there for a few percentage points, but that's small potatoes.

 

[The Rabbi]

So do you condone denying care, including emergency care, to non-payers?

Lets hear someone who does. If not, STFU and get on board with single payer.

Right Now the LAW says that no one is denied asswipe. And it isn't what I said shithead.

I know. That's the point everyone seems to be missing. You agree with me, yet you call me names.

Prices will not come down until you either get the non-payers insured somehow, or get them off the teat.

Sure there's a few things you could do here and there for a few percentage points, but that's small potatoes.

Actually that isnt the problem.
The problem is Medicare, which reimburses at less than cost. That cost must be made up by private insurers and private payers. And Obama wants to CUT Medicare to make his numbers add up. That makes the problem worse, not better.
And prices will not come down until people have to shop for their own care, rather than having their insurers write the check. Ever ask your doctor how much the medicine he is prescribing costs? They have no idea.

 

[The T]

So do you condone denying care, including emergency care, to non-payers?

Lets hear someone who does. If not, STFU and get on board with single payer.

Right Now the LAW says that no one is denied asswipe. And it isn't what I said shithead.

I know. That's the point everyone seems to be missing. You agree with me, yet you call me names.

Prices will not come down until you either get the non-payers insured somehow, or get them off the teat.

Sure there's a few things you could do here and there for a few percentage points, but that's small potatoes.

First? Get the Fed Government Camel's NOSE out of it. It is NONE of their business if policies carry over into other States. And i'd like to see States band together in a coalition to see it happen. (HSA's to be precise).

Second? Call off the Lawyers. TORT. Loser PAYS. Doctors for too long have been under the point of a gun held by Lawyers,and those the Lawyers PAY (Politicians) and why their Insurance rates are so high for Doctors to even practice.

Get those two things ironed out? Then we may speak to the rest. But the first is to get Government the Hell out. Real Free-market solutions will ease the tention.

The Consumers will see to it by their shopping/buying to what suits them best. NOT every claim is catostrophic. To hear the Government? Statists? Drones speak?

Every claim is HUGE and cost every claiment their life in dollars. That isn't so. It's disingenuous.

Basic maintenance, planning goes a long way. And that is also up to the individual.

Healthcare is NOT a right. What is a right is the Government, the Lawyers stepping OUT of the way and allowing Commerce to flow naturally as it should.

Healthcare is a Commodity.

 

[Care4all]

my mother in law, fried her food in LARD her entire life....she lived until she was 87.

My old boss was a vegetarian, perfect weight, walked 5 miles every day before he came in to work....he got prostate cancer and after a long battle, he died at 42.

My secretary, was a mother of 2, active and in shape young woman who died of colon cancer at 30 years old....her father had died of colon cancer in his 30's as well.

Life is like a box of chocolates, you never know what you are going to get....

 

[The Rabbi]

my mother in law, fried her food in LARD her entire life....she lived until she was 87.

My old boss was a vegetarian, perfect wait, walked 5 miles every day before he came in to work....he got prostate cancer and after a long battle, he died at 42.

My secretary, was a mother of 2, active and in shape young woman who died of colon cancer at 30 years old....her father had died of colon cancer in his 30's as well.

Life is like a box of chocolates, you never know what you are going to get....

I am assuming some part of that post was relevant in some way.
Yes there are people who smoke every day and die at 90. But insurance is about the probability of something happening. And plenty of people have eaten crap and smoked and died early from terrible diseases. That's what "high risk behavior" means.

 

[DE3]

Healthy people should not have to pay for sick people directly because sickness is often caused by poor lifestyle behaviors. If some people make poor decisions about their health, others (the healthy who would be forced to get insurance for cost-sharing) should not be forced to pay for it. Call me heartless, but I think if you eat so much that you're 300 pounds and need coronary bypass surgery or something, you should be the one to pay for it. It's basic personal responsibility.

It is already that way.



What you are suggesting is that there should be a healthy pool and a sickly pool. How does that change the cost issue in our HC system? It doesn't.

 

[The T]

my mother in law, fried her food in LARD her entire life....she lived until she was 87.

My old boss was a vegetarian, perfect wait, walked 5 miles every day before he came in to work....he got prostate cancer and after a long battle, he died at 42.

My secretary, was a mother of 2, active and in shape young woman who died of colon cancer at 30 years old....her father had died of colon cancer in his 30's as well.

Life is like a box of chocolates, you never know what you are going to get....

I am assuming some part of that post was relevant in some way.
Yes there are people who smoke every day and die at 90. But insurance is about the probability of something happening. And plenty of people have eaten crap and smoked and died early from terrible diseases. That's what "high risk behavior" means.

That's it, and it's education and Responsibility.

 

[Care4all]

my mother in law, fried her food in LARD her entire life....she lived until she was 87.

My old boss was a vegetarian, perfect wait, walked 5 miles every day before he came in to work....he got prostate cancer and after a long battle, he died at 42.

My secretary, was a mother of 2, active and in shape young woman who died of colon cancer at 30 years old....her father had died of colon cancer in his 30's as well.

Life is like a box of chocolates, you never know what you are going to get....

I am assuming some part of that post was relevant in some way.
Yes there are people who smoke every day and die at 90. But insurance is about the probability of something happening. And plenty of people have eaten crap and smoked and died early from terrible diseases. That's what "high risk behavior" means.

dying is a benefit to the insurance companies.

And yes, my grandfather began smoking, according to him, at 10 years old by picking up cigarettes tossed out by others, and smoked until he was 68 and lived, healthily....in to his 90's....he and my grandma even lived in their own home, by themselves. People like my grandfather should not be penalized when they cost the system even less than someone who has inherited type 1 diabetes.....

The whole aspect of the op to me is preposterous, and very authoritarian and certainly selfish and not what i would expect for someone who lives in the land of the free.....don't you think?

Shit happens to some and not others....you could be in a car accident tomorrow, and be hospitalized for a year....or get cancer, even though you are supposedly healthy....some people may smoke, but guess what, they don't have diabetes or breast cancer that runs in the family or they do not sky dive or they are a stay at home wife who is never exposed to the flu or colds as others might be.....the only way Insurance works for both parties, is by spreading everyone's individual risk.....some will ALWAYS be more at risk than you for one disease or another, whether through carelessness or through inheritance or through lifestyle....still doesn't mean that you are risk free or an accident hospitalizing you for a half a year won't happen to you.

 

[uscitizen]

In a self responsible world each one would pay for their own health insurance based on thweir own health and risk factors.
There would be no group health insurance policies.

Seems like Libertarians would be against Group insurance policies and refuse to participate in them based on their principles.

 

[Care4all]

In a self responsible world each one would pay for their own health insurance based on thweir own health and risk factors.
There would be no group health insurance policies.

Seems like Libertarians would be against Group insurance policies and refuse to participate in them based on their principles.

precisely.....

but this is not the case for those who work and have "GROUP INSURANCE" rates available....TRY buying an Individual Insurance policy, last year for Matt and me, in Maine, from Anthem BcBS, $25,000 A YEAR with a $5k deductible, with neither of us with any ailments and neither of us on any medication....which was questions they asked before giving you the price of the policy!


GROUP insurance....having a GROUP to spread ALL the risks out, is OBVIOUSLY the way to go at this point in the game though....

Though your point is well taken....IF WE HAD never gone to an insurance based health care system and had just individually been responsible for our own health care, there would have been resistance in the market to the double digit increases health care services has instituted over the last decade and health care prices would not be as high....PERHAPS?

 

[rightwinger]

Hell yeah!
Let's reward poor planning by bailing out not just companies but individuals that engage in bad decision making and we'll punish the prudent by taxing them to pay for it all. That'll encourage people to act prudently. Right?

Right you are Rabbi

These morons shouldn't spend money for luxuries like rent, heat and food when they could be paying off a $15,000 doctors bill. Its poor planning on their part

You treat all healthcare as catostrophic. it isn't. Nice strawman though...

Sing with me now...

...if I only had a brain...

And thats the key to heathcare. Thankfully, most people only need the basics from year to year. But once you do have a significant episode you are faced with massive bills. My wife spent three weeks in the hospital last year and had a six hour heart procedure. The bill came to over $250,000.
Thankfully, I have the best health insurance in the United States and only ended up paying $15,000 out of pocket. I could afford it without much hardship but many Americans would have been devistated

 

[uscitizen]

In a self responsible world each one would pay for their own health insurance based on thweir own health and risk factors.
There would be no group health insurance policies.

Seems like Libertarians would be against Group insurance policies and refuse to participate in them based on their principles.

precisely.....

but this is not the case for those who work and have "GROUP INSURANCE" rates available....TRY buying an Individual Insurance policy, last year for Matt and me, in Maine, from Anthem BcBS, $25,000 A YEAR with a $5k deductible, with neither of us with any ailments and neither of us on any medication....which was questions they asked before giving you the price of the policy!


GROUP insurance....having a GROUP to spread ALL the risks out, is OBVIOUSLY the way to go at this point in the game though....

Though your point is well taken....IF WE HAD never gone to an insurance based health care system and had just individually been responsible for our own health care, there would have been resistance in the market to the double digit increases health care services has instituted over the last decade and health care prices would not be as high....PERHAPS?

Had we always had individual risk insurance policies, the healthcare industry would be about 75% smaller now. It would also be cheaper.

Our childhood mortality rate would be the worst in all the developed countries, etc.