Monday, February 04, 2008

A different question on Clinton's mandatory health coverage plan

There's been a lot of discussion about Sen. Hillary Clinton's proposal to mandate health coverage for all Americans, including garnishing wages in order to force individuals to pay for coverage. This New York Times article gives some details of the plan and the potential payments and penalties.

But here's the question that everyone seems to miss in the discussion.

According to the article, "But about 20 percent of the uninsured have household incomes of $75,000 or more, according to the Census Bureau, meaning they presumably can afford coverage but prefer to take the risk."

Why is it never mentioned by the candidates that many people without health insurance make a conscious decision to forego such coverage? And, if this is a decision they've made, why must we force them to have insurance?

The other part of this involves access to coverage. If there are 20% of uninsured who choose not to have coverage, it means that they have access and choose not to take advantage of it. Many younger workers in good health often decide that the cost of insurance isn't worth the coverage that they do not need.

So the issue isn't really that such individuals don't have access to health services or that they cannot afford such health services - they just choose to not enroll.

And I'd wish that any discussion of the 'uninsured in America' would include the fact that some of the 'uninsured' are that way by choice.

Nanny-state proponents object to such a choice. Some justify forced insurance by saying that individuals without health insurance rely upon public funding when they get sick and need more expensive health services. The solution to that scenario is to not allow them such financial assistance. If they choose to back a bad financial decision, they can suffer the consequences. Individual liberty and responsibility demand no less.

In a country founded upon freedoms - including the freedom to make bad decisions - we contradict what made us a great nation when we force people to have insurance (or anything else) they do not want or need. We then compound the problem when we subsidize the costs of that forced service for low-income earners by forcibly taking (via taxation) from others who'd be better off keeping their own earnings to pay for their own services.

When did this concept become acceptable in America?


Unknown said...

If you realize you can not afford it, is it really a "choice"? I think the question should be if it was affordable how many people would opt to not have health insurance.

I don't disagree that there should be some type of an opt out, I do not believe anyone should be forced to pay for coverage. It should also be pointed out that any of these presidential plans dealing with health care would have to be approved through Congress. It's part of the reason why nothing has happened so far, Congress would actually have to agree on a plan as well.

I was re-watching a movie I have on Shirley Chisholm when I was sick and in bed not long ago and it struck me how some of the same issues we are debating now have been campaign promises for that many years that every four years are trotted out with neither side coming up with solutions beyond saying "their idea is better". It really made me think about how much progress have we really made. We've made government bigger, but in the end, what have we really accomplished from now to then...

Maggie said...

Good points, Lisa

But to clarify - my reference to people who 'choose' was to those who can afford to pay, but otherwise don't want to - or have different priorities to which they dedicate their monies.

Many 'poorer' people pay for insurance coverage and go without other things like cable tv, cell phones, etc... because it's important to them.

I believe, as you do, that people should be able to choose. I think that opening up the health care market - similar to the car insurance market - would have a much more positive impact on the situation than anything any politician in Washington could ever promise...evidence shows their 'promises' aren't worth much, as you point out.

Unknown said...

I agree with the premise of choice, I don't disagree as well that even if it was affordable there would be people who would decide they wanted to opt out.

That of course raises questions such as if someone opted out then faced some type of catastrophic health issue what would happen, but I'm sure there would be a way to deal with that better than the present system.

Right Wing Toledo said...

First, a quote from my blog today:

"There is no worse tyranny than to force a man to pay for what he does not want merely because you think it would be good for him."

I think my response would be: "Except to force him to pay for what you think would be good for you."

The problem with an "opt-out" plan is that you would never, really, be able to opt-out. Does anyone think that the level of taxation required to fund a government run health care program would be refunded to those in such a program? More likely, the anyone wishing to opt out would be forced to find healthcare in another country - the doctors and hospitals would become de facto government employees. Medical specialists wishing to exist on private practice (rest assured, moonlighting won't be allowed) will have huge taxes levied on them, a la Great Britian. And, in the end, both the amount and quantity of medical care would be lowered.

But, perhaps, something good would come of this - with doctors now as government employees, lawsuits and judgements would be severly limited - or won't the government provide malpractice insurance? Perhaps this would drive some of the trial lawyers out of business.

Timothy W Higgins said...


The answer here may be simpler than some of the discussion that has gone on would indicate. Going down the path to government health care would simply place us behind such countries as England and Canada, and the failure that they have experienced.

Even with all of the flaws in the current system, choosing a plan that we know will not work does not seem like an alternative.

You put it best at the end. This is a country of freedom (choice) and responsibility. Taking either away is a betrayal of the founding principles of this country.

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