As a person who has never bought health insurance, I am really not qualified to talk about it. I don't know the details, such as the price and the type of coverage, that are agreed to when a person buys health insurance. I don't know how insurance companies operate in industry or about their relationship with hospitals. I've also never been seriously sick or injured (thank God) so I have only a vague idea of how hospitals work. I don't know about how they hire doctors and nurses or how they go about charging their patients.
So now that I've convinced you to immediately discount everything I say, let me begin. As far as I see it, I should be allowed to buy health insurance from a company if I want to. I should also be allowed to not buy health insurance if I don't want to. Free country, right? I make a choice and must live with the consequences. I should be free to choose to give a company money periodically with the reservation that if I fall ill or become injured, that company must now pay my medical bills. I like to think that I would do this if I could afford it. I like to feel secure and I imagine that this would give me peace of mind.
If it were to happen that I could not afford the health insurance, that's tough. Maybe I should work very hard at my job so I can eventually afford it. But does our free market economy work in this particular market? I see no reason as to why it shouldn't. The health insurance companies want to insure as many people as possible; more customers means more profit. This means that they will seek to offer the lowest prices they can (while still making a profit) in order to become more appealing to the consumer than the other health insurance companies. This mentality drives prices down to something that most people can afford. Also, if health insurance becomes too expensive, fewer people buy it which compels the company to reduce the price.
Now I know all the liberals will be up in arms at this point saying things like "But the poor deserve health insurance too!" and "The health care industry is horrible, denying coverage to the sick," and things like that. I agree that it is sad when a sick, poor person cannot get the health care they need. There should be certain cases in which the government steps in and pays for the health care of the sick, poor individual. But there are also cases when the government should not step in to foot the medical bill.
Let's imagine a man who had the means to buy health insurance, but enjoyed and exercised his freedom to not buy it. Then he got sick and had to pay for all of his medical bills on his own. Now he has no money but still needs more medical treatment. Should the government pay for his treatment? Ehhh, I don't think so. He made a choice to not have health insurance and now he's reaping the (incredibly dire) consequences. It's sad, but comes with no cost to the taxpayer.
Now let's imagine a man who does not have the ability to buy health insurance. What happens when he gets sick? Well, if he didn't have the means to buy health insurance because he was lazy and didn't work, then he's outta luck and the government should not pay for his treatment. But say he's poor because he honestly couldn't find a job. He'd been out of work for several years after losing his job. He tried applying everywhere: all the companies in his particular industry, in related industries, local restaurants, even McDonalds. Then he got sick and couldn't pay for his treatment.
Here I'm torn. Part of me says that life is tough and the average Joe American should not be forced to pay for the health care of this guy who can't pay for it himself. It sounds mean, but in a truly free country, I should not be mandated to help him out. Now if he came to me personally and asked for help, maybe I would. Maybe I wouldn't. But either way I should not be forced to pay for his treatment.
But then another part of me says that we, as a moral and civilized society, should be mandated to pay for his health care. This part of me says that I should not oppose a tax that goes to help this man pay his medical bills. If this man would die without the care, we are obligated to pay for it. In this scenario, I'm being forced to pay for his treatment (a negative, losing a small bit of freedom) but I've allowed him to be healthy and continue his life (a positive, hooray for humanity).
So where does the role of the government lie? Could the sick, poor people make appeals to their community instead, sincerely asking for help with their medical bills? Would the community help? Or do we need a federal mandate that makes us all be "good" citizens and help the sick and the poor? What if I'm an asshole and don't want to help? Does the government have the right to tell me that I have to? I am unsure of where I stand in the case of the poor person who never could afford health insurance and eventually got sick. Leave a comment and try to convince me either way.
In the end, I'm always wary of government intervention in the economy; I'm afraid of an overly powerful government.
Maybe instead of imposing a tax to care of sick, poor people we could do something that would lower the price of medical treatment. Is that possible? Someone with more expertise in the medical industry could chime in here. Is there any way, even through government intervention, to lower the number on the average patient's hospital bill? Maybe this way more people would be able to afford their own care. I don't know; I'm just thinking out loud.
So this post addresses a more theoretical topic in regards to a government's right to tax and to provide health care to its citizens. I imagine my next post talking about the real-life example of Obamacare, its constitutionality, states' rights, etc. I have had an ongoing conversation with a friend of mine in which we argue about these topics. I have asked him if he wouldn't mind me posting some of our emails to eachother that I think would enlighten the discussion. Hopefully he gets back to me soon. I'm also thinking of writing a post about this same topic but from a very different perspective; I have a close friend who takes a vastly difference stance on this topic than I do and I want to try her argument on for size. No matter what's next, I'm sure there will end up being many posts about health care, so get ready.
Please comment below with thoughts or questions. I wanna know if you think I'm crazy, rational, ignorant, informed, uncaring, right-on, or a mixture of several.
Since no one had the guts to say that health care is a privilege, not a right, we have to deal with the fact that everyone demands health care and now we have to figure out how to pay for it with out bankrupting our nation or destroying the high caliber of care. Oh, wait, you can't. Pick one or the other- universal care will drive America into the ranks of the third world due to its drain on our economy or the American health care system will atrophy and provide the level of care no one will want.
ReplyDeleteIt is so sad that we have to pay for things The price for medical care for every man, woman and child for their entire lifetime is not doable. The best solution, although not perfect is to let the free market work with out interference from the government. It is the only way to get the best coverage for the most people.
The government couldn't efficiently handle cash for clunkers, you want them making decisions about your health care?
If you seriously needed health care but didn't have insurance, the American people would not be comfortable letting you die. That's simply a fact, and we should take it as a given (even Ron Paul was unwilling to say that he'd let someone in that situation die). Thus, when you choose not to buy insurance, you're (stochastically at least) imposing a harm on others.
ReplyDeleteAs to your defense of the free market in health care, you should note that there are massive market failures in the market for individual (non-group) health insurance, mostly due to adverse selection. I don't really have the energy to explain that, but I figure that Wikipedia does a pretty good job.
As to your aside proposing simply making health care more affordable, I completely agree. I would also like to shit rainbows and win the lottery.
If you really want to learn about how health care works in the U.S., I suggest you take the Health Econ class. I think it's 14.21--or 14.12, I forget.
"If you seriously needed health care but didn't have insurance, the American people would not be comfortable letting you die."
DeleteI bet there's at least one American person who would be comfortable with it. Does the federal government have the power to make him help too? And if the American people would not be comfortable letting you die, why do we need the government to force us into not letting you die. The people would help on their own, right?
"Thus, when you choose not to buy insurance, you're (stochastically at least) imposing a harm on others."
I'm not sure I understand this. Are you saying that by not buying health insurance, there's a decent probability that I get sick and then the taxpayer pays my medical bills? The "harm on others" is the tax imposed on the taxpayers? You know what would solve this? Not obligating the taxpayer to pay for the medical bills of people who didn't have insurance (like I explain in the 5th paragraph).
So adverse selection causes market failures? When did companies lose the right to refuse coverage to high risk individuals? If I'm a health insurance company, I'm trying to make a profit just like any other company. If a person comes to me and says "I want to buy insurance from you," I would assess how "risky" this person is. Wikipedia uses the smoker example. I would charge more for health insurance on the smoker than I would for the non-smoker. I should be free to do that right? If either person feels the price I set is too high, they are free to not buy the insurance.
This leaves a certain percentage of the population uninsurable by private companies because of preexisting conditions which means they are very high risk. I wonder if these people have ever had insurance before. If they did, why isn't the insurance company paying for their medical bills? If they have never had insurance, refer again to paragraph 5.
Sorry for making a naive suggestion about a potential solution to the problem. That was real stupid I see now, as you so gracefully pointed out.
I'll definitely look up the class. Thanks for commenting, Lucas!
Owen, you're actually proposing a coherent health care reform. Make health care a free-er market, and hold fast to market outcomes--i.e., let uninsured people die.
DeleteThe point that I'm trying to make is that, in general, the American people are not comfortable with that outcome. Getting rid of Obamacare would not bring us to your desired outcome; it would just maintain the broken status quo, where freeloaders can impose a cost on the rest of us.
My understanding about people with pre-existing conditions in the individual market: I believe that you effectively have to renew these policies every few years. So if you *develop* a pre-existing condition, you're out of luck.
Are you being sarcastic in your first paragraph? If the American people, in general, are not comfortable with letting the uninsured die, then they can act without government intervention, right?
DeleteWho are the freeloaders right now and what cost are they imposing on the rest of us?
Regarding your understanding of people with pre-existing conditions in the individual market, this has to do with the type of agreement between the individual and the health insurer. Being as I've never bought my own health insurance, I feel unqualified to speak about it.
Thanks for keeping it interesting!
Regarding your first paragraph:
DeleteI'm not arguing that they have the *right* approach. Only that Americans will demand a health care system in which young people don't die simply because they don't have insurance. The problem is known as the "Samaritan's Dilemma."