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Proposals in Congress to overhaul the way Americans get health care are — as political observers like to say — moving targets. But one element that all the Democratic versions have in common is that they contain a mandate that individuals buy health insurance. President Obama has likened that to the requirement that drivers buy car insurance. But not everyone is required to drive a car.
And mandates are far from being universally embraced. In Massachusetts, where health insurance mandates have been in place for more than three years, the results appear to be mixed, depending on whom you ask.
As Congress gets closer to debating specific bills on the House and Senate floors, how do you feel about being told you must have health insurance — or else? If you don't have insurance right now, how would the threat of a tax penalty affect your decision to purchase insurance? If you're a health insurer, what do you think mandates would mean for cost and care?
GUESTS:
- Robert Restuccia: Executive Director of Community Calalyst
- Steffie Woolhandler: Co-founder of Physicians for a National Health Program
- Mark Richardson: Dean of the Medical School at Oregon Health & Science University
- Karen Seccombe: Professor of Community Health at Portland State University
Tagged as: health · politics · rx
Photo credit: a2gemma / Creative Commons
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U.S. Americans should not be forced to pay for health care if they don't want it or can't afford it. Let's focus on the problem: health care is non-existent, too expensive, ineffective, and ineffecient for too many of us.
Obama and I (smirk) have advocated that everybody pay a small share so a few don't have to pay a lot, but I add the condition that the services we receive must be beneficial, efficient and reasonably priced. It makes no sense to pay for what doesn't work.
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Individual mandates for health insurance would be a disaster if that were the only health care reform on the table. That’s why Obama rejected the idea when Hillary Clinton proposed it when campaigning for the primaries. The full picture of health care reform includes provisions that may be made more effective by requiring the population to have some form of health insurance, such as lowering costs for health care over time and ending abusive practices of for-profit insurance companies. None of the proposed changes alone would make a huge difference in our health care system, or even be advisable, without the presence of the others.
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I support single payer or a public option. It is the most important component of meaningful change. I am, however, very concerned about the mandate to enroll.
My adult son has a personality disorder that makes his self support difficult. He is often homeless and, even when working, very poor. He has no money to pay for health care. Worse, his paranoia won't permit him to apply for any government assistance of any kind. He has said he will go to prison rather than submit to government health care.
He is, by any rationale thinking, in a no win position, but is also in need of assistance. How will any mandate accomodate people like this?
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Empkae,
Thanks so much for your comment. I'm curious to know: given your son's mistrust of government health care, and his disinclination to apply for government assistance of any kind, what system do you think would be best for him? What system would provide the care he needs in a way he would find safe?
Dave
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I can see all the downsides of the current health care reform plan, at least the one coming from the Senate Finance Committee. It's too bad people inside the Beltway can't seem to get behind Senator Wyden's plan. But in answer to the day's question, in general, I'd rather be "forced" to pay for my own family's health insurance than to be paying for the families of the uninsured, which is what happens now. In other words, I'd rather pay for their insurance directly through increased taxes and subsidies than indirectly through increased insurance premiums (which also give more profit to the insurance companies).
Patricia Oldham
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I don't think it is widely understood that an insurance company is really a cooperative. We all pool our money to protect ourselves from a known risk. The problem occurs when there isn't enough money in the pool to cover the costs. That happens when there is something called "adverse selection".
Here's an example: an insurance company goes to a small company to offer health insurance. People are allowed to join or not, their choice. There are 10 employees at the company. Two are marathon runners and never take an aspirin. Six are average and have the usual minor health issues. Two have major on-going health issues such as diabetes, heart disease, etc. Guess who the first two to sign up will be? The next most likely will be the six average people. The least likely will be the healthy. Because those two and maybe some others don't join the pool, there's not enough money in there to cover the expenses of the sicker members. Either the company must raise the premiums to put more money in, cut benefits, or stop offering the coverage altogether. A mandate without any teeth, allowing peope to pick and choose and jump into a plan when they need services, is adverse selection. The result will be higher premiums for all those participating. It won't bring insurance prices down.
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The one problem with this analysis is the fact that insurance companies are making record profit. I do not think it is fair to require people to pay money for record profits.
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I agree with terryann. I want health care reform that is effective for its customers. Shareholder and executive enrichment should be set at a lower priority level.
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Are you aware that in the state of Oregon, most Oregonians are insured by the three largest companies: Regence Blue Cross, Kaiser Permanente and Providence Health Plans? All three are non-profit organizations.
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So where is the money going? I just got the Providence Individual and Family Plan Rates update for 11/01/09 - 10/31/10.
Optimum 500 Individual and Family $1,000 deductible -- $702 - $927/month.
$11,000 a year to cover an individual and family? Maybe the pool of insured has gotten much smaller? $11,000 a year ends up being more than 20% of an individual's $50,000 a year NET income.
A friend told me that executives at his company have their health care coverage fully paid while employees partially pay for theirs'. It's not full coverage as it used to be when I worked for that company.
The price for health care and coverage has gone up much faster than the rate of inflation.
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"Insurance" is the wrong model for health care. A for profit corporation is obligated to make money for its owners. Insurance models require minimizing risk to their profits. This means minimizing risky clients. This leaves those in need without this option. An insurance company has a difficult, or even impossible to reconcile conflict of interest in insuring "health."
Better models for health care are other public services that succeed - libraries, schools, water systems, roads - a single payer, or public option alternative to insurance. Health care consumers can, if they choose and can afford to, select private alternatives, but will make their contributions to the common good.
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I absolutely agree wih you, empkae. There is a cognitive dissonance with health 'insurance'. The arguement must be re-framed. The fact that for-profit health insurance companies are morally-duplicitous institutions must be drilled into people heads. By their very nature they cannot trully 'insure' people, all-the-while maximizing their profits for their stockholders.
Russ J., in Beaverton
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I am all for mandating health insurance, but under one condition. There must be a robust public option.
Russ J, in Beaverton
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Very muddy conversation so far. The guest on now is incomprehensible.
What exactly is the focus here?
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The focus is on individual mandates: a requirement for individuals to buy health insurance, which very well could become federal law. We're starting with a conversation with two folks from Massachusetts because they've had a similar statewide system for the last three years.
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why can't Medicare just be expanded to the entire US population?
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I think the problem with expanding Medicare is because it pretty much pays for everything. It lacks a consistent cost containment system. Perhaps, medicare using evidence-based criteria would work.
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I think it is obscene to REQUIRE that people give money to a for profit third party although I don't see why the medical profession itself shouldn't be profitable.
But then I think INSURACE is about gambling on risk, not filtering basic, usual care.
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I support a government mandate that all American citizens pay me a dollar every year and if some people are too poor, the government will subsidize them and just send the dollar directly to me.
That is exactly what is on the table here. Just substitute the insurance corporations for me and increase the dollar amount obscenely.
An individual mandate to pay profits to the Insurance companies is wrong, wrong, wrong.
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Wow. Deja vu. Raised by a single mom in the 80's, we had to choose between food, heat, and car insurance. We chose food (we used our oven for heat). It was very stressful for us kids knowing that we were breaking the law every time we were in the car with our mother, but we didn't have a choice as a family - we were struggling to survive (I'm talking "here's a scarf for Christmas" kind of survival).
Throughout my life I've been in the gap between having enough money to really afford everything, and making too much to get any assistance (even as a fifth year teacher in PPS, I was cut to half time and had to work at a pizza place at night - I'm no longer a teacher). I've worked out the numbers on insurance premiums in case of a mandate - everyone like me is in trouble. We can't afford hundreds of dollars a month for our families' insurance, on top of deductibles and co-payments.
The doctor who is speaking is absolutely right. We will end up getting cheap coverage that doesn't really help us, in order to avoid paying penalties, or I'll be back in the same position I was as a kid - surviving in spite of what the law wants me to do.
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people need care, not insurance. money needs to be appropriated for the provision of care, not for insurance companies.
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It is all a masquerade.
This lame second-rate attempt to provide universal health-care by forcing people to buy insurance, from the same companies that have been raping and discriminating against the public for all these years is utterly asinine. We need more then a finger in the dike!
Instead of truly reforming and revolutionizing things what do Americans do? Give the insurance companies more business! How low can we go? How stupid can we get? We can plop rovers on mars, replace a face, invade foreign lands, but we can't figure out health-care for all?
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Lame and second rate is right. How is it that all of those other countries that pay so much less per person and have better health outcomes than the US achieve this? Oh, yes, they have a government plan that covers everyone.
They also have a tort system that doesn't encourage people to try to get rich over an honest mistake. They ban advertising medication because it encourages people to get medication they don't need. And finally, they give doctors incentives for keeping their patients healthy - not just paying them per procedure.
This new plan does none of that. It is placebo reform.
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Wow. Deja vu. Raised by a single mom in the 80's, we had to choose between food, heat, and car insurance. We chose food (we used our oven for heat). It was very stressful for us kids knowing that we were breaking the law every time we were in the car with our mother, but we didn't have a choice as a family - we were struggling to survive (I'm talking "here's a scarf for Christmas" kind of survival).
Throughout my life I've been in the gap between having enough money to really afford everything, and making too much to get any assistance (even as a fifth year teacher in PPS, I was cut to half time and had to work at a pizza place at night - I'm no longer a teacher). I've worked out the numbers on insurance premiums in case of a mandate - everyone like me is in trouble. We can't afford hundreds of dollars a month for our families' insurance, on top of deductibles and co-payments.
The doctor who is speaking is absolutely right. We will end up getting cheap coverage that doesn't really help us, in order to avoid paying penalties, or I'll be back in the same position I was as a kid - surviving in spite of what the law wants me to do.
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To make all laws which shall be necessary and proper for carrying into execution the foregoing powers, and all other powers vested by this Constitution in the government of the United States, or in any department or officer thereof.
Article I, Section 8 of the US Constitution. It seems that this, plus the generally reserved power to provide for the "general welfare" of the people is more than enough authority for a mandate that costs individual citizens' money. Congress can levy taxes and duties under the commerce clause, also.
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A lot of the fear and problems with the mandate has to do with the fact that incomes have not kept up with inflation, and health care costs have surpassed it. The rich and the poor will be taken care of, but the lower middle class, those 40 million uninsured who may only have a single income earner in a low wage position are really scared.
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One major problem I have with the congress implementing ANY changes is the US Constitution specifically amendment 10 which states "The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people." There is no where in the constution is there an explicit mandate for this. As a tax payer I'm very tired of the federal government putting mandates on my tax dollars that are quite frankly questionaable under the constitution. one example would be the entire department of education. It is the individual states responsibilituies for overseeing this NOT the federal governments.
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the 10th amendment will not trump the commerce clause or Congress' general power to provide for the "general welfare" of the people. There is a federal interest in providing for uniform national health insurance and there will be no problem in finding Congressional authority to pass laws in this area. There are already many federal health-related laws and regs that are far more intrusive to invidual choice than madated health insurance.
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I'm also starting to see the whole national health care debate as a disguised way to actually prop up a failing system and PREVENT something better from growing in it's place.
If nobody has insurance, then they will KNOW what the costs are and start demanding accountability. If hospitals and doctors are held accountable for their costs by their clients, they will get more efficient and lower costs. If patients actually have to pay for their own care, then they will CARE about the costs and be more selective about their demands.
As long as insurance covers basic care, what we have won't change appreciably.
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I am a single 50 year old dad insuring 4 kids. I am unemployed an currently paying 307/month (subsidized or it would be 878/month) and am filing bankruptcy. My problem is finding a job and what my health care options are with my potential new employers! Could fall through the cracks here soon.
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I'm not buying this insurance mandate as a way to spread the cost of health care. If we want everyone to pay for healthcare why don't we create a progressive healthcare tax and provide a government option. Why should we force people to support private insurance companies which are the major problem.
thank you,
David Brandt
Mosier, OR
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Is anyone talking about enforcement of the mandatory system. Will we have the HSEA (Health Insurance Enforcement Agency) and a new category of criminals in our society?
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One argument I have heard is that the cost of health care would be less expensive if the risk was spread across the entire population. In the past the government has gotten industries such as airlines, and what are now public utilities, by creating regulation in the industry. Would it be an option to explore putting rules in place, such as all individuals must be offered the same price for the product they are purchasing without discrimination to their health or preexisting conditions?
In addition, the patient is charged less (sometimes 50%) if they have health insurance because there is a contracted rate and the hospital ‘writes off’ the overage. Therefore and insured person can have very large medical bills quickly in an emergency. With suck a large bill bankruptcy is often the best option, which increases the cost for those who can pay. If that bill was regulated to be 50% like the insured person, it might be an option to avoid bankruptcy, which would keep the costs spread to all who seek medical attention.
Shelby Tigard
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Oops the TOL site hanged.
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you just invented unemployment insurance
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I lived in Canada until I was 32. Since moving to the US, I have never had so little choice, waited so long for a GP appointment, spent so much of my own time haggling with health insurance providers, or had such difficulty finding providers as I have had here. People need to be somewhat more civic-minded and agree that overall the broken system is not serving the population well, and there must be a better way.
I think it's just too bad that people are so afraid of a single payer system. The Canadian model may not be the right one for the US, but people have no idea what a huge relief it is to not worry about bills, in or out of network, or even not having insurance. It may not be perfect, but it sure seems to work better than here. There has been a lot of misinformation spread about the Canadian system.
From a macroeconomic perspective, it's odd that Republicans don't support a system that would offer absolute free labor movement, similar to free movement of money and trade in goods and services. The economy is hamstrung by the costs
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I already purchase individual health insurance through Blue Shield of Oregon. It is $343 a month with a $2,500 deductible. How is a mandate going to help me?
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As long as there is “Health Insurance NOTHING has been done.
Taxation without representation. Added to a few other things started a revolution.
Mandated Health Insurance. Will we be able to just reuse all the old songs... -
My 28 year old son has long standing mental and physical issues. He has not held a job since 2003 and has no insurance. He could apply for SSD, but it is a very hard process to go throuh and takes years to get, especially when you are basing it on a mental disability. He cannot afford to contribute toward his health care costs, but he is desperatly in need of it. I make $40,000.00 a year and cannot afford his healthcare either. I have spent a lot of money on his dental and psychiatric bills. Luckly, OHSU is covering his physical costs at this time. However, they do charge $250.00 evry 6 months.
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I am 63 yr old vet, college educated, I spent time in New Zealand.
When they formed thier gov. , they set out the parameters of what gov should be. The resources of the country belong to the people for basic needs, those are health, education, food, and housing. The gov takes care of those and the luxuries are your problem. I was impressed with the gov, health care, and the people. Handing over as was done early in this country, the resources, and the basic needs of the people to private capatalistic intities doomed this system to failure as we are now in.
Benevolent capitalism does not exist, greed takes over. human nature. Health care for corporate profit has proven to be a joke.
It is not different than handing over the rights to the air we breath to Exxon or Enron, Which may be the next thing that congress does, because quite obviously we have a for profit congess.
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People keep comparing mandatory health insurance to mandatory car insurance but ignore that we overpay for car insurance as well.
In many countries, the cost of automotive 3rd party liability insurance is covered by one's vehicle registration. If one wants additional insurance, one can purchase it separately. This meant while in Australia my premiums and registration for similar levels of coverage on a similar vehicle about 30% lower than they are in the US despite getting a 'good driver' discount in the US.
We created a mandate that every car owner speak with a sales person - no wonder our premiums are higher!
We should also expect the same or worse from mandatory health insurance...
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Just to get it out of the way, its important to state that Health Insurance Company profits are on average between 3-6%. Many Health Insurance Companies are non-profit institutions.
The current proposals in congress will not work without mandated Health Insurance coverage for all people. When healthy people choose to remain uninsured because of the belief that they don't need it, they reduce the pool. Insurance is all about risk, and the pool of people and dollars to cover that risk. If everyone carries insurance, premiums can be reduced. When people and dollars are in the pool are reduced, premiums go up.
I also beleive that there need to be wellness incentives. People that are of normal weight, do not smoke, have low LDL and high HDL cholesterol levels should be rewarded with lower premiums on their health insurance. It is within the power of any person to acheive these health goals, and once these goals are acheived then their health will improve and expenses will decrease.
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(You should do a show about the ethics of 'wellness incentives.' Or maybe you already have.)
Why should people be rewarded with lower premiums on their health insurance because they are healthy? How exactly do you determine that it is within the 'power' of 'any person' to achieve these 'health goals?' Oh, is it really? Obviously these incentives are primarily incentives for insurance companies, disguised as rewards for the consumer. The insurance companies are clearly banking on them not working for most people, because if everyone got healthy, and premiums were reduced commensurately then how exactly would insurance companies make money? Insurance companies 'thrive' on disparity. -
Being obese puts more than doubles one's risk of:
- developing heart disease,
- type 2 diabetes,
- depression,
- cancer,
- having a stroke,
- having high cholesterol,
- suffering from PMS (assuming you're female),
- sleep apnea
Safeway estimates 70% of their health care costs were related to behavior before they started offering incentives to employees to maintain a healthy weight and not smoke.
Those who refuse to take responsibility for their health deserve to pay more.
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Too bad our thinking on this topic is so cloudy. Ironically, slow food liberals are often the group that support this campaign against the obese, and corporations have joined the camp with wellness incentives. Why ironic? Because African-American, American-Indian and Hispanic-American women have the highest risk of becoming overweight. These women will be the largest group not benefiting from these incentives. Not to mention that the female gender will be effected more then the male.
Why stop at wellness incentives for obesity and smoking? What other behaviors are not healthy? Why not charge homosexual males more for insurance because they are at greater risk for HIV and depression? Perhaps we can create an incentive for monogamy, for people who don't drink, for people who don't engage in brutal and extreme sports, for people who don't go in the sun, for people who recover from depression? Can't we all just pick ourselves up by the bootstraps?
Many people are not fat by what we commonly think of as choice. No one can read minds and know what it takes for each and every person to change their habits. Many people grow up with fat parents, many people are abused, depressed and have bigger fish to fry (ha, ha) then getting skinny. I certainly don't think we should be adding another level of discrimination to insurance, under the guise of an incentive.
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Scottmill, do you really think providing support and incentives to women and minorities to do something that increases their life expectancy by about 1/3rd does wrong by them? Really?
The obesity epidemic is new. Our genetics have not changed, our behavior did. Tackling this health issue requires fixing our behavior.
And while we're on the subject, the UK is changing their prescription for depression from pills to exercise. Study after study support exercise as the single most effective anti-depressant. Those people who you think need an excuse to be fat because they're depressed would be better served by getting some activity in their lives. Two birds with one stone. How's that for efficient?
And get your stats right - It's college age women that lead the population in per capita new cases of HIV. And yes, they should also be changing their behavior to prevent that disease. Or are you too worried that reminding them to use a condom will hurt their feelings?
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Yes. Really. I do. Incentives, in the form of paying less for insurance because you have the ability to loose weight is indeed stupid. Not only is it stupid but it is terribly offensive and senseless. I find it shocking that so many people are willing to live in a society where the skinny are rewarded, and the obese are punished because of an alleged lack of self-control. It is even more shocking that this idea has largely been cooked up by alleged progressives. The motivation behind this is larger then any statistic and is one of judgement, sketchy assumptions and bourgeois unsophisticated moralizing.
How funny, you mention increasing 'their life expectancy by about 1/3rd.' Why in the world would the same crowd that is worried about overpopulation want to increase the life expectancy of anyone? I do not for a second believe that 'folks' are concerned about the health of the obese and that their motivation for proselytizing about the virtues of a wellness incentive that leads to a skinny body stems from care and empathy for their fellow human. This is foremost about punishment, blame and ridicule. The arguments to support these incentives are on shaky ground, and really the only authentic argument is an honest one that says it saves insurance companies money.
And, no, I am not worried about hurting anyone's feelings.
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Everyone who is overweight has the ability to lose it. Suggesting it is impossible is insulting and keeps those with the condition hopeless and helpless.
The countries that have national health plans and have been effected by the obesity epidemic all take obesity very seriously. They have developed programs to help the obese lose weight. They also encourage people to protect themselves from skin cancer by using protective clothing, shade, sunscreen, hats. They encourage people to wear UV protective eyeglasses to prevent cataracts. Do you object to those incentives? They still support those unfortunates who, despite good behavior are afflicted with disease, but they control costs by encouraging responsible behavior.
Your oversimplification of a complex movement into your narrow, ignorant view, conveniently lumping all who disagree with you into a simple categories of hypocrite or fool, is stupid.
There are devout catholics who believe all sex should be for the purpose of procreation who also believe that respecting the sanctity of life means treating your body well. Just as there are atheists who believe that failing to take care of your body is a really bad idea. There are Republicans & Democrats who believe fat people should take better care of themselves.
There may be population control people who, as you suggest, believe the obese should just die out, but I sure haven't met any. Most of the population control movement I've heard about seems be about getting women education and opportunities because women with education and opportunities tend to have only as many children as their bodies, resources and communities can support.
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hazeladd,
You make a strong case. But, to me the reasoning is incorrect. I did not suggest, nor do I believe it is 'impossible' for any person to theoretically lose weight. That is exactly the problem: this matter of 'choice.' When a perceived 'choice' enters into a discussion or when we believe people bring things upon themselves, we propose the solution is as simple as just deciding to change. But life and the human condition is more complex then that. People don't set out to be fat, just as people don't set out to be poor or uneducated. Many things are beyond or at least influenced by external things often outside of our control. For us to say people should be given a reward, because for some reason their circumstances, mixed with genetic disposition, and the nature of their mind, allows them to have the will, determination or capacity to forge ahead and lose weight, is terribly unfair to people who for whatever reason can't, or as you essentially suggest won't.
I think everyone should loose weight, (generally) nobody likes to look at fat people, plus they are functionally inconvenient (seat size, etc.). I think programs to promote and encourage weight-loss are fine, providing they don't cross the line by financially rewarding people who do. Because that reward by proxy punishes people who don't, it also comments negatively on people or stigmatizes people who don't. I can't understand how many people who are so empathic towards other aspects of humanity, such as poverty, or disparities between class and race---when it comes to obesity they have little room for empathy and a lot of room for blame.
My view is not an oversimplification, nor did I call people who disagree with me stupid. I said the ideas were stupid. But, anyway, in most discussions it is only sensible to focus on motivations and arguments collectively, rather then this crazy obsession we have with labeling every argument a generalization. If I am speaking about a group of people I am going to generalize on behavior and motivation, it is the only way to get anywhere.
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You are correct - obesity disproportionately effects the disadvantaged. Unfortunately, ignoring the problem will only increase the poverty cycle. One takes grandparents out of communities that need them. Kids learn their eating habits from their parents so by ignoring the problem, we also condemn their children to an early death.
Would you be more comfortable rewarding those who engage in healthy behavior?
Your comment "Why in the world would the same crowd that is worried about overpopulation want to increase the life expectancy of anyone?" paints all those who disagree with you as death mongers. This is not true. Generalizations like that are foolish at best.
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The idea of forcing people to buy health insurance is ridiculous! Our representatives in Washington D.C. have lost touch with WHY health reform is necessary. Somehow this debate has taken a punitive tone. It seems to me that they are trying to keep the current health care system afloat while making the public responsibilty for its failure. I am in favor of all having health care coverage. But to level the playing field, the government needs to intervene to PROTECT the citizens by providing nationalized coverage supported by taxes. If we stop being the world's police force, we can easily afford to cover everyone in a reasonable and satisfactory way. I am facing a medical retirement after working for 25 years for the same hospital. My health insurance was terminated (unless I could continue an individual plan at $600 for one person). I was told when I applied for Social Security disability that Medicare wil not be available until I have been on Social Security Disability for TWO YEARS! How much did you say the fine will be?
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One of the goals of our nation, its people and its government should be health. And yet we see each day on the news, and as we interact with our friends and coworkers, as we walk down through the grocery store, or through the mall, that health and wellness truly are not the goal of many individuals, and we are all paying for those individuals in terms of higher health insurance premiums on ourselves, and in taxes for the uninsured. Should healthy people be rewarded? YES, and those rewards would be extended to those who acheive wellness through lifestyle change and medication. A person who reduces their weight, and stops smoking, but still experiences high blood pressure or diabetes, or high cholesterol, or all three, should be rewarded for treating these conditions responsibly with medication. As long as the conditions are controlled through lifestyle and medication, their chance of experiences heart attack, stroke, and cancer is greatly diminished. These are seriously expensive illnesses, it is the responsibilty of individuals to treat themselves appropriately to avoid these illness, and the responsibility of our government to provide the resources. Both parties are responsible, not just one or the other. But if an individual, who is capable of handling this responsibility fails to do so, they should not expect the same rewards of an individual that does. In the end, their reward is good health and longer life, if monetary incentives (in the form of lower premiums) are what get them there, then everyone is better for.
BTW,if health insurance companies preferred their membership to be ill, they wouldn't underwrite against it.
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Of course insurance companies would prefer that everyone was healthy PROVIDING that everyone still paid close to the same amount for insurance. But if everyone actually got healthy then those alleged incentives wouldn't work, those incentives require that many people do not get healthy. The only interest they really benefit is that of the insurance company. Because if some people get healthy, then the insurance companies make more money.
The reason (most) insurance companies are promoting health is not motivated by a concern for the plight of the average human being, they simply want to make or save money. Presenting this personal responsibility hogwash as corporate altruism is sickening, and it is raising the blood pressure of many, making us all sicker! It is proven that in countries where one doesn't need to worry about health coverage, this peace of mind actually makes people healthier. If insurance companies were motivated by collective health then they would already provide coverage to everyone for every illness, without being forced into it.
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It's bad enough that we as a nation have decided it's acceptable for millions of people to die of treatable diseases. But to force people to choose between the mandated health insurance payment and housing or food? Unconscionable!
An individual mandate to purchase private, for-profit insurance is absolutely wrong as it fails to address the root causes of our shameful health care system: for profit insurance. There will never be any significant improvement in health care access and affordability until these vampires are driven out and the only way to do that is with a strong public option.
Forcing people to buy a product that only meets the needs of the insurance companies is simply wrong. It would, in fact, be worse than the abysmal system we currently have.
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I fully support effective health reform and always have.
That being said, if legislation is passed and signed into law that the feds enforce to require everyone to be insured and do not provide a public option, then it is tantamount to federal alliance with the insurance companies!
Yes, there is language to require certain things from the companies, but there are most likely loopholes. Companies will find a way to hurt people and health providers if it means they can clear a profit.
The only effective way to get profit motivated companies to tow the line is to give them competition that is motivated by the public good.
I will not support any candidates in the upcoming elections if they vote for or approve health care "reform" that is ends up being government enforcement of furthering profits for the private sector!
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I wonder if the health insurance reform bills that Congress are considering will truely result in health care reform. The goal should be better health care at an affordable price, but I am skeptical that any of the reform bills will achieve that goal.
I also wonder if the federal government has the authority under the U.S. Constitution to mandate health insurance. I understand states requiring auto insurance since a person has the option to own a vehicle. A person does not have the option not to live with regard to mandatory health insurance. How can the federal government know what is best for each citizen and family when there are so many different household situations that cannot entirely be reduced to numbers?
My situation is a single-person household, recently unemployed at age 60, and in danger of not obtaining the American dream at retirement age. My previous employer paid full health, dental, vision, and prescription coverage that cost the employer between $1,000 and $1,100 per month per employee, with $35 monthly contribution per employee. I could continue that coverage at 35% of the premium for up to 9 months, courtesy of American Recovery and Reinvestment Act provisions. I have a home mortgage and car payment. As I see it without income, I would need to choose between continued mortage and car payments versus mandatory health insurance coverage payments with potential penalties. I could sell my house or car, but I cannot sell my life. I would immediately choose to have a roof over my head and transportation, especially since I live in a rural community.
I would prefer national health care coverage funded from personal and corporate taxation than mandatory health insurance coverage where the cost comes out of pocket, especially when many Americans' pockets are almost empty and the unemployment picture is grim into the forseeable future. The advantage would be more emphasis on preventive care and less insurance administrative costs. Anyone who could afford and wanted more coverage than the national plan could pay for it.
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SINGLE PAYER will simplify health care and make it affordable. Insurance companies may say they are non-profit, but their executives make a lot of money. For example, the Oregon Public Employees Benefit Board decided to self insure starting in 2010. PEBB figures it can put the 3 million Regence would have made in profits to better use. Also to the man on the program who said that his emergency room pays 40 million per year for ininsured patients-- it's my experience that unless you can prove you have health insurance, the emergency room doesn't give you the tests that an insured patient would have. For example, a wonderful 54 year old woman went to the emergency room at Samaritan Hospital in Corvallis last month not feeling well. She no longer had health insurance. They said she was fine and sent her home. She died about three hours later at home from a heart attack. She died because the hospital doesn't take care of people with no insurance. This in the country with the most wealth in the world. We need nationalized, single payer health care.
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It would be very wrong to mandate that all American people pay profits to Insurance companies.
If the Insurance Companies get their way and everyone is mandated to buy insurance, I think that it should be mandated that they can make no profit from it.
A zero profit mandate!
There is no "Divine Right" for the greedy to make profits from the disease, sickness, suffering, and dying of the American People.