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Robin asked what I think of mandatory health insurance. My reply was so lengthy that I decided to copy it here.
Mandatory health insurance is important.
1) All of us who have health insurance and all of us who seek treatment at the hospital are subsidizing those who do not have insurance–regardless of whether they’ve chosen to spend their money on other things or if they simply couldn’t afford it. We aren’t talking about pennies. This is subsidy on a grand scale. However, it isn’t a logical and carefully targeted subsidy. (If I end up in the hospital this year and you don’t, does it make sense that I should take a greater share of subsidizing the insuranceless than you should, just because you happened to avoid the hospital this year? No.)
2) We should provide a basic level of health care for everyone. It is a shame for a nation with the resources ours has not to provide a basic level of health care for its people. Without health, it is difficult to pursue happiness and it is also difficult to contribute to society.
3) If we do provide basic health care to everyone, then everyone should help bear the costs. No young, “I feel immortal,” risk-taking freeloaders allowed. Because the fact is, we don’t want to leave even young and stupid, risk-taking freeloaders to suffer, taking their potential with them, if a basic level of health care could allow us to avoid that.
4) Therefore, if we continue under the current insurance-based system (as it now seems obvious we will) everyone should be required to carry insurance. Unfortunately, we will have to figure out how to help many people pay for this, because we can’t require insurance if it means people end up going without their groceries to pay for it. But how to pay for those more explicit subsidies is another bucket of worms . . .
Other recent C&G posts about health care:
American Health Care (the comments are worth reading also)
Sketchy Thoughts on Health Care
Did you write your senators and congressperson yet?
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2 Responses to “Mandatory health insurance? Yes!”
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Just a quick comment as I still haven’t done any of the things on the naptime to-do list. I drive Martin nuts with reading a lot about this issue and subjecting him to my talking about it, but I haven’t really found anyone out there with an approach I agree with, so that I can actually get involved in some way.
More and more, I think that health insurance should be mandatory but that the only way to do this is to make it mandatory in the same way that medicare is mandatory — a payroll tax, preferably fully employee-paid so that the cost of healthcare is visible to everyone and not hidden in employee benefits, and potentially with the healthcare ultimately available through private insurers via vouchers, rather than through single-payer. I think people would get sticker shock if they had to pay 10 – 15 – 20% of their pay to healthcare (I haven’t crunched or googled the exact numbers) but they shouldn’t pretend that the rich can pay for everyone.
What I’m thinking about, though, is: is healthcare a “need” like food or housing, where everyone has a responsibility to care for their own family and the government steps in only as a safety net, or is it more like education, where everyone pays into the system (roughly as a percent of pay, when you consider that the wealthier you are, the larger a house you pay property taxes on), and receives “free” benefits? The delivery mechanism is secondary — the first question is what the “fair” way of paying for healthcare is. What do you think?
Hi Elizabeth, (Wow, it has been a long time since we have seen you guys–you may barely remember me),
Just curious if you think the status quo for food and education is correct, i.e. best that we have a safety net approach to food and a “free” approach to education. I’m pretty sure I wouldn’t like the “free” approach to food (I’m thinking of some huge community cafeteria–uck) but I’m not sure I would be against the safety net approach to education. My question is a bit off topic but as the spouse it seems like I should be given more leeway. I am curious. And…as long as I’m off topic, let me add this. It is terrible whenever we create the safety-net approach and then draw an all-or-nothing line. We all should be against solutions like that everywhere. The example of our neighbors shows the terrible situation that creates. We have some neighbors who are immigrants without much money. They are older and both work at a grocery store as baggers–not easy work given their age. They recently got a raise which kicked them over some limit such that they no longer qualify for medicare. Given their family finances they can’t afford health insurance. What bothers me most isn’t that the income limit is too low (it is in their case but ever situation is different)…what bothers me is that it doesn’t make sense to penalize people for making more money. I can’t understand why their isn’t a sliding scale for this type of thing.