Politicians often paint a picture where a hard working, low-income, father of four breaks his back and without insurance his family is stuck on welfare, but that's not where all the money goes. Most money goes to pay for the palliative care for obese, 60-year-olds with a thirty year history of smoking. People expect that when they are in the hospital absolute phenomenal care is used (and such care typically happens) and the cost of such care is very high.
One way to limit the actual cost of health care is to change the way we live as a society.
Another way to limit the cost of health care is to actually make people pay for care they receive. If an uninsured person needs to be in the ICU for a week, guess who foots the bill? All the people who actually pay their bills.
The way to limit the costs of health insurance is to either sell more plans with limits on self-inflicted health costs (aka an unhealthy lifestyle) or actually come up with a way that people are responsible for any care they receive (whether or not they are insured).
Forcing people to carry health insurance is only going to anger the people who take care of themselves and are willing to live without insurance by giving them a perceived "tax" that they are stuck paying that will then just help pay for the health costs of those that don't take care of themselves. I personally have and pay dearly for comprehensive health insurance even though I have never had any major health issues - but that is my choice. Mandating health insurance means people are required to prepare for the possibility of an emergency.
Rather than instituting a state-mandated health insurance modeled after the inept Social Security system, we need to figure out a way where people are responsible for themselves. The government's job is not to insure that all people are the same because the simple truth is that people are different. Some people will spend their lives smoking and never get sick while others will try to take good care of themselves and wind up with cancer. The role of insurance is to allow those that are risk averse (and life is full of risks) to pay to avoid some of those risks.
People in America have many, many choices to make. If John decides that he'd rather party than go to classes in college and ends up dropping out and working construction, who's fault is it that he can't afford insurance? If Matt grows up under the poverty line but then starts his own restaurant and decides to pay for health insurance for his employees, why should he have to help cover the costs when John gets emphysema?
If people have to live with the consequences of their actions then they will actually be better able to judge how much "risk" they are willing to take. Right now, though, there's a safety net where uninsured people are not expected to foot the bill for care they receive.
The American dream is that with enough work, people can reach their goals and live the way they want to live. Conversely, the dark half of the American dream is that some people will work and as a result of decisions they make, they will fail. The role of the government is not to step in and act as a safety net for everyone but to provide an opportunity for people to make their own choices in life. Insurance is simply a way that people can minimize the cost of potential future problems but, as desirable as it may be, it should still be a choice.
1 comments:
These comments open several cans of worms for me.
First, one of your last comments about how the government should not be a safety net for people who made bad decisions is absolutely true. I've thought of this most recently with all of the people who got in over their heads in mortgages and are now defaulting on their loans. The president wants to freeze interest rates for THEM ONLY for five years so they don't lose their homes. I'm all for not making people homeless, but it is their own fault for the predicament they are in. Also, all homeowners are obviously not happy with the currently falling market and rising interest rates, but the rest of us, smart enough to not get in over our heads, are not getting any special help from the government. We're not asking for it either.
Second, you mentioned the American Dream. Sadly, it appears to me that the idea of said Dream has changed for everybody from Generation X down from "work hard and you can vastly improve your situation" to "My parents have it good, I want it now". Part of that is that parents don't realize they are hindering their children by paying for their school, cars, letting them live at home indefinitely, etc. and part of it is that new technology (like You Tube and digital cameras) and the media have turned our country into a me-first, instant gratification society. Look at the rising credit card debt, the endless amount of teens trying to be the next big thing on YouTube and MySpace and the over-glamorization of the shallow parts of celebrity lives for examples of this.
Third, as for health care, I think the only real way to get people to change how they live is money. Health obviously isn't enough of a factor because EVERYONE knows what they should do to be healthy, but they don't do it. Briefly (got to get back to work) my proposal is that businesses give insured employees and annual health checkup and if they pass (in shape, active, good cholesterol, etc.) they get a kick-back of a certain percentage of their already-paid insurance premiums. I pay like $3,500 a year in health insurance premiums and if I got say $1,000 of it back if I was healthy, that would definitely motivate me. And a healthy me would save the company more money than they'd lose by giving me money back. Granted, this is a limited-reach proposal, but it would help at least a little bit, which is better than nothing, which is happening now.
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