This is very tangible evidence of the fact that we need reform, and hopefully it will wake up some Republicans who think that it's wise to kill efforts at reform because it's political gold. 22-year-olds should not be dying because they're scared of paying to go to the doctor.
I don't care how exactly we go about guaranteeing affordable insurance for everyone. We can have vouchers, or Medicare for all, or a public-private hybrid system. I really am not that picky. But people our age should not die because they're scared of the bill that comes from seeing the doctor.
Friday, September 25, 2009
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But should they be sent to slammer for failing to comply with mandate?
http://www.foxnews.com/politics/2009/09/26/baucus-mandate-penalty-lead-prison-congressional-analysts-say/?test=health
The tax code violation implications of not buying into a health care package have no bearing on the issue that we need to ensure that all people have coverage. Saying that we shouldn't prevent this girl from dying because some people might get sent to jail for not paying their taxes seems to really confound the issue.
Also, just because you could be sentenced to jail for a crime doesn't mean such a sentence ever occurs. Plenty of crimes can include jail time, but jail is almost never applied to them. I can't imagine a prosecutor ever asking for jail time if someone didn't buy health insurance. I doubt even more that a jury or judge would agree to that sentence.
Should a person who has the means to pay and doesn't pay a fine? Absolutely. They're imposing a huge (potential) negative externality on the entire system if they do need treatment. Jail? Not gonna happen.
Fines for imposing "potential negative externalities" seems like a slippery slope. Should high school (or college) dropouts be fined? Should non-voters be fined?
Neither being a high school dropout or a nonvoter imposes a negative externality on anyone. Not having health insurance, however, means that when you get sick, the cost is dumped on everyone else. It's the individual equivalent of a company pouring toxic waste in a creek. Free to them but harmful to the community at large-and that's something the government does regulate.
High school dropouts reduce productivity, imposing cost on society. Non-voters contribute to a civic deficit.
High school dropouts fulfill important low skill labor demands. Is there any evidence that a 'cultural deficit' exists? Australia mandates voting, I believe, but they aren't exhibiting signs of cultural supremacy over us.
You're stretching Evan.
Huge negative externality may not be that huge. Kaiser Foundation estimates cost at $200 a year per insured family.
http://factcheck.org/2009/07/obamas-health-care-news-conference/
Let's take the low estimate and say it's $200 per family. If we're trying to keep individual costs down, don't we want to not have any additional cost per family? Is $200 acceptable, but $1000 intolerable? What about $400? $550? $817?
Is there a "tolerable" level of this that we're willing to accept? We avoid this problem via mandate in other areas related to insurance. We mandate car insurance to prevent people from doing lots of damage to others and not being able to pay for it. I fail to see why health insurance is any different. When you don't have health insurance your only risk is your assets. But obviously your cost can be much higher than the value of your assets, and we also can't deny care. Instead of just banging our heads against the wall trying to get around this problem, why don't we just mandate insurance?
But more to the point, you have not addressed, head-on, the original issue of this post: whether or not all Americans should have health insurance. Certainly it'll be difficult. And none of the current plans are ideal in my eyes. But are we going to let the perfect be the enemy of the good?
Two caveats about car insurance: 1. only required if you wish to own and operate a vehicle. 2. only liability insurance is mandated.
Do I think all Americans should have medical insurance? Probably not. Bill Gates can probably self-insure. Others may make unwise choices about insurance, just as they make unwise choices about many things.
That said, there are many things that could be done to improve markets for medical insurance. Young people, for example, might benefit from low cost insurance with high deductibles to protect against catastrophic illness. My understanding is that most current proposals go in the other direction, mandating one size fits all coverage.
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