Mandatory health insurance?

[Matthew]

What do you think of the future mandatory health insurance?
I feel the fines imposed for not having it are like taxing people to be alive. Wasn't wages, property, sales, etc. enough already? Shouldn't free people have the option to opt out?
I think this being mandatory is going to be huge in keeping many ERE's from ever reaching the goal (unless they pay the fine) and I don't think the government is addressing the problem with health care. That being, it is outrageously overpriced and expensive, but most people can't opt out of getting a broken arm set. Many people keep working for health insurance alone. Not a problem for me since I work, but I won't be surprised to watch high deductible plans evaporate and the premiums on young people sky rocket as they offset everyone else. Hence giving people yet more incentive to never stop working.
I think this will be one of the next future bubbles in a few decades. Right now there is a shortage of medical people, but after the baby boomers die out, I don't think you will see many people becoming nurses, because they won't be getting the equivalent 50-100 grand a year anymore.
I remember 13 years ago when I was looking at careers and a nurse made less than 20 grand. Just a couple years ago physical therapists were only to expect 50 (my buddy makes well over 80 today).
If cheap care is not available, mainly because workers only pay a small portion out of pocket (so they tend not to care how often they go to a doctor or take several prescriptions), what does this do for people who don't work? It's a shame that health care was ever covered by employers. I think people would have demanded change long ago.
But I shouldn't worry about freedom or health care, we aren't responsible for our health, the government is...but if only they would control our diet and exercise as well

[jacob]

As part of the fairly strong libertarian contingent on the blog/forum, I can't say that anything mandatory which has no public impact pleases me.
Mandatory insurance is just yet another patch on a fundamentally broken system which focuses more on technological fixes and litigation (legal entrepreneurship) than health.
From a basic point of view, if people are required to keep working simply to "stay healthy" there's something really really wrong. Under normal circumstances, staying healthy should not incur major effort. What is actually happening is that the parasite (see above) on health care is killing the host. And now the host just got put on life support.
Indeed, it would be great if employers could not offer health care without paying taxes on it. Then again, aren't corporations the new government?

[JohnnyH]

Yes, it is an utter nightmare... A dangerous precedent mandating that people buy services from corporations (indeed the new govt).
Would citizenship, and healthcare benefits, in another country get you out of the fine?
However, the welfare will be easier to get. So many EREs would qualify for "free" (haha) sickcare.... I'm starting to look at not working/welfare as potentially doing your part to bring the stupid system to its knees.

[Kevin M]

I think it might be the worst of both worlds - now we are forced to purchase the crappy product that got us to this mess in the first place. I was hoping for universal coverage but even that I'm not sure of - I guess I just thought anything other than what we have now would be better. I guess the only hope is to see what type of coverages are offered by the "exchanges" in 2014.

[Maus]

I expect to be a net beneficiary of the mandatory health insurance scheme. As an ERE practioner, my tax burden will be very low, and my income level will be such that I will qualify for the subsidized policies made available through the exchanges in 2014. I may not like Big Brother's policies or his taxes, but I am only too happy to take his resources.
Philip Brewer at Wise Bread had a great post on the upside of the health care reform: http://cache.wisebread.com/health-care- ... le-like-me

[Q]

Why would this bother us.
1) Virginia and many other states are suing and the case stuck as of this week - States rights here in the USA is a force to be reckoned with... we are the UNITED states for a reason. *Glad to see states exercise some rights again finally (very side note )
2) The fines are so pathetically low, it was just a posturing move anyway. Media hype
3) HDHP + HSA means tax free savings now (for the young of us), to use later when it *might* be needed.

[Steve Austin]

I have just been enlightened on matters of health care:
http://www.house.gov/brady/pdf/Obamacare_Chart.pdf

[jacob]

That's what happens when you hire a chip designer to fix the problem.

[Night Runner]

Just playing the devil's advocate here, but:
Consider car insurance. You *must* have it if you want to drive a car. Most people think of themselves as above-average drivers, and don't think they'll ever get in an accident - until they do. That's when the insurance comes in: instead of paying *everything* out of your own pocket, your liability is greatly decreased.
Same thing here: we all may think that we'll live forever and never get sick, but what if you get cancer? Or get bit by a rabid dog? Or mugged and beaten up so badly that you need a visit to an ICU? On the off chance that you can see the future, you need health insurance, just like you need car insurance or home insurance. Consider it a passive investment in yourself - a way to hedge the bets.
And after all, it can't really cost all that much, can it?

[Maus]

@Night Runner

I don't know how you define "all that much."
At 48, my current HMO policy, with a $40 co-pay, provided through work, would cost $500 per month under COBRA. After 18 months, it would be unlikely that anything cheaper would be available in the private insurance market, despite HIPAA's guarantee of portability. In two years, at 50, the monthly premium jumps to around $800 in today's dollars; but rates have been climbing 15-20% annually. So, a conservative estimate of $12K per year purely for the policy is hardly unsound. With 15 years until Medicare at 65. And who knows what state that will be in after 2025.
By contrast, if I were to retire immediately, health insurance would represent over 30% of my net income from investments. I define that as "too much."
I have a pre-existing condition that makes HDHI & an HSA unworkable. Should the exchange pools in 2014 manage to come into being, I will look eagerly to the possibility of obtaining a reasonably priced policy. If they can create policies that strip out maternity care and infertility treatment, neither of which I need; so much the better. All I really want is something to cover the catastrophic events (cancer and accidental injury). I am only too happy to manage the regular costs of treating my chronic condition.

[Matthew]

All good points, but what bugs me is that no one is forcing me to buy/drive a car that requires car insurance or own a home that requires home insurance, so on and so forth. Of couse it is good to have insurance on these things, when you need insurance, but if you own something, you should not be required to have insurance on it (though many things still require it).
I like to think that freedom is about being responsible for yourself. Insurance companies only exist because they make a profit. If you are healthier than the average, then a person might save a lot of money by gambling on themselves.
Everyone is going to die. People with health care will still die, just in a hospital. I would rather have a sin tax added to the unhealthy fast food industry (which could offset the cost of health insurance or at least inspire a few preventative measures) than to force everyone to buy health insurance which also covers 400 lb people who ride rascal's to McDonalds to spend their disability check:)
The first few years of fees are supposed to be low, but what will be the limit in the future? How much could it cost? My parents are nearing 60, healthy (especially compared to the average american), and pay over $12,000 a year to be in a group health insurance plan because they are afraid of rising rates in an HDHP if they did loose health.

[Matthew]

One last thing. I believe medicad only covers people who don't have savings. We might all be too hopeful in thinking our low income will save us from paying through the nose in the reformed bills.

[JohnnyH]

@Matthew: well that's terrible... you any sources on that?
Are people with high savings excluded from welfare programs generally?

[jacob]

It would make sense if they were [excluded]. One reason that the poor don't save is that savings would disqualify them from some assistance programs. This conflict of interest results in a perfectly rational response.

[Night Runner]

@Maus:

Ouch! O_o I had no idea people pay *that* much for health insurance... I pay ~$50 a month for my employer's healthcare program.
@jacob:

"One reason that the poor don't save is that savings would disqualify them from some assistance programs."

I think you've got it backwards. People don't become poor because they think "Gee whiz, I wonder how much free money I can get from the feds!" By and large, people become poor for whatever reason, get trapped in the poverty cycle and can't save up - or simply don't know how to.

[jacob]

@Night Runner - I didn't mean people intentionally became poor to take advantage of the system. Taking advantage of the system is, after all, close to a full time job in terms of filling papers, permits, etc. However, once you are on government life support, there is an incentive not to get out of it (by saving), because there is a gap. To give an example from a country with generous benefits. Suppose you get the equivalent of $6/hr not working as long as you don't have any savings, but you can get a job paying $7/hr if you start working. Would you work? Would you save? Some would, but many would not.

[Maus]

@Matthew

Regarding the mortality of humans, I agree. I noticed that there is thread on Stoicism; and it seems like many bloggers interested in alternatives to work/consumerism gravitate to Stoic philosophy. I am trying to cultivate a greater sense of indiffernce to death and the fear of death. In some ways, I would prefer to live a short but meaningful life rather than a long, shallow one propped up by the miracles of American health care wizardry. In a recent broadcast, NPR highlighted that half of Medicare's costs are incurred in the last year of dying patients lives because of hospital-based treatments that only extend life a matter of weeks and that involve pain and a decrease in dignity.
To the extent that I can, I have made it a firm purpose to die at home surrounded by friends and family. And to face death, when it comes, not as an enemy to be conquered but as a guide to an unknowable mystery.

[Kevin M]

My employer pays our health insurance, which comes to about $800 a month, just increased to $1,000 effective 8/1. I am 35, wife is 29 and our kids are 3 and newborn. The worst thing I've ever had medically in my life is outpatient surgery from a hernia. My wife's biggest expense are obviously the kids' births.
Our policy has $1k deductibles per person and 20% coinsurance. To me, that is highway robbery, especially considering the fact that our insurer just upped earnings estimates and will record multi-billion dollar profits. I'm trying like hell to try to get into an HSA/HDHP so we can cut our premiums and save the difference, but so far it's not making sense financially for everyone in our group plan.
I don't think health insurance, much like police/fire protection, should have a profit motive, therefore I am for universal coverage. Like Maus, I wish I could have something that would only cover me if something catastrophic happened, but right now even those policies are expensive.

[Marius]

@Maus "I am trying to cultivate a greater sense of indifference to death and the fear of death."
I see how that could be useful and may try that later on.
I fear death, a lot. I think mortality is the biggest problem we have and the one humanity is most in denial of. I think we should try to do something about it. Aubrey de Grey explains it much better than me:

http://www.ted.com/talks/aubrey_de_grey ... aging.html
In October I'm going to attend the Immortality Institute conference in Brussels www.imminst2010.com (Aubrey de Grey is one of the speakers)
My current life is very stressful and I'm not getting any younger. The mirror shows me that I need to change the way I live.

And that's one of the major reasons why I want ERE.
But being free of stress, regardless of onrushing death, is probably good for longevity, so I'm interested in your techniques anyway.
(obligatory on topic statement: health insurance is cheap in Belgium so I'm not fretting about that)

[FrugallyLiving]

I came across this info on the "Affordable Care Act's Early Retiree's Reinsurance Program": http://www.healthreform.gov/affordablecareact.html. I'm very skeptical about how the ACA is going to work out.