I previously posted about the latest rash of scandalous photos coming out of Afghanistan showing U.S. military atrocities under Obama’s command, and wondering if the media would pick up on it the way they did when it was Bush’s army… Well, here’s a twist I wasn’t expecting: yes, one of the U.S. media, Rolling Stone, [...]
Jeffrey Goldberg, a correspondent for the Atlantic, cast a spotlight on yet another disgustingly overt example of pure bias in the mainstream media, particularly at the anti-Semitic Reuters newswire. He points to a Reuters news item which contains the following despicable sentences: Police said it was a “terrorist attack” — Israel’s term for a Palestinian [...]
In the [sparse] reporting of the Palestinians’ massacre of the Fogel family, several newspapers stand out with their distorted sense of “balance”, i.e., where they feel overwhelmingly uncomfortable describing the barbarity of the Palestinians without at least taking a swipe or two at the Israelis, no matter how patently irrelevant or disgustingly disrespectful it comes [...]
Fines For No Health Insurance?
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The Associated Press recently reported that:
Just as auto coverage is now mandatory in nearly all states, [Sen. Max] Baucus would require that all Americans get health insurance once the system is overhauled. Penalties for failing to do so would start at $750 a year for individuals and $1,500 for families. Households making more than three times the federal poverty level–about $66,000 for a family of four–would face the maximum fines. For families, it would be $3,800, and for individuals, $950.
Setting aside any serious discussion of this idea for a moment, James Taranto of the WSJ had an amusing corollary to this suggestion, namely, “Outlaw The Homeless”:
Why not apply this principle to other areas of social policy as well? For example, we could deal with the problem of homelessness by passing a law requiring everyone to have a home, and levying thousands of dollars in fines against those who fail to comply.
But, seriously, what to make of Baucus’s proposal?
The analogy to auto insurance does hold water to some degree, so if you think that mandatory auto insurance is a good policy, should mandatory health insurance follow?
Mandatory auto insurance is important because—as the argument goes—most of the time an accident harms not just the owner of the car but others as well (passengers, other vehicles, pedestrians, etc.), and much of the time, the cost of those damages exceeds what most ordinary people can shell out at a moment’s notice. Therefore, most people in an accident without insurance simply would not have the money to cover the extent of the damages they caused. It only makes sense, then, that mandatory insurance be enforced for car owners—at least for the protection of others, if not also to protect the car owner as well.
So, is health insurance the same? In some ways no, and in some ways yes.
The first major difference is that a person can choose not to own a car and, therefore, not to assume the responsibility for a costly insurance policy; a person obviously cannot choose to stop living in order to avoid health insurance. So, mandating health insurance is effectively pushing another expense on an already over-taxed public.
Another important difference is that in many auto accidents, the bulk of the damages is often to other innocent people who do not deserve to be saddled with any costs for repairing that damage; in health care, the “damages” is mainly to the policyholder himself. The only potential second-person “damages” come about when an uninsured patient is treated despite not being able to pay for the medical services, in which case the cost is absorbed by the care provider and, potentially, other patients of that provider within “the system”. While costs can obviously get passed on to other innocent people, it’s hardly as clear cut as an auto accident.
On the other hand, though, clear cut or not, those costs are still passed on to innocent people. When someone gambles by not having health insurance, he is not just gambling with his own health and money, but with other people’s money. A young person who thinks he doesn’t need insurance and then unfortunately gets hit with leukemia is going to drain a lot of money from a lot of people.
So, again, should mandatory health insurance follow auto insurance?
The libertarian approach, which I often take myself, is probably a resounding NO (followed by a call to do away with mandatory auto insurance, to boot). Ideally, that’s a great idea, because less governing is typically better. Unfortunately, though, we don’t live in a utopia where the general public is noble enough (or even just capable enough) to take care of one another in lieu of a mandated financial solution.
If, however—and I realize that this is a controversial “if”—doctors and hospitals were not forced to treat patients who couldn’t pay for their care, and the uninsured patients were forced to go around on their own to friends, family, and charitable organizations to secure the funds for their treatment, then I think that would actually remove the entire analogy between auto insurance and health insurance by removing innocent people from the equation, and would allow us to keep the government out of an individual’s personal choice to gamble with his health care.
To complicate matters, though, that sort of policy, in turn, would require that we figure out a way to make health insurance more easily available to everyone. I think the most obvious way to do this would be to remove the link between employment and health insurance (obviously requiring tax reform) and to remove state restrictions on health insurance, thereby stimulating much more competition and consequently allowing people to shop around for affordable coverage that they could take with them from job to job, if desired.
Once health insurance is more easily available, it would then be acceptable and even justified to remove any government-imposed laws forcing doctors and hospitals to treat uninsured patients (leaving exceptions for certain extreme, excusable situations). That, in turn, would then make it acceptable and even justified to keep the government from imposing any laws on an individual’s choice to gamble with his own health.
Until those policy reforms are in place, though, it’s quite difficult to justify allowing people to gamble with other people’s money by refusing to purchase health insurance. So, short of a better, more limited-government alternative, as long as we’re forcing doctors to treat uninsured patients, we probably do need some way of forcing people to obtain health insurance.
The hitch in this roundabout conclusion, though, is the same as that in the libertarian approach I described: you can’t just fine people for not having health insurance when the tax laws and state health insurance policies still make it difficult for some people to get it in the first place.
So, either way, the first step is going to be making health insurance more available and more portable. Beyond that, may the better solution (the libertarian one, in my opinion) win.