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Three Questions to the Left about Health Insurance

Submitted by chemjeff on Fri, 05/22/2009 - 12:11
in

1. If I do not want health insurance at all, and am willing to accept the risks involved, would you permit me to forego it?

2. If all the health insurance I want is catastrophic care, and I am willing to pay out of pocket for everything else, would you permit me to do this?

3. If I have objections to modern medicine in general, either based on religion or efficacy, would you permit me not to subscribe to a health insurance system that is entirely based on Western medicine?

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Comments

I wouldn't hold your breath

Submitted by Lonestar Bill on Fri, 05/22/2009 - 13:37.

waiting fo them to answer this.

"Pro Choice" only applies to abortion.

Universal health care is one-size fits-all. Maeaning we'll all get the same crappy coverage whether we want it or not.

 

1. If I do not want health

Submitted by acinphx on Fri, 05/22/2009 - 13:41.

1. If I do not want health insurance at all, and am willing to accept the risks involved, would you permit me to forego it?

Are you just willing to accept the risks, or do you have funds on hand to pay several hundred thousand dollars if need be if you end up having a major illness or accident?  If you don't have the hundreds of thousands, are you willing to forego medical care?  After being injured in a serious car accident -- would you be willing to tell the paramedics to just take you home and you'll treat the broken bones, ruptured spleen, etc., yourself, if you don't have the funds?

Or will you do what the uninsured do now when a need for medical care arises, and show up at the ER regardless?  In which case, the "risks you are willing to accept" end up as costs we all bear when it's passed along as higher hospital charges to insurance companies and self-payers.  If that's the case, no, I don't want to pay your costs just because you're "willing to accept the risks" -- you're not actually taking any risks if others end up paying for your care.

How does the assumption in your question differ from the situation we have now with mandatory auto insurance laws?  We all know some number of people still don't buy insurance because they're 'willing to accept the risks' or just don't have the money.  So the responsible among us pay extra for the uninsured/underinsured motorist coverage.  Net result?  We cover the insurance cost for those who don't buy the mandatory insurance, for whatever reason.  And we're currently doing the same with healthcare costs for the uninsured.

2. If all the health insurance I want is catastrophic care, and I am willing to pay out of pocket for everything else, would you permit me to do this?

Of course.  Many people do this now.  As long as you have catastrophic coverage so that we don't end up having to bear the astronomical cost of your catastrophic care factored into the charges to our insurance plans or out-of pocket expenses, I'm good with that.

3.  If I have objections to modern medicine in general, either based on religion or efficacy, would you permit me not to subscribe to a health insurance system that is entirely based on Western medicine?

If you're in an accident and your unconscious self is dragged out of a wrecked car, nobody on scene is going to be asking whether you want Western medicine to set your bones, deal with that head trauma, etc., or if you lose consciousness in the office because you're having a heart attack, they'll transport you to the ER, not to your chiropractor.  If you're better in a few days and want to leave the hospital, and sign the waiver to accept responsibility for declining treatment, you have my blessing.

Personally I think it would be reasonable to mandate catastropic coverage for Western medicine, which is far more likely to be the treatment mode in catastropic situations (major accident or illness).  If you want to buy coverage for alternative treatments, there's no reason you should be prohibited from doing that. The truth is, though, that if you collapse on the street or get pulled out of a wreck, you're going to be taken to a traditional ER for Western medicine. 

If you object on religious or efficacy grounds to Western medicine, don't go for that treatment and don't buy any more than catastrophic coverage.  If an insurer offers coverage for alternative treatments, buy it if you'd like.  Whether it works better or not as well as Western medicine might for your condition isn't for me to worry about.  (Actually, I believe in the healing properties of the mind-body connection more than most probably do, but I don't want the government to mandate that we all buy alternative coverage.)

health insurance

Submitted by chemjeff on Fri, 05/22/2009 - 14:00.

Are you just willing to accept the risks, or do you have funds on hand to pay several hundred thousand dollars if need be if you end up having a major illness or accident?  If you don't have the hundreds of thousands, are you willing to forego medical care?  After being injured in a serious car accident -- would you be willing to tell the paramedics to just take you home and you'll treat the broken bones, ruptured spleen, etc., yourself, if you don't have the funds?

"Accepting the risks" means, in my mind, that if I don't have insurance, I don't have money, and I am injured in an accident, that I will be just left to die.  The only costs incurred by the state will be those of the county coroner's office.

If you say it's immoral to just leave people to die, then I agree; however, who should pay for the consequences of this moral consternation?  Those who hold this moral view, or those who don't?  Of course it encourages freeloading.  But that is the inevitable consequence of the "nobody should be left to die" moral view.  If we don't want the freeloading then we should re-examine our moral stance.

On catastrophic insurance only:

Of course.  Many people do this now.

This will no longer be the case under a socialized medicine scheme.

If you're in an accident and your unconscious self is dragged out of a wrecked car, nobody on scene is going to be asking whether you want Western medicine to set your bones, deal with that head trauma, etc., or if you lose consciousness in the office because you're having a heart attack, they'll transport you to the ER, not to your chiropractor.  If you're better in a few days and want to leave the hospital, and sign the waiver to accept responsibility for declining treatment, you have my blessing.

Perhaps I don't want my bones set.  Perhaps I don't want my head trauma looked after.  Perhaps I just want to die, as God intended it to be.  Or something. 

I don't see the logic in

Submitted by acinphx on Fri, 05/22/2009 - 14:26.

I don't see the logic in taking a position that encourages freeloading -- remember, you get more of what you incentivize?  You didn't answer this point:

How does the assumption in your question differ from the situation we have now with mandatory auto insurance laws?  We all know some number of people still don't buy insurance because they're 'willing to accept the risks' or just don't have the money.  So the responsible among us pay extra for the uninsured/underinsured motorist coverage.  Net result?  We cover the insurance cost for those who don't buy the mandatory insurance, for whatever reason.  And we're currently doing the same with healthcare costs for the uninsured.

I shared my personal preference, that we treat catastrophic health coverage as we currently treat auto insurance under mandatory minimum laws.  A specified minimum coverage.  No need to buy more if you don't want to, but if you prefer better coverage it's available in the market.  Just as if you accept the responsibility of driving you accept responsibility for a minimum amount of coverage, if you want to live in a civilized society where people aren't left on the side of the road to die, you accept responsibility for the 'cost' of the common good by bearing the cost of mandatory minimum coverage for catastropic needs. 

Are you and other conservatives working hard right now to get mandatory auto coverage overturned?  If not, why not?  Isn't that the government dictating that it's not OK to just 'accept the risks' of being an uninsured driver?

Granted, my personal preference for health care is probably not that of the "left" or 'socialized medicine' as some would define it (which can refer to a multitude of models as they differ around the world).  But I see it as preferable to our current system.  Maybe I spoke out of turn in answering your questions because I'm not technically on the 'left' but as part of the mushy middle, I think there are many of us who want to explore better ways to address health care than our current system.

more health insurance

Submitted by chemjeff on Fri, 05/22/2009 - 15:34.

I don't see the logic in taking a position that encourages freeloading -- remember, you get more of what you incentivize?

I didn't say it was logical per se.  It's the result of a moral stand.  If we want to eliminate freeloading, the only correct solution would be to make every person fully responsible for his/her own health care costs.  But, we collectively have decided as a moral truth that we aren't going to permit that if failure to pay would result in the patient's death.  So yes it encourages freeloading but only as a direct result of the moral position that we are taking.  Of course we should work to minimize such freeloading, but as you correctly point out we get more of what we incentivize, so in this case it is a necessary evil we must live with.  Our moral choices have costs and we should be the one to pay those costs, not those upon whom the moral decision is foisted.

Are you and other conservatives working hard right now to get mandatory auto coverage overturned?  If not, why not?  Isn't that the government dictating that it's not OK to just 'accept the risks' of being an uninsured driver?

Well I am not a big fan of mandatory auto insurance laws.  I see it as yet another example of the nanny state trying to save me from myself.  But at least mandatory auto insurance laws can be justified on the grounds that they are only applicable when driving on public roads.  My body and my health, on the other hand, are not publicly owned.  (Well, not yet.)

Just as if you accept the responsibility of driving you accept responsibility for a minimum amount of coverage, if you want to live in a civilized society where people aren't left on the side of the road to die, you accept responsibility for the 'cost' of the common good by bearing the cost of mandatory minimum coverage for catastropic needs. 

Well, this is a bit of a non-sequitur.  If I believe in the moral proposition that nobody should be left to die because they can't afford health care, then it doesn't logically follow that I must pay for the consequences of that moral proposition by purchasing health insurance on myself.  There are plenty of ways to pay the costs associated with that, up to and including public funding of a Medicaid-style system, but I insist on reserving the right to not purchase health insurance if I so choose.

In fact I don't really see what is the moral principle behind requiring everyone to have health insurance.

Granted, my personal preference for health care is probably not that of the "left" or 'socialized medicine' as some would define it (which can refer to a multitude of models as they differ around the world).  But I see it as preferable to our current system.

What, specifically, do you find that is wrong with our current system that you think would be solved by socialized medicine?

Auto Insurance

Submitted by TimW on Fri, 05/22/2009 - 16:00.

Manditory auto insurance is normally limited to liability coverage.  That means I have to have a "minimum required amount" of coverage to pay for the damages that I inflict on others vehicles, property and health.  It doesn't usually include covering my own property or health (though this could vary in some states).  It's also pretty low, and could easily not be sufficient if I were to rear-end a Bentley.

Now, if I were to go buy a new car and take a loan out on it, I would probably have to pay for comprehensive coverage on it.  That's because I wouldn't "own" the car (it's the collateral on the debt), the loan-company would - and they want to make sure the damage to their car is paid for with insurance.  Comprehensive coverage usually comes with a medical part as well, but that's probably because the loan company wants to make sure I get well enough to pay off the loan.

So anyway, I say all that to say:  You're talking apples and oranges.  Me paying for manditory liability auto insurance isn't to protect my health, it's to protect everyone else from me.  Universal health care is the other way around.  I think?

good point

Submitted by chemjeff on Fri, 05/22/2009 - 17:52.

That is a very good point.  I hadn't realized that distinction before.

In Florida, auto insurance...

Submitted by Paleo-Skeptic on Fri, 05/22/2009 - 19:19.

... requires $50,000 personal injury protection.

My impression is that this varies widely from state to state. 

Me paying for manditory

Submitted by acinphx on Sat, 05/23/2009 - 00:52.

Me paying for manditory liability auto insurance isn't to protect my health, it's to protect everyone else from me. 

True enough.  That's why I would support a law mandating that you pay for minimum catastrophic health coverage, to protect me from the liability of having to pay your catastrophic healthcare costs.

Sorry, chemjeff

Submitted by Paleo-Skeptic on Fri, 05/22/2009 - 19:21.

...but you left out my favorite question:

4). Who the fuck died and left you God? 

heh

Submitted by chemjeff on Fri, 05/22/2009 - 19:32.

Heh.  Well I try to remain civil.  At least when I'm sober.