Massachusetts makes health insurance mandatory
What do you do when an individual makes the choice to remain uninsured, yet has the resources to afford health insurance? Why, you assess a tax penalty, of course!
Massachusetts lawmakers passed a bill yesterday that will mandate health insurance for every resident. The very poor will receive "free" healthcare from the state/federal government. People who fall below 300% of the poverty level will receive subsidized plans with sliding-scale premiums. And people who can afford their own care, must do so or face tax penalties. Businesses that do not provide a plan for employees will be assessed a $295/employee yearly fine.
This bill passed with near-full, bi-partisan support and the Republican Governor (and 2008 Presidential hopeful) Mitt Romney is expected to sign it.
You can read the full story here at Bloomberg.com.
There is at least one good point to this legislation. The state is using private insurers to cover the low-income population instead of creating a bloated government bureaucracy. That is a great step toward utilizing the free-market.
The glaring problem with this legislation is, of course, the fact that the government is forcing people to comply or else face a financial penalty. This is the problem with declaring health insurance a "right," the government then feels that they have the right to force their policies on the people.
I do not agree that the government has the right to force free citizens to buy health insurance coverage for the sole purpose of obtaining a statistic that they arbitrarily deemed desirable.
They can't just say, "Massachusetts is the first state where everyone who wants health insurance has it"? Isn't that just as good? No, they need to say, "Massachusetts is the first state where every man, woman, and child has health insurance."
They can add to that, "Massachusetts is leading the charge toward full erosion of individual freedom."
Update: There is a great article in Business Week that gets into the details of the Massachusetts situation. Of the 500,000 uninsured, 40% are have a high enough income to afford insurance , but choose not to. Another 20% already qualify for medicaid, but are not signed up. That means at least 60% of the Massachusetts uninsured do not need this legislation to solve their insurance "problem".
(Wasn't I just saying the other day that I seriously question the number of uninsured that is used to justify universal coverage? I rest my case.)
47 comments:
the government then feels that they have the right to force their policies on the people.
Uh...yeah. That's what a government does by definition. Government has a monopoly on the legitimate use of force.
Anyway, what about car insurance? The government forces you to buy that. Is that an erosion of liberty? How about the liability insurance restaurants are forced to buy?
Sounds like Massachusetts is moving in the right direction to me.
The examples you gave are to make sure that in the event you harm someone, they will receive just compensation. Health insurance is to protect yourself, not others.
There are people who would rather pay out-of-pocket, there are people who would rather be part of one of those Christian groups that work together to pay each other's medical bills. The government should not force people to buy health insurance.
You and I have different philosophies. We might agree at times, but often we won't. You seem to think we need the government to take care of us. I believe that we can take care of ourselves if the government would just butt-out.
The MA plan is completely dependent on tapping into a pool of money that they have always allocated to cover the cost of uninsured visits to the emergency room, a pool that most states (including VT, I would guess) don't have. Without this money, there is no plan.
In any case, there is an excellent chance that this bill will never be implemented. MA also passed a health care bill in 1984 that was never implemented.
When someone shows up at the emergency room with no insurance- that affects everyone, not just that person. They WILL be treated and society WILL pay.
The difference in our philosophies is that I've accepted that we're all part of a whole, while you still cling to the illusion that individuals live in a vacuum by themselves.
Individual repsonsibility for one's self is very important, but people have to be responsible for each other, too. We're not all in the prime of our lives and our earning power. Children, the elderly, the handicapped and the unlucky deserve our help because each of us will be some or all of those things at some point in our lives.
I'm glad to have differing opinions like yours to spar with. This kind of mental exercise helps me refine my own beliefs. It's a good thing.
Thanks for your comments, anonymous.
According to the Bloomberg article, "The legislation was passed under pressure from the federal Centers for Medicare and Medicaid Services. They said they would cut off about $385 million a year in funding for care of the poor if the state didn't enact reforms by July 1." It sounds like they will have to implement it. Also, this passed almost unanimously, whereas the old legislation passed by only 2 votes.
You raise a good point about this mysterious "pool" of money. The Clavelle Plan was based on that same money, which as you stated, does not exist in a form that can be tapped.
The truth is, the proposal cannot be sustained with no new taxes. In our case we were lucky to have a Republican governor who called it what it was, "Hocus pocus." Apparently, Romney and the other Republicans in Mass. are not willing to do the same.
"Children, the elderly, the handicapped and the unlucky deserve our help"
You've said that you receive state-subsidized health coverage - which of those are you?
Many children are covered by parents who take responsibility for them. Many elderly were responsible in saving during their peak earning years, or have children who will fund their health care. Many handicapped people are perfectly self-sufficient as well, so it really boils down to "the unlucky." I think that if all we were being asked to cover were the truly unlucky, no one would have a problem. That's just not the case, unfortunately.
“The difference in our philosophies is that I've accepted that we're all part of a whole, while you still cling to the illusion that individuals live in a vacuum by themselves.”
No, the difference is that I have accepted that we will take care of each other without the government telling us what to do all the time, while you still cling to the illusion that we are all selfish little monsters who need big daddy government to make us play nice.
And I have accepted that we will all do better economically and socially when we are free, while you still cling to the illusion that we need the government to take care of all our needs.
And I have accepted that it is our capitalist system that has made America the great wealthy nation that it is, while you still cling to the illusion that socialism will work better, even though history has shown otherwise.
“I'm glad to have differing opinions like yours to spar with. This kind of mental exercise helps me refine my own beliefs. It's a good thing.”
Now, there is something we agree on.
I’ve gotta go. Tensel - out! (See, it sounds totally lame even when it’s not Ryan Seacrest saying it. I had to try it to be sure.)
"It sounds like they will have to implement it."
Businessweek has an article that speculates that it may not be implemented. I don't know all the details though, I just read about it yesterday like everyone else.
Clavelle's plan also omitted all of its startup costs. When Douglas would point that out in debates, Clavelle would start screaming, "vicious cycle virtuous cycle! Don't you understand?" It was truly pathetic.
"the difference is that I have accepted that we will take care of each other without the government telling us what to do all the time, while you still cling to the illusion that we are all selfish little monsters who need big daddy government to make us play nice."
Bravo Charity. I couldn't say it any better. Not half as well actually.
Sometimes it seems like people on the left have no faith in humanity - that if we don't create a big controlling government to enforce that everyone be provided for, it will never happen. Why so pessimistic and negative? As a conservative, I think of myself as an optimist; I believe that we can and will take care of ourselves and one another without being forced to do so by the government. I believe that most people are good and that they want to make the world peaceful and equitable. I don't need someone forcing me to do it.
Y'all are nuts. If humanity is so giving, why are there so many uninsured and so many poor?
We are little selfish monsters! Don't you get it? That's what the founding fathers believed. That's the whole reason behind checks and balances.
I believe that we can and will take care of ourselves and one another without being forced to do so by the government.
Where are the charitable trusts to cover the 40 million without health insurance?
Optimism is easier to muster when you're well fed. I want to be careful to avoid getting too personal, but you said yourself this morning that you're not earning your own living while your finishing your out-of-state costing UVM degree. That's a pretty cushy position from which to call others who are struggling "pessimistic" don't you think, T?
Well, you are pessimistic.
The reason that we don’t have a charitable trust to cover the uninsured is because the government does it. If the government got out of it, the people would pick it up – for those with real need, but not for those who can do for themselves.
If your neighbor came to you asking for a contribution because her child was really sick and they had no money or insurance, would you give to their collection? (I’ll assume that you would.) Do you think that is the exception or the norm?
As a family of five on a single income, we are on a very tight budget, but we give away money every month. That is why I believe in people’s generosity – because there will always be people who are willing to give to those who have less, no matter what their own situation is. (And of course, those with lots who give lots away.)
Sure. I'd give my neighbor maybe five bucks. If the medical bill was $50,000, which is not uncommon-she'd only have to hit up about 10,000 neighbors. Good plan.
You keep touting your family's tight budget. It sounds like you might be one illness, injury or house-fire away from economic disaster, much like most of us.
I hope to God you never have to go begging door to door to pay for one kid's medical expenses. If sure if you ever did, you'd become a socialist pretty damn quick.
"You keep touting your family's tight budget. It sounds like you might be one illness, injury or house-fire away from economic disaster, much like most of us."
Not everyone spends every penny they make. There are plenty of millionaires who are on tight budgets.
"I hope to God you never have to go begging door to door to pay for one kid's medical expenses. If sure if you ever did, you'd become a socialist pretty damn quick."
...and not everyone wants their neighbors to have to pay their debts, no matter how large. Although that may seem hard to believe in Burlington.
You don't make sense.
Five bucks?? No wonder you have no faith in humanity. You were bitching on your blog one day about not being able to buy a coffee, yet you would only give your neighbor 5 bucks for her sick child. That at least explains why you think people will only take care of each other if the government makes us.
“It sounds like you might be one illness, injury or house-fire away from economic disaster, much like most of us.”
Umm, no, we have the prudence to buy health insurance and renter’s insurance.
You imply that anyone who struggles financially would be a socialist. Since I am not, I must have all sorts of money. Neither of those things is true.
It’s all about choices.
I choose to give my money to people who need it rather than buy coffee.
"You don't make sense."
I dumbed it way down for you, I guess not quite enough. Feel free to point out which part of the post I can help you with.
I was never "bitching" about not being able to buy coffee. You got that totally wrong.You brought up coffee as one of the pious sacrifices you like to brag about.
How much money should I give this imaginary woman? $100? How much of your husband's money would you give? Would you make him work a second job to pay for this charity?
I'm not implying anything. I said if you ever had to beg door to door for your hospitalized kid, I bet you'd become a socialist. That's true. I'm sorry if you can't imagine walking a mile in anyone else's shoes.
I can see you're getting huffy and puffy and it's clouding you're ability to get the facts straight.
I'll get out of here and let you cool off for a while.
anonymous: thanks for dumbing things down for me, but when you dumb down something that's already dumb, you pretty much just get a pile of feces. -Appreciate the effort, though.
"something that's already dumb"
So is the fact that proper budgeting does not indicate low net worth a "dumb" idea to you? Or is it the notion that not everyone with a large debt will automatically want society to pay it off?
I'm in a charitable mood today, so I'll reiterate my offer to clarify these apparently difficult subjects for you. Please enlighten me on how these well understood and easily demonstrable concepts could be considered "dumb." Or just continue to avoid the subject by petulantly characterizing them as "feces" without making any attempt to refute them, your choice.
I am not huffy or puffy, but now that you mention it, it is slightly annoying that you went off on Tirade about not being poor enough to call you pessimistic, then when I brought up my own financial situation (hoping I had the right to criticize you), you said I was touting my financial situation.
FYI: A child in Essex needed a bone marrow transplant and my husband donated close to a hundred dollars to his fund. I did not bring this up earlier because I knew you would accuse me of being pious, but since you already did, I might as well say it.
By the way, I can imagine walking in another's shoes, that's why I know that I don't need the government to tell me to help people.
I will never become a socialist. If I was careless enough to not have health insurance for my kids...wait, that would never happen...well, if I was, I would not turn around and blame the government for my problems or ask it to solve them.
As for the coffee thing, you had a blog entry where you were all pissy because your debit card was declined when you were trying to buy a cup of coffee. I couldn't have brought it up. I don't even like coffee. If I did bring it up, it was in response to the fact that you like to whine about how poor you are, but yet you still buy coffee.
It's about choices, Haik. If you need to call me names in order to feel better about your choices, then have at it. I am secure enough in my own choices that I can take it.
I just think it is a little nuts that Mass is requiring their residents to have health insurance. If someone doesn't want insurance, that is their problem. If someone has the money to pay their medical bills without insurance then more power to them. (Well, I think it is nuts to NOT have insurance, but that is just my opinion.)
Creating a law saying one HAS to have insurance is just an attempt to make the state look better.
Fells
"Do you help people just to brag about it, or what?"
Yes. That's why I mentioned it right off the bat instead of using a fictitious example.
In fact, we were thinking about doing this.
Look, I was not trying to brag, but you keep saying that people will not take care of each other unless the government makes then and I know that that is not true.
Yes, arguing is addictive. That is why I married someone who does not like to argue.
I know you are, but what am I?
"what am I?"
I think you've more than answered your own question.
If someone doesn't want insurance, that is their problem.
I disagree. Individuals without insurance may forego care which endanger the community. When confronted with a serious illness, they may stop working, they may even divorce, so as to qualify for tax-payer subsidized care. Or, they simply seek emergency care and the cost is shifted to the fully insured through higher premiums, the hospital is going to recoup its costs somehow.
If you have question as to the impact of the uninsured on a community, talk so someone who lives in a city where there is a high concentration of non-documented aliens aka illegal immigrants. (Take for example a food worker with hepatitus b or turbucolosis, if they are uninsured, they may forego care and it becames my problem.)
Someone once explained to me that Fletcher Allen, as other hospitals through out the state, is a part of our infrastructure. So even if individuals were to seek out hospital services less and less, we still need to maintain the asset. All taxpayers benefit by having that asset in place and I happen to believe taxpayers should be billed (taxed) accordingly. I think mandated coverage is a step in the right direction.
Thank you 3PO! Yay! Another voice of REASON!
"I want to be careful to avoid getting too personal, but you said yourself this morning that you're not earning your own living while your finishing your out-of-state costing UVM degree. That's a pretty cushy position from which to call others who are struggling "pessimistic" don't you think, T?"
This is true Haik. I have a pretty great life (I have everything I need and want). But I've also lived on the other side. You wouldn't even believe how down and out I have been. And I pulled myself out of it - I didn't rely on the government to provide for me when I couldn't do so for myself. The reality is that I'm better off for it. Sure, I've been able to get loans and borrow money from the folks, but that doesn't shape my belief that people should not be required to provide for others by their government.
Our main difference (it seems) may be that health care and insurance are not rights, while others (I presume you) do.
Damn, I erased some of it. I meant it this way:
Our main difference (it seems) may be that I believe that health care and insurance are not rights, while others (I presume you) do.
"Rights" is just a concept. They are what we make them.
Right now the government forces me to pay for the roads you drive on.
Why should roads be a right? Why should anything?
"At least I'm an ass who stands behind what I say with an IDENTITY."
By "identity," do you mean "Haik Bedrosian" or "User Deleted Comment"? You've deleted literally dozens of your comments across various blogs that I've seen. Is that standing behind what you say?
The only impact anonymity has on blog discussions is that it allows a participant to speak freely, and in theory it should help to keep things out of the realm of ad hominem. I could just make up a name and you'd never know the difference, I'm not sure how that would change anything. I have no idea whether the name you use is your real name and I couldn't possibly care less.
You have continually posted hysterical rants, called fellow commenters a wide variety of profane names, told readers of your blog to "f*ck off," and attempted to derail comment threads on other blogs with a variety of childish tactics, all under what you say is your own name. Given the content of about half of your posts, I wouldn't call that brave, I'd call it stupid. If you don't understand why I would say that, then you should really, really speak with an adult about it.
"Why should roads be a right?"
They're not a right. If you really believe that, try driving south on 89 in an unregistered vehicle tomorrow and report back to us on the results.
OK. If not roads, then sidewalks. Why should sidewalks be a right?
If you don't think sidewalks are a right, tell me something you think is a right. Do you agree it should be? Are there any rights you believe in? If so, what are they and why?
Are you an anarchist?
Who me?
Well, as for roads, I am not opposed to the government paying for highways, but only because approx 89% of american households own one or more cars. It's not a right, but everyone benefits. This is the same with any public good: clean air, protection of the environment, roads, etc. These are things which everyone (undeniably) benefits from.
Public (government mandated) healthcare/ insurance for all doesn't benefit everyone. Far from it in fact - not the people who pay for it, or the people who are covered by it. Just look at Montreal. I know a lady up there who has been waiting for almost a year to get an MRI for a painful kidney condition. How is that beneficial?
Is it a person's right to have to wait months for crummy healthcare because all the good doctors left town (to work in places where they can make enough money to pay off years of med school loans or buy high tech medical equipment and supplies)?
Interesting point about the old lady from Canada. Yeah... I guess I don't believe in national health insurance after all...
but actually I was talking to "anonymous."
Oh... and Charity- I totally excerpted something from your blog and posted it under the picture of Kaufman on mine. Hope you don't mind.
"Are there any rights you believe in? If so, what are they and why?"
You've been down this road before. I'd post a link, but I think you deleted your side of the argument.
If you want to try to make a case that health care should be a right, go right ahead. It hasn't worked out for you in the past, but don't let that stop you from trying again. Think it through, and if you can come up with something that makes sense, post it. I'm not going to do it for you.
Oh my God! You have no identity and you don't believe in ANY RIGHTS! I can't believe this!
Your question wasn't relevant to the post or the discussion. Mine was. If you can't answer it, there's no law that says that you have to make frustrated noise instead.
Sounds like a dodge. What 'relevent' question did you again? You've asked a lot of questions.
I know, scrolling up three inches and reading would have been tough. Tell you want, you're obviously extremely overtired... or something. Why don't you get some sleep and try again tomorrow.
I did scroll up. That's how I remembered you asked a lot of questions.
Whatever.
"Whatever."
Touche!
Healthcare is a right - explanation attempt take three. Try again in the morning.
Haik: "the 40 million without health insurance?"
What 40 million?
http://www.townhall.com/opinion/columns/larryelder/2006/01/05/181083.html
"I think you mean there are 43 million Americans without medical insurance. And even the term 'American' should be taken with a grain of salt. For, out of the 43 million, this includes approximately 10 million people here illegally. Furthermore, the 43 million includes a large number of young, healthy Americans who decided to keep the money otherwise spent on premiums. And of that 43 million, Ted, approximately 20 million go without health-care insurance for four months or less. So when you get down to it, the hard-core number of Americans without health-care insurance is probably 10 to 15 million Americans, and out of a population of nearly 280 million, do we really want to call this a crisis?"
The crisis is not just how many are uninsured, but also the rate of cost increase.
Also, if it is 'only' 10-15 million uninsured- that is still a crisis.
As for illegal immigrants, I think they should be granted citizenship rights and free health care too.
"if it is 'only' 10-15 million uninsured- that is still a crisis."
So, if we had 3.5% to 5% unemployment, would that be an employment crisis?
Here's an even better example:
If we had only 3.5% to 5% of kids in public schools failing to achieve, would that be an education crisis?
Reduced quality of health care for the majority of Americans who pay for it would represent a much bigger crisis.
"As for illegal immigrants, I think they should be granted citizenship rights and free health care too."
They do get free health care. Why should those whom you acknowledge are illegal be granted citizenship? Would this be a one-time amnesty, and if so, how do you manage the issue going forward? Just repeal all of the immigration laws?
3-5% unemployment is as good as it gets. Economists would call that "full employment" That wouldn't be a crisis, but you're comparing apples and oranges.
Perhaps health care should be rationed to give everyone equal access. There shoudn't be any uninsured.
I think if you can get to this country, you should get to be a citizen. But that's just me.
"Perhaps health care should be rationed to give everyone equal access."
It's already rationed under the model that produces the greatest abundance -- it's called the exclusion principle.
"There is no need to mandate it."
If you are hit with a $1/2 mil hospital bill for yourself or someone that you hit with your car, and neither of you can afford to pay for it, who picks up the bill? It's called protecting the taxpayers from idiots.
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