2firfun50 wrote:I've got a serious question for those opposed to paying for health insurance or being taxed for that decision.
I understand that Plan A is to never have a serious illness or injury, not pay any taxes, or health insurance, etc..
But if misfortune should strike, what is Plan B? Who pays the bill?
This is an excellent question, but it's framed in a way that
might cause folks to try and answer you in a narrow way...
A broader question would be "How do you fix healthcare so that fewer folks are without coverage?"
And as we all know, the answer is complicated... But, let me try and answer your question with some healthcare "fixes" and we'll see how it goes..
1. Postulate: If insurance costs less, more people will buy it. The cost of insurance is too high, because the cost of healthcare is too high and regulations and laws are misguided, causing further cost escalation.
- Reform healthcare tort, set limits on malpractice suits based on some reasonable categorization of injury/disability/etc.
- Reform FDA rules for drug discovery
- Implement technology to remove waste and fraud from the system
- Allow insurance products to be sold across State lines. The states with the most beneficial combinations of offerings will win. Other states will follow. For example, the insurance industry in Texas, IN MY OPINION, is a rigged game that favors insurers. The insurance regulators in TX, IN MY OPINION, are in cahoots with the industry. Why can't I buy an insurance product sold from Missouri?
- Allow ad-hoc, industry, professional, trade and other groups to band together to purchase healthcare insurance as a group. Currently, for example, TAM, who appears to be self employed (making assumptions here) cannot join together with a "web developer" trade group and go to the insurance companies to purchase a group plan. TAM must apply for coverage as an individual. This is insurance over-regulation at it's worst. It impacts entrepreneurship severely. Who will take the risk to start a business if you can no longer afford health insurance because you lost your buying power? Stupidity.
-There are MYRIAD other regulatory changes that would make insurance cost less. I'll let you ponder that and move on.
2. Postulate: If people knew the costs and could shop for care, competition would drive costs down.
- Witness the cost and technology of vision correction / laser eye surgery. Huge leaps in technology, dramatic decreases in cost. Why? Because most insurance doesn't cover it. People know what it costs because it's not just a copay.
- HDHP - We switched to a high deductible healthcare plan a few years ago. IIRC, our family deductible is about $4,000 before we see any benefits from our insurance company, except that our plan covers preventative care from $0. Where before I didn't care what the doctor visit cost, because I paid $25 or $35 per visit regardless, now that I have to pay $200 for an office visit when I have the sniffles, I behave differently. I talk with my doctors about cost, I've changed doctors due to cost, I review the bills and fix discrepancies before the bill gets paid, my expectation of my doctors has changed, I view them as service providers and don't stand for hour-long waiting room times... My insurance cost went down by about $400/month. More than enough to cover my deductible. By putting the saved cost into a HSA, I can save tax-free for medical expenses. After a year or two the balance in the HSA will be such that I can start reducing my HSA contributions and putting that money into my pocket for things like toys and vacations.
- Transparency. The cost for all medical procedures should be required to be available to all CUSTOMERS. Hospitals should post their fees, same for doctors, etc. Technology will help you shop for medical services just like Kayak helps you shop for airfares. Doctors who are good and also efficient will thrive. Doctors who are not will find something else to do.
- again... ad infinitum.
3. Now that we've driven the cost down.... and allowed people to band together to buy insurance.... we'll have more people covered for less money and we'll bend the cost trend line downward. But, some people will still not buy insurance. That is a risk they take.
- If a person has a major medical event, and does not have insurance....
---- Means testing....
......... If they are below the poverty line, they would be eligible for Medicare or other existing programs.
......... If they are making $60,000/year and have a house full of TV's and a garage full of toys (and a safe full of guns
), then they have made a financial decision about their life that they will need to take personal responsibility for. Rather than "TAX"
people for not buying insurance, you make those that don't buy it "accountable" for the risk they chose to take. YES, that could be a life-altering financial miscalculation. But if we are a nation of Liberty, we also need to recognize that Liberty comes with Responsibility.
......... Community organizations.. How many times a year are you asked to contribute to cover medical costs for a friend at Church, a coworker, etc. How many charity golf tournaments do you play in? There are many "community based" ways of covering unexpected healthcare costs. Hopefully these are needed less frequently as we bend the cost curve down.
In today's regulatory environment, healthcare is unnecessarily expensive. First we need to fix that, then we need to let people be responsible for the decisions they make.
YMMV