A Health Insurance Mandate That Works Like Auto Insurance? Think Again

[Chris_]

A Health Insurance Mandate That Works Like Auto Insurance? Think Again

In building the case for mandatory health insurance, President Obama and congressional Democrats are comparing a proposed requirement to buy health coverage to the need for all car owners to buy auto insurance.

"Unless everybody does their part, many of the insurance reforms we seek, especially requiring insurance companies to cover preexisting conditions, just can't be achieved," Obama said in his address last week to Congress. "That's why under my plan, individuals will be required to carry basic health insurance -- just as most states require you to carry auto insurance."

But this analogy is becoming a liability, so to speak.

It's true that most states require drivers to carry auto insurance. And it's equally true that the administration wants a federal law that will require individuals and employers to buy health insurance.

But the similarities end there.

Now critics are starting to urge the administration to use a different, more representative comparison to justify a virtually unprecedented federal mandate.

"It doesn't make sense," Robert Gordon, senior vice president for policy development and research at The Property Casualty Insurers Association of America, said of the analogy, noting several inconsistencies in the comparison.

First, the auto insurance mandate is easily avoidable. If you don't want to pay, don't drive a car.

Don't want to pay for health insurance? Drop dead.

What a Rookie.     ...not even smart enough to hire a decent speech writer.  Those people are out of their depth in a parking lot puddle.

MORE

[DixieBelle]

And don't the rest of us have to pay for a little thing called unisured motorist's coverage to mitigate being in an accident with someone who didn't buy car insurance??

[Chris_]

And don't the rest of us have to pay for a little thing called unisured motorist's coverage to mitigate being in an accident with someone who didn't buy car insurance??

Uninsured motorist coverage may be optional, but it is always recommended.  Of course with Uncle Eg0's plan, you get to buy your own insurance and someone else's too.

[DixieBelle]

Whoo hoo!!!!

A socialist pig is still a socialist pig no matter what you dress it up with.

[Chris_]

Whoo hoo!!!!

A socialist pig is still a socialist pig no matter what you dress it up with.

Hey.     you just insulted pigs.



 

[Splashdown]

Bad analogy to begin with.

Nobody is forcing you to have tune ups, gas stops, and oil changes covered with your auto insurance.

[thundley4]

Bad analogy to begin with.

Nobody is forcing you to have tune ups, gas stops, and oil changes covered with your auto insurance.

Preventative maintenance on your car makes sense, and some new car warranties cover those. However the CBO has stated that preventatve health care is more expensive overall than treating illnesses as they occur.

[Chris_]

Preventative maintenance on your car makes sense, and some new car warranties cover those. However the CBO has stated that preventatve health care is more expensive overall than treating illnesses as they occur.

Gee, under Uncle Eg0's plan, can I drive my car until it falls apart, then call a tow truck, have it taken to a garage and repaired at someone else's expense?

[Splashdown]

Preventative maintenance on your car makes sense, and some new car warranties cover those. However the CBO has stated that preventatve health care is more expensive overall than treating illnesses as they occur.

But it isn't covered by, say Allstate or Liberty Mutual or State Farm. If it were, it would be at a rather expensive premium.

[AllosaursRus]

But it isn't covered by, say Allstate or Liberty Mutual or State Farm. If it were, it would be at a rather expensive premium.

No,no, no! Acording to the Obummer look-a-like, Allstate is cheaper than Geico! (wink, wink)

[Deuce]

I actually sortof agree with an insurance mandate, in principle. *hides behind flame-proof shield*

No, seriously. Let me explain. (and please make sure you read the end before jumping on me as some sort of communist!)

If someone gets sick or injured, and doesn't have any insurance, they still go to the hospital. They get treated, and they should, it would be criminal and immoral to just let people die because you aren't sure they can pay you. If you think otherwise, you should probably stop reading here because you seem to think being poor is being deserving of death. As a Christian I respectfully disagree.

So, this person who is uninsured and injured gets treated, but can't pay for it. Who pays for the care? The hospital has to pay doctors, and pay for supplies, and that money comes from somewhere.

It comes from you. And it comes from me. Your average working Americans who pay taxes and pay health insurance premiums. When YOU go to the hospital, your insurance company is deliberately overbilled to compensate for uninsured patients. This raises our premiums. We also spend a fairly large number of tax dollars propping up hospitals that need it.

We're already paying for the healthcare of others.

So by having everyone buy insurance, they're at least paying some share of the costs.

Also, legislating against the pre-existing condition denials pretty much requires a mandate. If an insurance company has to take unprofitable customers, they need to offset that cost with more healthy customers. Otherwise the system would be rampant with abuse, I could just not buy insurance until I get cancer, then jump on with Aetna and force them to spend tens of thousands on my care when I never paid them premiums before. They would have to jack up premiums tremendously.

In short, I'm tired of paying higher premiums and taxes because some dumbass 20-something thinks they're invincible and doesn't buy insurance even when they can afford it, and then ends up in a car accident or gets cancer.

Here's one serious problem

Some people can't afford insurance. You can't make people buy insurance when they can't even afford food. Worse, they want to PENALIZE people who can't afford it? That's just wrong. Wrong on so many levels.

So what's the option? These people are going to end up in the hospital eventually. Having them exempt from the insurance requirement just leaves us with the exact same problem. They get sick, we pay. Since we're going to pay, why not buy them an insurance policy via medicaid? At least that way some of their tax dollars are paying some tiny share of the cost. (assuming they work) Tax dollars are the only way to subsidize that.

There's one additional benefit to having 100% of the population covered. People with insurance go to the doctor more often. This will often catch a serious illness in earlier stages where it's far cheaper to treat. The $100 bottle of antibiotics to fight off pneumonia instead of waiting until it gets worse and going in for a $3000 hospital visit. I'm guilty of this one myself. This is one area where full-coverage systems in other countries save some money. The Swiss, for instance, have all-privatized health insurance companies but a mandated insurance law. 100% coverage but not socialized. Their healthcare spending is among the lowest in the industrialized world.

The other, far larger problem

Without a way to control them, what's to stop insurance companies from just jacking up premiums once we're all forced to be their customers? Premiums will skyrocket and profits will go sub-orbital as insurance companies dance around in piles of money handed over by their now-federally-captive customers. HR-3200 ("Obamacare") does very little to control the ever-increasing costs of healthcare. The weak-ass public option they put in wouldn't even be available to like 90% of the population, and the premiums would be "capped" at levels most of us can't afford anyway. Tax dollars would pick up the slack... soooo what's to stop premium increases? "Hey, even if we charge Joe Schmoe more than he can afford, we'll still get paid by uncle sam! woohoo!"

"Baucuscare" is even worse. (the bill introduced by the so-called conservative democrat Max Baucus) His bill doesn't do anything to curb costs. It's twice the handout for Big Insurance. Baucus is a conservocrat who is so bad at compromise he's managed to create a bill even worse than the liberal democrats!

What's my solution? MORE CHOICE. Right now, any given area has very few choices in health insurance. Most of us are pretty much stuck with whatever our employer uses. Open up the market across state lines, create more inter-state non-profit co-ops. The market will drive prices down and force insurance companies to stop being so wasteful. We also need to force insurance companies to play nicer when it comes to canceling policies and claims denials. Hell, throw in a public-option while you're at it, as long as nobody's forced to choose it or pay for it the worst that can happen is that it goes bankrupt and shuts down.

MORE CHOICE. Right now we have the illusion of a free market.

Holy crap that post ended up long.

[Chris_]

I actually sortof agree with an insurance mandate, in principle. *hides behind flame-proof shield*

No, seriously. Let me explain. (and please make sure you read the end before jumping on me as some sort of communist!)

If someone gets sick or injured, and doesn't have any insurance, they still go to the hospital. They get treated, and they should, it would be criminal and immoral to just let people die because you aren't sure they can pay you. If you think otherwise, you should probably stop reading here because you seem to think being poor is being deserving of death. As a Christian I respectfully disagree.

So, this person who is uninsured and injured gets treated, but can't pay for it. Who pays for the care? The hospital has to pay doctors, and pay for supplies, and that money comes from somewhere.

It comes from you. And it comes from me. Your average working Americans who pay taxes and pay health insurance premiums. When YOU go to the hospital, your insurance company is deliberately overbilled to compensate for uninsured patients. This raises our premiums. We also spend a fairly large number of tax dollars propping up hospitals that need it.

We're already paying for the healthcare of others.

So by having everyone buy insurance, they're at least paying some share of the costs.

Nope.  Not everyone would be buying insurance.  My tax dollars will be buying it for lots of people....so I get hit twice.

Also, legislating against the pre-existing condition denials pretty much requires a mandate. If an insurance company has to take unprofitable customers, they need to offset that cost with more healthy customers. Otherwise the system would be rampant with abuse, I could just not buy insurance until I get cancer, then jump on with Aetna and force them to spend tens of thousands on my care when I never paid them premiums before. They would have to jack up premiums tremendously.

In short, I'm tired of paying higher premiums and taxes because some dumbass 20-something thinks they're invincible and doesn't buy insurance even when they can afford it, and then ends up in a car accident or gets cancer.

Here's one serious problem

Some people can't afford insurance. You can't make people buy insurance when they can't even afford food. Worse, they want to PENALIZE people who can't afford it? That's just wrong. Wrong on so many levels.

See your comment upthread highlighted in red?  You just said that everyone would be buying health insurance.  Now making them do so is wrong?  Pick a side.

So what's the option? These people are going to end up in the hospital eventually. Having them exempt from the insurance requirement just leaves us with the exact same problem. They get sick, we pay. Since we're going to pay, why not buy them an insurance policy via medicaid? At least that way some of their tax dollars are paying some tiny share of the cost. (assuming they work) Tax dollars are the only way to subsidize that. 

How is this going to be cheaper?  Adding government bureaucrats will make it worse, not better.

There's one additional benefit to having 100% of the population covered. People with insurance go to the doctor more often.

Great, just what we need.  Everyone at the doctor's office every time the sneeze.  Hey, it's "free", so why not?     Guess you like waiting a few months to see a doc when you are really sick, huh?

This will often catch a serious illness in earlier stages where it's far cheaper to treat. The $100 bottle of antibiotics to fight off pneumonia instead of waiting until it gets worse and going in for a $3000 hospital visit. I'm guilty of this one myself. This is one area where full-coverage systems in other countries save some money. The Swiss, for instance, have all-privatized health insurance companies but a mandated insurance law. 100% coverage but not socialized. Their healthcare spending is among the lowest in the industrialized world. 

The other, far larger problem

Without a way to control them, what's to stop insurance companies from just jacking up premiums once we're all forced to be their customers? Premiums will skyrocket and profits will go sub-orbital as insurance companies dance around in piles of money handed over by their now-federally-captive customers. HR-3200 ("Obamacare") does very little to control the ever-increasing costs of healthcare. The weak-ass public option they put in wouldn't even be available to like 90% of the population, and the premiums would be "capped" at levels most of us can't afford anyway. Tax dollars would pick up the slack... soooo what's to stop premium increases? "Hey, even if we charge Joe Schmoe more than he can afford, we'll still get paid by uncle sam! woohoo!"

"Baucuscare" is even worse. (the bill introduced by the so-called conservative democrat Max Baucus) His bill doesn't do anything to curb costs. It's twice the handout for Big Insurance. Baucus is a conservocrat who is so bad at compromise he's managed to create a bill even worse than the liberal democrats!

What's my solution? MORE CHOICE. Right now, any given area has very few choices in health insurance. Most of us are pretty much stuck with whatever our employer uses. Open up the market across state lines, create more inter-state non-profit co-ops. The market will drive prices down and force insurance companies to stop being so wasteful. We also need to force insurance companies to play nicer when it comes to canceling policies and claims denials. Hell, throw in a public-option while you're at it, as long as nobody's forced to choose it or pay for it the worst that can happen is that it goes bankrupt and shuts down.

Ok, where do I sign up to opt out of paying for the public option?

MORE CHOICE. Right now we have the illusion of a free market.   [/quote]
That illusion will be a faint memory if Uncle Zer0 has his way.

Holy crap that post ended up long.

[Deuce]

The public option previously in the bills was opt-in, not opt-out. It's moot, since that was taken out in committee anyway.

Did you miss the part about me saying "as long as nobody was forced..."

To clarify, I would only support a public option if it had to pay for itself via collected premiums like any other insurance company. No tax dollars. Otherwise it wouldn't be on a level playing field and could wreak havoc on the healthcare industry.

I'm ok with public options as long as they are actually OPTIONAL.

[Chris_]

The public option previously in the bills was opt-in, not opt-out. It's moot, since that was taken out in committee anyway.

Did you miss the part about me saying "as long as nobody was forced..."

To clarify, I would only support a public option if it had to pay for itself via collected premiums like any other insurance company. No tax dollars. Otherwise it wouldn't be on a level playing field and could wreak havoc on the healthcare industry.

I'm ok with public options as long as they are actually OPTIONAL.

So by having everyone buy insurance, they're at least paying some share of the costs.

That doesn't sound optional.  Maybe you should get out that dictionary again.

[RightCoast]

Bad analogy to begin with.

Nobody is forcing you to have tune ups, gas stops, and oil changes covered with your auto insurance.

Not to mention when you get full car insurance you typically have to have someone take pictures of it BECAUSE PRE-EXISTING DAMAGE ISN'T COVERED

[Carl]

This will often catch a serious illness in earlier stages where it's far cheaper to treat. The $100 bottle of antibiotics to fight off pneumonia instead of waiting until it gets worse and going in for a $3000 hospital visit.

This argument is made often and always gets under my skin because it isn`t provable nor does it allow for the opposite assumption.
That being a flood of visits at some expense for every sniffle and cold that will get better on its own.

That part of the equation is ignored and never expensed.
What would be the increase in visits that are not there now and prevent nothing?
How much will it cost as opposed to the scenario you mention.

[thundley4]

This argument is made often and always gets under my skin because it isn`t provable nor does it allow for the opposite assumption.
That being a flood of visits at some expense for every sniffle and cold that will get better on its own.

That part of the equation is ignored and never expensed.
What would be the increase in visits that are not there now and prevent nothing?
How much will it cost as opposed to the scenario you mention.

Studies have shown that for an individual, preventative care is cheaper. However, when preventative testing and screenings are done over a larger population, the cost benefits drop quickly.

[Carl]

Studies have shown that for an individual, preventative care is cheaper. However, when preventative testing and screenings are done over a larger population, the cost benefits drop quickly.

I understand that preventative care is cheaper should something be prevented.
That is the assumption made...something will be prevented.

My issue is that there is no way to know if that is the case so if not then it will up the costs dramatically as people access facilities.
Not every cold will become pneumonia so where in the preventative argument is the fact that visits may increase with no saving benefit realized.
It is never suggested.

I think that is what you are saying with the last sentence,just annoys me it isn`t discussed when this preventative care will lower costs argument is stated.

[thundley4]

I understand that preventative care is cheaper should something be prevented.
That is the assumption made...something will be prevented.

My issue is that there is no way to know if that is the case so if not then it will up the costs dramatically as people access facilities.
Not every cold will become pneumonia so where in the preventative argument is the fact that visits may increase with no saving benefit realized.
It is never suggested.

I think that is what you are saying with the last sentence,just annoys me it isn`t discussed when this preventative care will lower costs argument is stated.

I've seen it talked about on blogs, but not in the media.

[bkg]

The public option previously in the bills was opt-in, not opt-out. It's moot, since that was taken out in committee anyway.

that's actually incorrect. Did you read HR3200? It was optional only the first year. Clever wording and legal-eze prevented people from keeping private insurance long term.

To clarify, I would only support a public option if it had to pay for itself via collected premiums like any other insurance company. No tax dollars. Otherwise it wouldn't be on a level playing field and could wreak havoc on the healthcare industry.

I don't get your logic on this one. What's the value of a public option if it's fully self sustained... just like a private insurnace company? Why make it public at that point?

[bkg]

Studies have shown that for an individual, preventative care is cheaper. However, when preventative testing and screenings are done over a larger population, the cost benefits drop quickly.

Can you cite those studies? Because CBO and others recently stated them to be complete BS. I'd like to dig into this more.

[thundley4]

Can you cite those studies? Because CBO and others recently stated them to be complete BS. I'd like to dig into this more.

The last I knew, the CBO said that preventative care costs more than treatment later on.

Congressional Budget Expert Says Preventive Care Will Raise -- Not Cut -- Costs

http://blogs.abcnews.com/politicalpunch/2009/08/congressional-budget-expert-says-preventive-care-will-raise-not-cut-costs.html

Reform proponents repeat this like a mantra. Because it seems so intuitive, it has become conventional wisdom. But like most conventional wisdom, it is wrong. Overall, preventive care increases medical costs.

This inconvenient truth comes, once again, from the CBO. In an Aug. 7 letter to Rep. Nathan Deal, CBO Director Doug Elmendorf writes: "Researchers who have examined the effects of preventive care generally find that the added costs of widespread use of preventive services tend to exceed the savings from averted illness."

How can that be? If you prevent somebody from getting a heart attack, aren't you necessarily saving money? The fallacy here is confusing the individual with society. For the individual, catching something early generally reduces later spending for that condition. But, explains Elmendorf, we don't know in advance which patients are going to develop costly illnesses. To avert one case, "it is usually necessary to provide preventive care to many patients, most of whom would not have suffered that illness anyway." And this costs society money that would not have been spent otherwise.

Think of it this way. Assume that a screening test for disease X costs $500 and finding it early averts $10,000 of costly treatment at a later stage. Are you saving money? Well, if one in 10 of those who are screened tests positive, society is saving $5,000. But if only one in 100 would get that disease, society is shelling out $40,000 more than it would without the preventive care.

That's a hypothetical case. What's the real-life actuality in the United States today? A study in the journal Circulation found that for cardiovascular diseases and diabetes, "if all the recommended prevention activities were applied with 100 percent success," the prevention would cost almost 10 times as much as the savings, increasing the country's total medical bill by 162 percent. Elmendorf additionally cites a definitive assessment in the New England Journal of Medicine that reviewed hundreds of studies on preventive care and found that more than 80 percent of preventive measures added to medical costs.

http://www.realclearpolitics.com/articles/2009/08/14/the_preventive_care_myth_97889.html

Spending More Won't Cut Health Care Costs

http://www.realclearmarkets.com/articles/2009/08/12/spending_more_wont_cut_health_care_costs_97355.html

CBO Says Preventive Care Costs More!

Surprise! Surprise! Another blow to healthcare reform. In an August 7, 2009 letter to the House Subcommittee on Health, the Congressional Budget Office (CBO) concludes:

"Although different types of preventive care have different effects on spending, the evidence suggests that for most preventive services, expanded utilization leads to higher, not lower, medical spending overall."

"Researchers who have examined the effects of preventive care generally find that the added costs of wide-spread use of preventive services tend to exceed the savings of averted illness."

You can read the rest of the analysis in the link to the CBO letter.

http://www.medlawblog.com/archives/legal-news-cbo-says-preventive-care-costs-more.html
PDF file of the CBO's letter

[Carl]

Thanks for the info.

[bkg]

The last I knew, the CBO said that preventative care costs more than treatment later on.

I apologize... I read the last part of your sentence wrong. My bad.  I'm a << I love the smilies on this place.

You are 100% spot-on; (so-called) preventative care on a mass scale increases costs.

[Deuce]

that's actually incorrect. Did you read HR3200? It was optional only the first year. Clever wording and legal-eze prevented people from keeping private insurance long term.

I don't get your logic on this one. What's the value of a public option if it's fully self sustained... just like a private insurnace company? Why make it public at that point?

I did read HR3200. I didn't see this sort of language, could you link me to it? I understood the public option as being only available through the exchange, and even then only to those meeting specific criteria. I didn't see anything making exchange participation mandatory.

(c) Transition- Individuals and employers shall only be eligible to enroll or participate in the Health Insurance Exchange in accordance with the following transition schedule:

I'm not fantastic at lawyer-speak so maybe you can point me to the specific clause. This stuff should be written in plain language so the public actually understands it!

As for the self-sustaining public option, it would (theoretically) operate more efficiently due to lack of high executive pay, no profit margin necessary, and less need to advertise. In theory, it would force the private insurers to clean up some of the waste and offer lower premiums to compete.

In theory. Of course, the dems' public option is nothing like the one I describe. Theirs is propped up by taxpayers and hardly available to anyone. (or so I thought. i'm hoping BKG can clarify that for me)

Also lug_nut: You're mixing up the insurance mandate with a public option. They're two entirely different things. You can have a public option without a mandate, or you can have a mandate without a public option. Or both. Or neither! (after discussions here I'm leaning towards neither) Replace the words "public option" with "extra insurance company staffed by government employees."