Over the weekend I participated in several discussions on the health care summit and other general reform topics. The one argument I heard over and over dealt with comparing the individual mandate with Minnesota's requirement of car insurance to drive a car. At first when the comparison was being made I struggled to fathom how such a comparison was being made. As the conversations wore on, I noticed that every time someone brought up the Constitutionality of the individual mandate the response from its supporters was to compare it to car insurance. Now, Minnesota law states that everyone that owns and operates a vehicle on State roads must carry liability insurance. Last time I checked, the Department of Motor Vehicles was not handing out driver licenses to anyone that wanted one. One must go through an approved Drivers Ed class, pass a written exam and pass a driving exam all before a license is given out. Granted to renew ones license all one needs to do is pay the renewal fee and answer a few questions.
Within the car insurance analogy the argument was made that requiring everyone to carry insurance keeps the costs down and spreads the risk. True it does spread risk but the original intent of requiring every Minnesota driver to carry liability car insurance is to protect the other driver. Remember that the type of insurance required is liability which will do nothing for one if they are the only party to an accident. In a good show of understanding I relented my position and agreed with the car insurance analogy. As I converted my stance, I asked the group what everyone paid for car insurance. Ironically not everyone paid the same amount or had the same type of coverage. I asked the group why. We brainstormed for a while and came to a consensus that it was determined mainly by ones driving record. Even though everyone had car insurance, it was brought up that not everyone qualifies for car insurance. A story was shared about a person that could not get insurance because of several DWI's and other items on their driving record.
To which I asked, can we make the comparison of one's driving record to one's health pre-condition. A consensus on this was not able to be reached, so I pose this to those reading the blog: Is a driving record the same as a pre-existing condition? The reason I brought this point to light was that everyone pays a different amount for their car insurance even if their coverage is the same as another. So, if a driving record can be used to rate someone up then why cannot a pre-existing condition be used in the same manner? Better yet, why cannot someone who frequents a clinic or hospital more than another pay a higher rate on their insurance? After a few more questions, a few of those that used the car insurance analogy started to re-think their position.
Is the car insurance analogy viable to mandating health care insurance? One does not need to own or drive a car in order to accomplish the basic functions of life. I have gone over the Constitution again to see where it states that Congress, Executive Branch or the Judicial Branch can mandate that Americans purchase any particular item or service and I still have not found where it is stated or implied. Granted I am not a Constitutional scholar but I do believe the Founding Fathers wrote the Constitution for more than lawyers to understand. If we eliminate pre-existing conditions do we then eliminate the driving record in determining rates for car insurance? Does the Car Insurance argument hold water when comparing it to the health care mandate?
Here is something that a friend of mine on Facebook posted in response to this entry:
ReplyDeleteI think the difference between car insurance and medical insurance is the fact that, whether or not you have medical insurance, if you come into an emergency room with a critical injury, you will be treated regardless. You can still get around without car insurance. Now if the hospital cannot collect on that treatment due to a lack of insurance, ... See Morethe hospital has to pass that cost on to the rest of it's customers.
Also, not having medical insurance is pretty much a guaranteed trip into destitution if you have a major illness or injury. Right or wrong, our society has pretty much agreed that certain people (the elderly, families with children, veterans etc) should not be allowed to starve in the streets, so when people end up destitute, all of society is required to pony up for their support. I believe the thinking is to eliminate that one route to poverty by requiring medical coverage.
I'm not sure that requiring medical insurance is going to reduce health care costs, so I'm not sure why this is being called health care reform. I thought the idea was to make health care affordable for everyone.
Medicare is pretty much a health care insurance mandate as it is, you just need to survive to retirement age to begin recovering the money you've paid in all your life. Something to think about when it comes to a government run insurance program is the majority of retired people who are satisfied with their medicare coverage.
I have debated healthcare reform with you on this site, however, I personally do not like to make comparisions with auto insurance. Remember, my mortgage company requires me to carry home-owners insurance also. The federal government has never mandated any kind of enrollment before, and doing so could be legally sticky....
ReplyDeleteI believe that the mandate, whether you like it or not, is the ruse of the insurance companies who are going to have to abide by the new regulation put forth. If everyone is required to carry the insurance in some fashion or another, insurance companies can use that to spread the risk around. Remember, huge mulitnational corporations, state and city governments, they pay less for healthcare because they have enough risk to spread around.
Now, the argument on whether it will reduce costs is up in the air...much like the whole program. The real issue to contend with is whether the government will want to regulate what those prices can be. I largely agree with Obama on many things, but that I have to disagree with doing that. It would amount to price-controls which is suicide for lowering costs of anything.
I think that insurers need to step up with the healthcare industry to cover more people who cannot afford it. Personally, I think that healthcare should be run non-profit wise to keep Wall-Street out of the picture. That alone might help curb costs...
I am warm to the non-profit aspect of health care but is it Constitutionally okay for the government to deem a certain sector as non-profit? I agree that price controls will kill the industry and does nothing to reduce costs.
ReplyDeleteI even made an argument on how Obama could Trojan Horse the health care mandate by phasing out Medicare and Medicaid for those under 55 and divert the dollars collected on those taxpayers to a HSA. The key to the success though is to leave the HSA in a seperate account and not allow the funds to go into the General Fund like they did with SSN. This way people get the benefit of a HSA while not skipping a beat as they already pay into Medicare and Medicaid.
ReplyDeleteGranted this change will benefit the younger people in American. Then again it is the least we can do for them since our current and prior administrations are doing their best to bankrupt future generations.
Sorry, there isn't much benefit to an diverting Medicare contributions to an HSA unless you are expecting those dollars not to be touched until one reaches a certain age. I make just over 50k and get paid bimonthly. My Medicare deduction each paycheck is a about 30 bucks. That doesn't do much to cover health care on its own.
ReplyDeleteI do admit that the $30 per check is not something that will be enough but it is a start. The funds will be accessible all through life and one will be able to contribute more. As I said, it will benefit the younger generation because one can start contributing with their first job. Now, if a person was putting in $30 a paycheck when they were 16 then that would be a good start since they will more than likely be on their parents insurance until 18 or 24 or even 27 if the President get's his way.
ReplyDeleteBut the HSA is just one aspect of the overhaul as many will agree that there is no silver bullet to health care reform.