The debate over health care and insurance is not about whether or not we have it in this country or not. We do. It’s just a matter of who pays for it.
Those who opt out of paying for health insurance are not opting out of the health care system; they are simply opting out of paying for it. Now, if you are wealthy and can just write a check for any care you receive no matter what, then many will call that the most American of traits – the ability to stand on your own and Ayn Rand would be proud. However, most Americans without health insurance are not in that situation and when they have an accident or contract cancer or have a stroke, they still receive care without paying for it in a manner that Rush Limbaugh might call mooching off everyone else.
(Ayn Rand, the darling of the Anti-Government crowd, the paragon of individualism, the prophet of the virtue of providing for oneself and all others be damned, whose books were often nothing more than very long parables about “parasites,” “looters” and “moochers” who used the levers of government to steal the fruits of other people’s labor, eventually was hit in the face by reality and took advantage of social security and Medicaid. No, I am not criticizing her. Our system will help even those who cry and rail against it. That’s just the way we are.)
The health care industry is massive. The numbers boggle. In 2004, $124.5 Billion was spent on the health services for the uninsured, or about $2,800 per person; the same year, about $523 Billion was spent on those with insurance – at a cost of about $2,975 per person. (Source: The Kaiser Commission’s Medicaid and the Uninsured.) The Center for American Progress estimated that the cost of the uninsured health care provision added $1,100 annually to a family’s health insurance premium in 2009; by 2013, this is expected to rise to about $1,300. (For an individual policy, the increments were $410 in 2009 and an estimated $480 in 2013.) This computes to about 8% of insurance premiums.
Yeah, so what the right says. It is unconstitutional. If Congress can use the Commerce Clause to force us to buy insurance, they could then also require us to buy a new American-made car every couple of years. After all, new car purchases stimulate the economy.
The difference is that no one needs a new car but there comes a time when everyone needs health care. And so long as hospitals and doctors are required to provide care for the uninsured, it does affect interstate commerce. To further blow a hole in the argument against the individual mandate by comparing it to the new car, try going down to the local car lot and picking up a car without paying for it and see how long it takes you to see the judge.
But enough from me for a few minutes. Let’s look at Newt’s words:
I am for people, individuals — exactly like automobile insurance — individuals having health insurance and being required to have health insurance. – 1993 (Meet the Press)
Personal responsibility extends to the purchase of health insurance. Citizens should not be able to cheat their neighbors by not buying insurance – 2007 (Des Moines Register op-ed)
Finally, we should insist that everyone above a certain level buy coverage (or, if they are opposed to insurance, post a bond). Meanwhile, we should provide tax credits or subsidize private insurance for the poor.” – 2007 (Real Change, Regnery Publishing)
Without putting too fine a point in it, it seems the individual mandate, if not Newt’s idea, was at least supported by him when Hillary Clinton was derided for trying to get reform done 18 years ago.
The last idea, that of posting a bond, has some merit. However, the bond would need to be sufficient to cover almost anything, including being hospitalized for two years before dying. Doubtful even half a million would be sufficient, and this is well beyond the means of just about everyone. Nevertheless, I would be in favor of it, so long as I get to manage the bonds.
One last Gingirchism: People whose income is too low should receive Medicaid vouchers and tax credits to buy insurance,” he continued. “Large risk pools (association health plans are one model) should be established so low-income people can buy insurance as inexpensively as large corporations. Furthermore, it should be possible to buy your health insurance on-line to lower the cost as much as possible.
Now from the legal side:
The U.S. Court of Appeals for the District of Columbia, which has been described as having a conservative slant, recently ruled the individual mandate constitutional, saying “That a direct requirement for most Americans to purchase any product or service seems an intrusive exercise of legislative power surely explains why Congress has not used this authority before — but that seems to us a political judgment rather than a recognition of constitutional limitations,” Judge Laurence Silberman, an appointee of President Ronald Reagan wrote in the court’s opinion. Silberman was joined by Judge Harry Edwards, a Carter appointee. But, they added, “The right to be free from federal regulation is not absolute and yields to the imperative that Congress be free to forge national solutions to national problems.”
Commenting on this ruling, the liberal Constitutional Accountability Center said the ruling from a solid conservative like Silberman, as the Supreme Court prepares to take up the issue, is a “devastating blow” to opponents of the law. “With two prominent conservatives, this panel was thought to be a dream come true for conservative challengers of the act,” said the center’s president, Doug Kendall. “Today that dream became a nightmare, as the panel unanimously rejected the challenges to the act, disagreeing only about why those challenges failed.”
No doubt, other courts of appeal have ruled the other way.
And, finally, a poll (this is how all decisions are made anymore, isn’t it?):
A new CNN Poll on the issue of health care reform finds that support for the individual health insurance mandate has climbed to 52%, with 47% opposed. When the last survey was taken in June, that a majority of 54% opposed it, with 44% in support. (Conducted November 11 – 13, 2011.)
To conclude: I believe our country has the best health care science in the world.
However, the World Health Report 2000, Health Systems: Improving Performance, ranked the U.S. health care system 37th in the world, For comparison, Cuba was 29th and Singapore was 6th. (The conceptual framework underlying the rankings proposed that health systems should be assessed by comparing the extent to which investments in public health and medical care were contributing to critical social objectives: improving health, reducing health disparities, protecting households from impoverishment due to medical expenses, and providing responsive services that respect the dignity of patients.)
The problem is access and cost. The number one leading cause of bankruptcies in this country is medical bills. While we may rail against the socialist France and Germany and United Kingdom and what we perceive as exorbitant taxes, we must remember that included in their taxes are all medical costs and that in Germany, unlike here, no one goes broke because they got sick.
Ok, the argument against those systems is that you might wait months for a needed procedure. Try to get a transplant here without insurance and money and see what your wait is.
In the end, the so-called Obama Care does nothing more than prevent people from, as Ayn Rand said, using the levers of government to steal the fruits of other people’s labor. Why is this opposed?