Because if you don't mandate insurance, then the entire system falls apart. Sick people need it, healthy people don't want to pay for it. You need everyone to pay to make it affordable.
You're confusing insurance with healthcare. Insurance is supposed to be for risk mitigation, rare but extremely damaging events. If everyone uses insurance for everything health related, like we all want to do now, it's impossible for insurance to be anything other than a premium you pay on top of your healthcare costs.
Insurance shouldn't be used for routine stuff, and people shouldn't be required to have it unless they want it.
"insurance" in this case is also a savings account. People need to be forced to put money into the system when young and/or healthy so that's there's enough money available when they are not.
If they're not forced to do this, then they won't and people are forced to stand by and watch as they fall ill and due which is bad for the economy and may already disease, even if you don't care about the moral aspects.
There's little benefit to seperating these things out and obvious downsides to them not being mandated.
The premium on top of aggregate cost complaint would also apply to "pure insurance". Or else no one would bother selling it.
Anyway, I'm pretty sure they were saying that insurance didn't work, which is manifestly untrue. If they are complaining that it makes healthcare more expensive, well fine, but that is probably more about the principal agent problem than the administrative costs and profits of insurers.
This idea, which lies behind a lot of American libertarianism, says that theft (as taxation is construed here) outranks most or all other moral values, but does not explain why.
Instead, it hopes dogmatically that other moral values will be met as a side effect of following this one.
Not just theft, but aggression of any sort, including the most serious offenses such as rape and murder. Is there not a more fundamental moral value that we can all agree on?
> I'm arguing against being forced to help others who I have no relationship with, live in far off places, hold different health standards than me, etc.
How is that any difference from defense, law enforcement, fire protection, or property rights standards?
You're assuming that if the government didn't mandate health insurance, nobody would step in to help those people, which I don't believe is true. Lots of different groups – religious, businesses, municipalities, etc. – could fill that role. Individuals could even give directly to strangers in need through something like https://donorsee.com/.
This is Dan Ariely describing "The public goods game" and the instability of 'cheating'. Cheating in scare quotes because the conclusion stands -- in fact is enhanced -- even when the 'defect' choice is regarded as a choice that members of society are free to take (in fact that is the case he discusses).
>You're assuming that if the government didn't mandate health insurance, nobody would step in to help those people
No, the assumption is that if government mandated dollars stopped coming in, voluntary contributions wouldn't make up the difference. And that seems pretty obvious to anyone who pays attention to the political dialogue. Look at the Republicans who believe Obamacare is too costly. Their sole goal is to have less of their own dollars subsidize the sick.
That's also assuming the costs would stay the same, which they wouldn't if government stopped intervening. With lower costs, more people could afford to pay for healthcare out-of-pocket, which would reduce the amount of voluntary money necessary to cover those who truly need it.
I try to keep an open mind. I don't believe things will just solve themselves, nor do I think the market is the perfect solution. I do believe, however, that it's a better solution than government intervention, and we haven't found a superior solution.
Look at health care costs pre- and post-1965. They began increasing in 1965 with the passage of Medicare and Medicaid, and have continued to increase as more and more government regulations have been added since.
So are you in favor of a law so they can't discriminate on who they help? As if you are, it's an optional tax played for by people who aren't fully aware of the need. And if you aren't, better not tell anyone about your differences, you might die if the coke distributor knows you drink Pepsi or if the church knows you're gay.
No, in fact, the ability for these institutions to choose who they help is key. A business being able to choose to help only its own workers makes it possible to even help them in the first place. If they had to help anyone, it wouldn't be feasible. Same for a church or any institution. Being able to discriminate is important; it's not a dirty word.
Now before you go and doomsay about all sorts of discrimination happening based on race, gender, sexuality, etc., I'd argue that lots of institutions wouldn't discriminate on those factors. Case in point: most of the major tech companies. And if one did, would you really want to be associated with them and/or have them paying for your healthcare?
The ones that have recently faced age discrimination suits, criticism for the lack of diversity in their employees, and a whole range of reports of terrible conditions in their manufacturing plants? For some bizarre reason, I'm sceptical.
>And if one did, would you really want to be associated with them and/or have them paying for your healthcare
When compared to dying or living with severe health problems, absolutely. This entire thing is about unexpected healthcare costs, I may not have the ability to shop around for the most ethical choice.
No, the myriad that say "we care deeply about diversity and inclusivity" in their job posts. The ones that come out against banning travelers from Muslim-majority countries. The ones that care about climate change and the effects it has on people of this planet.
So adding a line to your job postings and sending out press releases is a better indicator than their actual acts? As you're probably talking about the same companies as me.
I understand what you're saying with "the ability to discriminate is important," but free discrimination has led to the trampling of human rights repeatedly in history.
> How do you justify the healthy paying for the unhealthy?
Over the course of time, everyone falls into both categories; this idea that there are healthy people is silly, everyone's health fails eventually and often randomly. Healthy is a temporary state. Everyone should contribute so everyone is covered when they become the unhealthy, as they all will.
Better to pay a little bit all of the time than to pay nothing and be unable to afford a giant medical bill that hits you all at once. This is why everyone should pay all of the time, then there's enough money to cover the every changing subset of people, which will eventually include you, who are sick.
But not everyone is (or becomes) healthy or unhealthy to the same degree. If I have no family history of health issues, or I simply want to take a chance that I'll remain healthy, why should anyone else tell me how much I should value my health?
It's really about double jeopardy. For a second put yourself behind the veil of ignorance. You are prebirth, you have no control over any factor of your birth other than one. That factor is that you get to pick whether you are born into a country with universal healthcare or one with non-mandated insurance where companies are able to discriminate on pre-existing conditions. Anyone who is risk averse is going to pick the universal healthcare one, otherwise you are risking a life where you are both sick but also bankrupted by medical costs.
That some people in society look at the circumstances of their birth and post-hoc reason that they don't want universal healthcare because it wouldn't have benefitted them is not the point really.
Even if you consider death a state of health – which is odd, who says "yeah, they're really unhealthy: they're dead" – the path to that state differs. Some people get sick very quickly right before death, while others are sick their whole life before death. Their required medical care vastly differs.
This is true, but it's not predictable which one you'll be. This line of reasoning is akin to claiming your car insurance should be cheaper because you'll never get into an accident. It's simply not logical. You cannot know if you're going to be someone who doesn't put a drain on the medical system or not, the future is not knowable.
You could be the healthiest person in the world and get punched by someone who gives you an expensive disease through blood contact; you could randomly get cancer at any age no matter how healthy you think you are. So this notion that you think you should pay less is based on a naive understanding of how health actually works; you cannot predict the future. You could be disabled tomorrow through no fault of your own. As such, the system must be designed to consider that everyone will be sick at some point and most people will be healthy most of the time, everyone pays and the sick are covered, problem solved for everyone. Social medicine works better than any other approach, this is a fact proven around the world. Those objecting to it are doing so on ideological grounds, not on rational ones.
I don't. I think paying for firefighters should be voluntary. Either I pay for it individually, or as part of my neighborhood, or at some other level that's much closer to me.
If I don't want to protect against my house burning down, why should I pay for it? And before you go and say, "because your neighbor's house could burn down too", they could choose to pay for firefighters and have them come out to douse my house in defense of their own.
