My question was framed in the context of assuming that universal health insurance is a Good Thing. If we assume that it is, and it's only an assumption, the question then becomes, who pays?
My point is that if government pays for it, the money really comes from income taxes. Why put an extra layer of bureaucracy between the patient and the insurer? That just jacks up the ultimate cost.
Many would force employers to pay for health insurance. That won't do anything for self-employed people, and it won't really benefit people who work for very small companies, because the employer may decide, or be forced, to hire fewer employees due to cost.
Presently, most employers who can afford it already offer health insurance as a benefit, but they usually require co-payment by the employee. And the truth is that the co-payment by the employer is really in lieu of salary. If the employer didn't pay for health insurance, it could pay a higher salary.
My husband works for the federal government, and has really good health coverage, but even though we belong to Kaiser, which is an HMO, he pays $1200 a year out of pocket as a co-pay for the coverage, plus we pay $6 for a visit, and $6 for a prescription. And I don't think anyone in America has better coverage than federal employees.
There really is no free lunch.
I think it's rational for people who are healthy not to pay for health insurance, and self-pay when they get ill. That tends to skew the population of people who have health care coverage towards those who are less healthy. I don't think it's fair for those people to force the rest of us to pay for their health care when the calculation turns out to be wrong, and the risk is greater than they calculated. In other words, I don't think it's fair to make the rest of us pay for them if they get really sick.
Given the choice between forcing the rest of us to pay for them, or forcing them to pay for themselves, I choose the latter. If Bill Gates doesn't want health insurance, let him file a certificate with the state that he is able to pay for himself. In Virginia, you aren't required to have liability insurance if you certify that you are able to pay the $20,000 minimum out of your own pocket. |
