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HEALTH CARE: Insurance requirement makes sense

Letter by Cindy Toraya, M.D., Tacoma on Sep. 28, 2011 at 1:30 pm with 30 Comments »
September 28, 2011 2:19 pm

It’s difficult not to compare mandatory health care insurance to the current car insurance requirement. Many have argued that not everyone has a car, so not everyone has to pay auto insurance. The constitutionality of this law is not questioned. People seem to accept that if you have a car, it’s fair to require car insurance.

With that in mind, I would say the following: If you want to receive health care, then you must have health insurance. If you are willing not to go to a doctor, nurse, physician assistant, physical/occupational therapist, clinic, urgent care, emergency department or hospital, and you will not call 911 or receive the care of a paramedic under any circumstances, then yes, I agree you should not have to purchase health insurance. But if you will use these services for any reason, then you must take responsibility and pay for it. This is common sense.

We have a system now that spares no expense to keep people alive who are in their final hours and days, whether or not there is any ability to pay for it. This same system won’t allow certain medicines or care to those who could really benefit from it for months and years because the insurance they do have chooses not to pay.

We would be better served spending time, energy and money creating ethical, quality health-care insurance rather than wasting it questioning whether it’s constitutional to require it.

Do we really question the constitutionality of changes that come from common sense?

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  1. stetsonwalker says:

    You seem confused, many people own vehicles and have no insurance to drive them. You only need insurance if you are going to DRIVE the car. If you own a car but your son drives you around you need no insurance. If you own service vans and you work in the office you do not need insurance on your vans. Only the drivers need insurance, and only if they are going to be driven on the road. You need to get things in correct perspective. It is a requirement to drive on the public road to have a drivers license, a safe legal car, obey traffic ordinances, and carry liability insurance TO PROTECT THE INTEREST OF THE INNOCENT PERSON YOU MAY HURT. You do not have to insure your self on your auto policy.

  2. Universal coverage makes sense – everything else is just rearranging the deck chairs.

  3. “Do we really question the constitutionality of changes that come from common sense?”

    these are the type of “changes” that we should question most….

  4. also you have the option of self-insuring your liability coverage…

  5. stetson’s hat must be down over his eyes.
    Making the comparison between car insurance and health insurance is complete and total nonsense. He must not see that.
    And it is so easy for a rational mind. That tell us something else about Mr. stetson.

  6. One similarity between auto & health insurance is we who have pay for those who do not.

  7. stetsonwalker says:

    Publico
    “Making the comparison between car insurance and health insurance is complete and total nonsense. He must not see that.”

    Cannot read? The original post made the comparison, not me. I was simply explaining the difference between the two. I recommend you go back and read it again s l o w l y so you will understand.

  8. “The constitutionality of this law [requiring car insurance] is not questioned.”

    Exactly… that is because car insurance laws are handled by the state, not the federal government. The state governments can do things that, constitutionally speaking, the federal government cannot do.

  9. In the event (or probability) that payment for mandatory health insurance premiums are ruled unconstitutional, I would love to see legislation pass which would:

    (1) require the amount of any bill to show how much of the bill is attributable to recovering the costs of treating uninsured patients. It seems I have to pay for uninsured motorist coverage on my personal auto policy. It discloses the cost to me when some uninsured drivers runs into me.

    (2) that no person would be responsible for medical bills that exceed a reasonable percentage of his or her income, AS LONG AS he or she carries health insurance commensurate with his or her ability to pay.

    (3) that no person shall have reasonably incurred medical bills discharged in bankruptcy, if he or she elects to buy health insurance commensurate with his or her income.

    It’s time to end the free ride for those who feel it’s constitutional to stick it to the rest of us.

  10. LarryFine says:

    Lame analogy.
    The auto insurance mandate is for people who choose to drive… and it requires the person who chooses to drive to purchase liability insurance. (this is where it gets real tricky for some folks) In the event that the driver is at fault and causes harm to another person the liability insurance covers the other person.

  11. stetsonwalker says:

    “It seems I have to pay for uninsured motorist coverage on my personal auto policy.”

    Not true, depends on your insurance. A named operator policy does not have that requirement!

  12. BlaineCGarver says:

    Kill all health insurance, and I want a single payer, non-profit co-op, paid for by a national sales tax (so everyone pays according to their means) and a board to make sure nobody overcharges, and just do it. I’m sick of Big Medicine making trillions off the backs of the sick and dying.

  13. BlaineCGarver says:

    Dr Cindy seems to have forgotten her oath, and is all about the $$$$$$$

  14. “BlaineCGarver says:
    September 29, 2011 at 12:24 pm
    Kill all health insurance, and I want a single payer, non-profit co-op, paid for by a national sales tax (so everyone pays according to their means) and a board to make sure nobody overcharges, and just do it. I’m sick of Big Medicine making trillions off the backs of the sick and dying.”

    Mr. “Noun, Verb, Socialist” just demonstrated his socialism. Mark this day on the calendar…..

  15. As to mandatory health care insurance….

    It appears the leading Republican candidate for President was responsible for his state crafting a mandatory insurance law……

    In the past, Republicans have suggested a mandatory insurance law…..

    Now they oppose it because Obama pushed it through.

  16. By Julie Rovner….

    “For Republicans, the idea of requiring every American to have health insurance is one of the most abhorrent provisions of the Democrats’ health overhaul bills.

    “Congress has never crossed the line between regulating what people choose to do and ordering them to do it,” said Sen. Orrin Hatch (R-UT). “The difference between regulating and requiring is liberty.”

    But Hatch’s opposition is ironic, or some would say, politically motivated. The last time Congress debated a health overhaul, when Bill Clinton was president, Hatch and several other senators who now oppose the so-called individual mandate actually supported a bill that would have required it.”

  17. LarryFine says:

    Tard doesn’t know the difference between Federal and Sate… kooky

  18. If the Supreme Court overrules the mandatory insurance part of the health care reforms, it will likely hinge on the powers of the federal government under interstate commerce. If it is repealed, Washington State should immediately enact them into state law like Massachusetts did under Romney.

    Emergency room visits dropped dramatically and health care costs were reduced in the state by about $1 billion per year in that state. Costs to providers and payers, including private insurance, charities and government, have been significantly reduced.

  19. Not true – ED visits actually went up though the severity of the cases dropped.

    Deval Patrick stated on a talking head show that the health care bill ADDED about one percent to the state budget. Further analysis showed that some of the healthcare costs have been passed on.

    Those added cost were paid for by an increase in Medicaid money from the feds. Cost have also been passes on to businesses and individuals.

  20. xx, if you are talking to me, here is the study, so see for yourself. The costs to the state increased about $88 million. The savings to citizens and paers for medical services went down over 1 billion per year.

    I don’t know when or where Gov Patrick’s statistics came from, but this study is reported: http://www.econbrowser.com/archives/2010/11/the_impact_of_h.html

    I did see a study in the NEJM that showed that the rate of ED usage did not fall as rapidly as predicted and attributed much of that to the increase in illegal immigrants in Massachusetts compared to the decrease in most other states where ED usage has dropped as numbers of illegals dropped.

  21. Ok… a little sigh here…

    You got 88, the number I am seeing is 353 which equates to @1% of the Mass state budget.

    I tend to believe Deval Patrick, you know the Governor of the State of Massachusetts. I kinda believe that he uses his internal beancounters as oppose to blogs and such… that’s just me, I could be wrong.

    My assessment, since it came from the mouth of Deval Patrick, is to believe Deval Patrick in this case. I don’t see him having a whole lot of incentive to lie about this stat. Cost to the state went up.

    By his own statements, the plan was to insure people and then address cost controls. You own study states…

    ”… the Massachusetts reform did not appear to “bend the cost curve” upward or downward.”

    So therefore… cost have gone up.

    PS – from your own source there is a chart that shows emergency room visits were trending down prior to the implementation in 2006 to a low in Q3 2007 and has been trending back upward since… just an FYI

    PSS – speaking of charts, from your own source by the way… it does show a decrease in the uninsured as well as a decrease in the number of privately insured. Medicaid slight decrease. Medicare an increase (oh boy did it). This “Other” charts one would need to investigate more as it’s trend is a 45 degree angle up since 2006… that might not be so good.

    PSSS – speaking of more charts… the cost charts… hmm, olde Deval needs to work a little more in that area… all the charts show an increase that is consistent with their comparisons (other non-mandated states)

    $1 Billion??? Dude, don’t see it… and sorry to say your own study doesn’t support that number. I may have missed it…?

  22. Speaking of Deval Patrick… notable quotes…

    “I don’t think anybody is prepared to say that what we have done here in Massachusetts is necessarily the formula for the rest of the country or for a national reform, but at least we are trying.”

    Gold star for trying from me…

  23. hey tuddo, you made the statement…

    “The savings to citizens and paers for medical services went down over 1 billion per year.”

    … then why is Deval Patrick unveiling “legislation he says will rein in spiraling insurance costs by setting boundaries on the health care market.

    The push to slow soaring costs in Massachusetts has intensified since the state passed its landmark 2006 health care law. About 98 percent of residents are now insured.

    While the law dramatically expanded coverage, it did little to curb costs. Those costs are now putting increased pressure on the state budget and family finances.”

    …like I said not sure where that $1billion in savings is coming from, unless we are doing an Obama and saying it coulda been 2, 4, 6… billion.

    Just a curious find to me…

  24. I am always interested in statistics and facts developed by people whose job it is to do so. $88 million was the increase in state costs for medical programs. $1 billion was the total savings to all payers, not to the government, so I imagine the governor is just talking about state costs, a good thing to look at.

    I said I don’t know where the Gov is getting his numbers, so show me. Every study I read shows a decrease of usage of ED’s, and a decrease in costs to all consumers from 2006, the base year which is what I am going on. It is usual to look at before and after to see what impact a change has.

    Perhaps the governor is comparing 2009 and 2010 like the study in the NEJM did that showed a big increase in usage of ED’s by illegal aliens in Massachusetts that is slowing the benefits of the law.

  25. Deval Patrick and his numbers – I am not sure where he got his numbers from either. Doesn’t common sense tell us that they are from an official state funded source, typically the State of Massachusetts Bean Counting Department. Is this an issue? Are we calling Deval Patrick, the Governor of the State of Massachusetts misinformed? I am not sure why his numbers and the credibility of them would be an issue – he is a Democrat for God’s sake.

    About the Emergency Department – The studies I am reading consistently state the use of the ED is climbing. The population tends to be the elderly and the chronically ill. They are centered in urban area with Boston being the most users. The reasoning appears consistent that they are a population with chronic needs and access to primary care remains an issue. Just because you have health insurance doesn’t mean you have access to a Doctor. The rate of usage pre and post insurance appears to be the same. About 85% of those that are using the ER have some kind of insurance… the same is true today. As far as illegal, I have seen nothing relating to resident status.

    As far as costs – the studies I have read state some form of the following. Cost have gone up. Mass Health Mandate did nothing to contain cost. 10% from 2007 to 2009 in one, 12% in another. Costs to consumers have gone up. Also those that did not have to pay for insurance, now do or pay a penalty… that sir is a cost to the consumer.

    Costs part deux – subsidies, the state is subsidizing many of the plans so there is a cost to the state but guess who pays to run the state – taxpayers… some human being in the state of Massachusetts is paying more. It appears it is quite a few of them. Example – family earns $66,150, subsidize $3,000… great…. Oh wait the annual cost for the health plan is about $10,000. “Somebody” is paying dude somewhere in that state.

  26. beerBoy says:

    “Do we really question the constitutionality of changes that come from common sense?””

    these are the type of “changes” that we should question most….

    xx beat me to the punch on that response.

    I would also like to point out that the health care reform bill “solutions” were hardly common sense – they were a convoluted attempt to try to improve the situation while continuing to appease the Insurers and avoid discussing the only real solution – Single Payer coverage.

  27. KARDNOS says:

    “LarryFine says:
    September 29, 2011 at 9:08 pm
    Tard doesn’t know the difference between Federal and Sate… kooky”

    Oh…so when the Republicans suggested a mandate federally….that didn’t count?

    “But Hatch’s opposition is ironic, or some would say, politically motivated. The last time Congress debated a health overhaul, when Bill Clinton was president, Hatch and several other senators who now oppose the so-called individual mandate actually supported a bill that would have required it.”

    Then…of course, there was the Terry Schaivo case…which had nothing to do with Federal juristiction, but Bush did his midnight flight.

    If you’re a Republican, you get to pick and choose when it’s not federal juristiction

  28. KARDNOS says:

    I wonder how much Jesus would have charged for healing the sick

  29. xx98411 says:

    “I wonder how much Jesus would have charged for healing the sick”

    Well if you came to see me and it was just me and the boyz hanging out at the Temple then I would not have charged you anything…. watch your step there…

    but if it started getting busy and I needed some help with appointments, a waiting area, equipment, supplies, etc… I would have to charge…

    You know I would have to pay “livable wages”, taxes, unemployment insurance, my share of the taxes to the Romans and the local dude – Pontius, FICA, health insurance, disability insurance, a 401K for the assistant, ergonomic chair, liability insurance, malpractice insurance, will need an attorney on retainer, professional dues to the medical association, equipment replacement…

    … you get where I am going. Thet’s why I prefer to walk about with the entourage… funner, less regulation…

    God bless you. (kinda creepy refering to myself in the third person)

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