About the "uninsured"

KingCondanomation

New member
Often times when we hear about the uninsured we imagine some poor group of people who are so desperately poor they can't afford health care insurance or find a job that provides it, but let's look a little closer.



"Roughly one quarter of those counted as uninsured — 12 million people — are eligible for Medicaid and the State Children's Health Insurance Program (S-CHIP), but haven't enrolled. This includes 64 percent of all uninsured children, and 29 percent of parents with children. Since these people would be enrolled in those programs automatically if they went to the hospital for care, calling them uninsured is really a smokescreen.



Another 10 million uninsured "Americans" are, at least technically, not Americans. Approximately 5.6 million are illegal immigrants, and another 4.4 million are legal immigrants but not citizens.



Nor are the uninsured necessarily poor. A new study by June O'Neill, former director of the Congressional Budget Office, found that 43 percent of the uninsured have incomes higher than 250 percent of the poverty level ($55,125 for a family of four). And slightly more than a third have incomes in excess of $66,000. A second study, by Mark Pauly of the University of Pennsylvania and Kate Bundorf of Stanford, concluded that nearly three-quarters of the uninsured could afford coverage but chose not to purchase it.



Only about 30 percent of the uninsured remain so for more than a year, approximately 16 percent for two years, and less than 2.5 percent are uninsured for three years or longer. About half are uninsured for six months or less. Notably, because health insurance is too often tied to employment, the working poor who cycle in and out of the job market also cycle in and out of health insurance.


For example, young, healthy, and well-off people might be more inclined to buy insurance if it cost less. That means ending regulations, like community rating, that increase the cost of insurance for younger and healthier workers; eliminating costly mandated benefits; and creating more competition by allowing people to purchase insurance across state lines.

And if people are losing their insurance when they lose their jobs, we should move away from a health care system dominated by employer-provided health insurance. That means changing the tax treatment of health insurance.

The current system excludes the value of employer-provided insurance from a worker's taxable income. However, workers purchasing health insurance on their own must do so with after-tax dollars. This provides a significant tilt toward employer-provided insurance. Workers should receive a standard deduction, a tax credit, or, better still, large Health Savings Accounts (HSAs) for the purchase of health insurance, regardless of whether they receive it through their job or purchase it on their own."

Article here



Some important points from this are that

- In America, unlike most countries, you actually have the freedom NOT to pay for health insurance, a few people may disagree with their choice but it was their choice and we should respect it

- The vast majority of people declining insurance are NOT poor enough to afford it

- We can help best by doing real reform of reducing government's role in healthcare, rather than once again expanding it.

- Healthcare insurance is not a right, it is a popular middle man but not a forced or sometimes even desirable one.
 
I don't respect someone's choice to not pay. Know why? Because if they need medical care, chances are that I end up paying for it anyway.

As for the rest, insurance costs are increasing exponentially. Every year, more companies drop coverage or reduce benefits, and more families simply can't afford their own plans. It's a trend.
 
I don't respect someone's choice to not pay. Know why? Because if they need medical care, chances are that I end up paying for it anyway.
No you won't, they are forgoing health INSURANCE, not healthcare itself. In other words they can afford the insurance but would rather pay for healthcare when they need it, if they ever need it.

As for the rest, insurance costs are increasing exponentially. Every year, more companies drop coverage or reduce benefits, and more families simply can't afford their own plans. It's a trend.
The article addresses that with solutions involving reducing regulation and moving away from employer based insurance. I believe this was one of the few things you agreed with on Bush from a few years back, with not mandating universal healthcare and an ownership society.
 
"No you won't, they are forgoing health INSURANCE, not healthcare itself. In other words they can afford the insurance but would rather pay for healthcare when they need it, if they ever need it."

For the most part, they can't afford it; either the insurance, or the costs if they're injured or sick.

The only thing I agreed with Bush on was Social Security.
 
- In America, unlike most countries, you actually have the freedom NOT to pay for health insurance, a few people may disagree with their choice but it was their choice and we should respect it
Why? They're trying to game the system. It may work and it may not. Any way it goes, we can't really let them have a heart attack and refuse treatment because they can't pay. So they come out with an advantage. In an area of the economy where there's such moral hazard, there's nothing wrong or illiberal about mandating that people pool their risk in insurance.

The total societal effect would be rougly equal anyway, comparing a risk pool system to an individualist system in which everyone had complete and total personal responsibility. If they don't, then the individualists system is more expensive. Lose-tie situation.
 
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"No you won't, they are forgoing health INSURANCE, not healthcare itself. In other words they can afford the insurance but would rather pay for healthcare when they need it, if they ever need it."

For the most part, they can't afford it; either the insurance, or the costs if they're injured or sick.

A study proves they can afford it, from the article:
"A second study, by Mark Pauly of the University of Pennsylvania and Kate Bundorf of Stanford, concluded that nearly three-quarters of the uninsured could afford coverage but chose not to purchase it."
 
there should be some sort of forced penalty for those who don't get insurance.. like losing there individual federal tax exemption. that at least would cover if they have a health issue and keep the rest of us from absorbing it.
 
A study proves they can afford it, from the article:
"A second study, by Mark Pauly of the University of Pennsylvania and Kate Bundorf of Stanford, concluded that nearly three-quarters of the uninsured could afford coverage but chose not to purchase it."

What were the metrics?

Are we talking about people who "chose" not to have insurance because it would only take about a quarter of their monthly income? Obviously, they could still "afford" it, but most who don't have it "choose" not to because it would cost too much of their income.

And they usually can NOT afford any costs above an average doctor visit, if they are in an accident or get any kind of illness which requires treatment...
 
Why? They're trying to game the system. It may work and it may not. Any way it goes, we can't really let them have a heart attack and refuse treatment because they can't pay. So they come out with an advantage.
They are not gaming anything, given that they can afford it, they are taking a calculated risk, you disagree with their choice fine but it's their FREE choice, not yours. A homosexual has a higher probability of contracting AIDS, does that give you a moral or financial reason to stop them from being gay?

Also probably this group is healthier than most Americans because the (financial) onus is on them too.

In an area of the economy where there's such moral hazard, there's nothing wrong or illiberal about mandating that people pool their risk in insurance.
Sure there is, you are intruding on their moral and free decision, and on top of that, doing it without it even having any plausible case for being a physical detriment to you (like with car insurance).
 
there should be some sort of forced penalty for those who don't get insurance.. like losing there individual federal tax exemption. that at least would cover if they have a health issue and keep the rest of us from absorbing it.

Chap, you are NOT usually going to absord it, you will for the minority if they can't afford it (read article for numbers on how few that is), but you will for ALL if universal healthcare passes.
 
Sure there is, you are intruding on their moral and free decision, and on top of that, doing it without it even having any plausible case for being a physical detriment to you (like with car insurance).

No, society is deciding the groundrules for how everyone will approach health insurance. There is no moral right to individualism.
 
They are not gaming anything, given that they can afford it, they are taking a calculated risk, you disagree with their choice fine but it's their FREE choice, not yours.

You are pretending that society has no right to mandate anything. That's not necessarily true. There's no natural law that makes it so, and it's absurd to treat all situations in life in that way.

A homosexual has a higher probability of contracting AIDS, does that give you a moral or financial reason to stop them from being gay?

99% of analogies are reduction ad absurdums.

Also probably this group is healthier than most Americans because the (financial) onus is on them too.

No, most people who go without insurance put off necessary healthcare decisions to the detriment of themselves. In that respect, the mandatory risk pooling that mandatory insurance provides is superior for the health of the population in general.
 
What were the metrics?

Are we talking about people who "chose" not to have insurance because it would only take about a quarter of their monthly income? Obviously, they could still "afford" it, but most who don't have it "choose" not to because it would cost too much of their income.
Given that most are far beyond the poverty level, this is not applicable, however for those it is, you have a good point, it may well cause them to have to live in a townhome instead of a regular home or to just drive one less car, but nevertheless that was the choice they made. People take risks, motorcyle riders for instance have higher mortality rates than almost any other daily action. Yet in America, you are free to pursue your happiness as you see fit, not how others see fit to make you.
 
I think we should lean towards individualistic systems... but it should not have some sort of absolute veto in the matter. In healthcare the benefits of mandatorily pooling societies health risk are so enormous that it's justified.

And anyway, I think people have a right to protections from the malice of nature in the form of universal healthcare, just as people the right to protection from the malice of man in the form of universal police.
 
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Given that most are far beyond the poverty level, this is not applicable, however for those it is, you have a good point, it may well cause them to have to live in a townhome instead of a regular home or to just drive one less car, but nevertheless that was the choice they made. People take risks, motorcyle riders for instance have higher mortality rates than almost any other daily action. Yet in America, you are free to pursue your happiness as you see fit, not how others see fit to make you.

I have no problem with people "taking risks", if all it affects is them. That's generally not the case. As Watermark pointed out, most without insurance put off preventative care & early treatment, resulting in much more expense down the line, which the taxpayer often picks up.

You'd have us believe that those without are rugged individuallists, making a free & confident choice to go without coverage. No one in their right mind WANTS to go without coverage. You can get cancer or pretty much any catastrophic disease at any age, not to mention accidents. No one makes a comfortable decision to go without, and they can get burned if they do. The taxpayer can get burned, as well...
 
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