Wednesday, August 31, 2011

Health Care - Should We Cover Everyone?

Part of the argument we hear daily about health care reform is that we need to get insurance to people who don't already have it.

Really? Why?

Health Care

What about people in their early 20's who don't have health insurance coverage? Should we make them get insurance, even if they don't want to pay for it? And even if they can't pay for it, are we going to force it on them anyway and have taxpayers pick up the bill?

It seems plainly obvious that we shouldn't waste resources on people who either do not want or need a particular service, and it seems rather peculiar to force it on them. But there's more to this scenario than you might see at first glance.

Insurance companies actually love the idea of covering young, healthy people. When you have people paying into a system, but not using it, it can keep costs lower for everyone who is part of the plan. This is fundamental to insurance of any kind. The companies who issue insurance policies count on most people using less service than they are paying for. The people who don't use it essentially subsidize those that do.

If this sounds like socialism, then it's socialism created by private industry under a capitalist system.

In the US health care system part of the reason this has broken down is that a large number of the healthiest people in our society have opted out of paying for insurance, which ends up driving up the cost for everyone else. People have figured out how to game the system and refuse to pay into it.

This seems like a fair way to go until you realize that the people who opt-out are taking a gamble with your communities resources. That's because if they get seriously injured they will get treated at a local emergency room whether they have coverage or not. And if they don't have the means to pay, the hospital will have to absorb the costs (and possibly force the patient into bankruptcy), which raises the fees the hospital charges to those who do pay.

And for those who are chronically ill and who cannot get regular medical care because they are uninsured, they will continue to clog emergency rooms with relatively minor illnesses that should be seen by a primary care physician. The crowded ER's can potentially keep insured people from being seen for true emergencies - the original purpose of emergency rooms.

By covering everyone, both the healthy and the infirm, it lowers the risk pool for the insurers and helps to direct resources to where they are most effective.

Health Care - Should We Cover Everyone?

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