The random political thoughts thread (Part Deux)

[Alex]

If it became a legal requirement for every working citizen to have such health insurance, employers would no more be the "gatekeeper" for that than they are now for social security.

Yes, if that were true then that would follow. But what is discussed is not "every working citizen must have insurance" (for then you couldn't offer proof of insurance to gain employment since your employment will be providing the insurance) but rather that every citizen must have insurance and without it they can't get a job.

The very sentence "you might provide proof that you're insured as part of a job interview" says this is not employee provided or funded insurance. That's why that sentence in combination with her NPR interview yesterday makes little sense since that does have employers being the dominant provider and you can proof you have what you'll be given after getting the job.

And I still stand by saying that if it is universal governmentally mandated health insurance then making the employers the gatekeepers makes absolutely no sense. Because then you are doing nothing to monitor compliance by the unemployed. Unlike governmentally mandated health insurance (presumably) possession of a social security number is really only relevant if you're working.

Yes, I can think of proposals where employer involvement in health care is necessary. Just not any that should come up in the job interview. Heck, even your social security information doesn't come up at that point in the process.

[Ghoulish Delight]

Originally Posted by MouseWife

Insurance is expensive. When the Hubster was laid off for four months, we had Cobra. It was almost/over $800. a month. I think that was also not the normal price, but, what his company would be paying {minus his portion}. And remember, he was unemployed.

There are a couple factors to consider there. First off, employer-provided health coverage tends to be at a level that is much higher than most people would choose for themselves if they were paying for it themselves. I use only a tiny fraction of the services available to me under the rather comprehensive plan my company provides and when I was unemployed, I didn't bother with Cobra and just picked a cheaper plan that covered what I needed. The main thrust of Cobra coverage is to guarantee that you have uninterupted coverage, which is an issue if you have any factors that might otherwise make you uninsurable until you get your next job (i.e., pre-existing health conditions, age, etc.). Once you are employed at a company that provides insurance, you cannot be rejected from their group policy. But if you've been laid off, are healthy and insurable, Cobra is rarely a good option as it tends to be overkill.

The other consideration is that theoretically any change that would start to require coverage for all citizens/residents would coincide with major changes in pricing structure in the industry, as well as supplements from the government. Looking at Massachusetts as an example, they not only required residents to carry insurance, but if I'm remembering the details correctly they required insurers to offer a low-cost minimal plan as an option and introduced funding for low-income families to get them on that plan.

[MouseWife]

You are right with that. We didn't have any pre-existing conditions, but, we had two boys. We have used our insurance for different things and just felt we needed to keep up the coverage that we had. Emergency room visits, all medications, testing, etc.

Well, also, we thought he'd be right back at the same position way more quickly than four months.....and when he did get back to work it was a different insurance. Now, they don't cover our oldest {they will in March, they say...} and cover half of the costs. Which is over $1,000.

That is why I wonder about the costs of what they are going to supposedly offer. Will our costs be the same anyways? And, if we are unemployed, will we still be stuck at that rate {red tape and all}.

Right now my daughter has no insurance and I am trying to find a local doctor for her for basic checkups.

[scaeagles]

Originally Posted by innerSpaceman

scaeagles' opinion notwithstanding, social security is routinely considered the best thing the federal government has ever done. I daresay a requirement that everyone be health insured which resulted in everyone having health insurance would be similarly popular, and similarly devised by the people FOR the people.

So government intrusion and requirements are OK if the majority of the people agree with it. I am often amused by how many people are against government intrusion unless it is for something they think is a good idea. I admit to falling into that myself at times.

Social security was poorly planned and is doomed without major overhauls and increased taxes. When it started, life expectancy was around 66 years. Now that life expectancy is 10 years beyond that, retirement age (or better said the age at one which can begin taking benefits) will keep increasing.

I'm not sure who thinks social security is one of the best things ever done by government unless everything the governmnet has done has been more poorly planned than it, which is certainly possible. I was under the impression that most people my age don't believe they will ever see a cent of social security money, but I don't have exact polling numbers on that.

[innerSpaceman]

Originally Posted by scaeagles

So government intrusion and requirements are OK if the majority of the people agree with it.

Um, unless such intrusions or requirements were unconstitutional, isn't that EXACTLY THE POINT of government of the people, by the people and for the people? You've totally lost me, scaeagles.

As for those intrusions which are completely unconstitutional, let's start with the federal income tax in general, and the withholding of estimated federal income tax by employers in particular. Those are intrusions I object to, and have a right to object to.

I'm not sure that social security is unconstitutional, but I'm willing to take a look at that if you can provide any information to that end.


Otherwise, it's precisely the kind of thing that the populace might want to set up for itself via its elected government. Ya know, so that we don't end up starving in the streets or surving on dogfood while living in a cardboard box. The kind of thing that was, ahem, quite common worldwide and in the U.S. before social security. Yeah, not brilliantly planned out. Still ... The.Best.Thing.Ever.Done.By.The.US.Government.

[scaeagles]

I would argue, though I don't know why it would be necessary, that the government requiring anyone to have health insurance is an intrusion and unconstitutional. How could that not be considered an intrusion into my personal freedoms?

I would argue that I have a right not to have my money stolen. Social security can be viewed as legalized theft. The government says "I will take your money, give it to someone else, and there is no guarantee (regardless to the ridiculous concept of the lock box) that you will ever get it back". So if the people decide they can take my money like this it is OK? So, yes, I regard legalized theft as unconstitutional.

I'm with you on the income tax. That is simply a tax on the accumulation of wealth.

Government for the people and by the people must be limited to the constraints of the Constitution. The Constitution is not an enumeration of rights for the people, it is a limitation of the powers of the federal government, so the federal government cannot do something just because most people think it is a good idea.

[€uroMeinke]

I would love to just see a health plan that doesn't involve being linked to an employer. How is my company any better at picking health care options than my government?

[innerSpaceman]

I see your points, scaeagles. It's just that once I've accepted (not quietly, but accepted) the fact that the government takes 12.5% of my money for a retirement plan that may go bust, and another 32% of my money to fund, well, mostly war and violence to which I object with all my heart and soul ... I guess I'm just not going to blink an eye about another 14% taken for health insurance.

And before getting too outraged at the Constitutional envelope pushing/shattering of the above items ... I've no better idea how to prevent most senior citizens from starving or how to fund the expenses of the federal government.

[scaeagles]

(To EM: ) They probably aren't. One difference is that companies frequently (at least this is the case with both the school my wife teaches at and the very large corporation I work for) shop the market for better deals among the health insurance companies. I can also opt out if I choose.

I do not claim that this is a perfect system. I don't think there is a perfect system. Knowing the propensity for government to mess things up and have cost overruns in the hundreds of billions of dollars even on the comparitively small prescription drug program, I hesitate to want them to have an opportunity to control my health care costs.

(To ISM: )
How does one fund the expenses of the federal government? Not an easy task. I realize it is a necessary evil, but the spending is so horribly out of control on things that the federal government was never designed to handle or manage that I cannot help but think that the simple answer is that the feds should spend less. I'm sure you are familiar with baseline budgeting, which allows an increase of 5% on a budget item to be construed as a cut because there is a mandate from the Carter years that budget items go up 10% every year regardless of if the money is needed there. I wish I could have some form of mandate to increase my budget every year by 10%. Don't think it's going to happen. I have to be responsible and make tough choices with my spending, as does everyone....except the federal government.

[Alex]

It was bouncing about in the back of my head and it popped out today, but the question on employers being the gatekeeper for enforcement of mandatory universal health converage has been addressed in Massachusetts.

As of July 1, 2007, Massachusetts requires all residents to carry health insurance (I disagree with their logic that being uninsured necessarily unfairly passes your health expenses to society at large, but so be it).

The method of reporting is as I suggested above. When residents file their state tax returns they'll also have to include their insurance policy numbers. I'm not sure how this guarantees enforcement among the poor and dependent where it most likely to be an issue but that is how they do it. And there are civil penalties for failure to have health insurance. The first year it is loss of the personal tax exemption and then gets much more expensive in subsequent years.

While I wouldn't really support the Massachusetts law, if such is going to exist, that is the enforcement model I'd support. Between the person and the state, not the state putting a private bureaucracy in place as a private police force. The state also has requirements for employers related to health care, but in meeting those that is also a direct relationship between the state and the business (the state doesn't tell the electric company that they have to get proof of compliance before they can turn the power on in the offices).


By the way, it was Mitt Romney that signed this into law.