I meant to post on this when I saw the commotion over the Republican Tea Party Express "debate". Ron Paul was asked a question about a hypothetical young man in his 20's who decides to forgo purchasing health insurance because he is healthy. This young man then ends up on a coma or some emergency situation. Should he be given medical care.
Many people balked at the shout from the crowd to "let'im die" as well as Paul's comment that "This is America where you have choice."
Putting the law aside in regards to emergency care in which anyone who enters any emergency room must be given medical attention regardless of insurance status. And also putting aside the clear mean-spiritedness of the crowd, Paul was being completely consistent with his libertarian views, in a room of "debaters" who change position depending on which way the southern winds are blowing. But there is something hypocritical of making a mockery of Paul while advancing a healthcare "overhaul" that attaches the entire US population to insurance. Let me explain.
The insurance industry is based on risk assessment. People are given a premium based in part on the likelihood that the insurance company will have to pay out. The more likely the company will have to pay out and the more they think they will have to pay out the more they will charge you for your coverage. If the risk is deemed to high they will simply decline to cover.
The second means for insurance companies to make money is to decline to pay for services. They will make claims such as the "effectiveness of the treatment" and other reasons for not covering a particular procedure or medicine. Even in cases where they will pay, often it is not the full cost of the procedure or medicine and the customer is left to pay the remainder. This is what is referred to as a deductible or co-pay. In some cases the co-pay is prohibitively large even though upwards of 80% of the cost is covered.
If you can't afford the premiums or the co-pay, that's not the insurance company's problem that's your problem. In the auto industry if you can't pay then you don't drive. In the health insurance industry you can't pay then you die I suppose. Yet mandating that we sign up with such an industry is what passes for reform.
Under the new healthcare reform, it is proposed that everybody gets insurance from some company (constitutionally iffy but that is a different convo). Companies reportedly cannot turn a person down based on previous conditions. That is they would not be able to deem a person too risky per the earlier discussion. However; since they must cover anyone, they may increase the premiums (and I suppose co-payments) on such persons so long as such rates are "reasonable". Furthermore these companies can still decline to cover procedures or medication they deem ineffective.
I'm not sure how many people caught Michael Moore's Sicko but, one "nice" scene was the person booted from a hospital after receiving medical care because they had no insurance. Many people balked at that scene but really how do you blame a hospital, which is a business, from not wanting to deal with customers that do not pay? Would you work for free...all the time?
It's not like these hospitals get free supplies. Not as if nurses and doctors are volunteering. Not like all the electricity they use is being given to them pro-bono. If a customer does not pay for services rendered these expenses don't up and disappear. So you know what happens? You and I pay via taxes for all those who are uninsured but use the services of hospitals. And when that money doesn't cover the business expenses of a hospital it gets closed. When that hospital closes everyone who depended on it for services and all those employed by it lose. This is the other side of the "let him die" story.
Now some may object to my use of the term "customer" but that is exactly what one is in a insurance based healthcare system. If one objects to this then the only rational solution is single payer healthcare. Under such a system the question posed to Ron Paul could not be asked. No one dies from lack of money for healthcare, because healthcare is "pre-paid" via taxes, be it income or sales or a combination of the two. If one is actually bothered by the whole "let him die" attitude, then one ought to be equally bothered by supporting a system by which a private company can decide whether you deserve to have whatever procedure and medication paid for.
(17 years of informed commentary)