Dear Mr. President, I love you but I can CHOOSE to have a car; I can't choose to have a body--REPOST

Dear Mr. President,

As much as I love you, I have to take issue with your idea that health insurance should be required in the same way car insurance is. I can CHOOSE whether or not I buy a car. I can live (like a lot of people do) near the Metro or bus line and not have a car. I can ride my bike. I can get a ride to work from a friend everyday and can pay her for the gas. And I don't have to have auto insurance if I don't have a car.

But, I have to have a body. I can't get away from that. Just by the very fact that I live and breathe, you are telling me that I have to buy insurance.

Also, Mr. President, if I buy a car, I can choose one that is not expensive or sporty, one that requires less insurance. I can buy an alarm system or have off street parking and lower my insurance costs. I can also decide to buy a used car that's not worth much and only get liability coverage.

And in my state, Mr. President, all I am required by law to have is liability coverage in case I hit someone else. I am not required to have coverage to fix my own car.

But, I cannot choose what kind of body I have. I cannot choose what DNA I have and what possible illnesses that implies. I cannot necessarily choose what pre-existing conditions I have; not everything is the result of personal error. I can exercise, eat right, and still get cancer or break my leg or have a back injury.

What I am saying, Mr. President, is that, despite your wonderful speech last night, you need to take another look at your idea that health insurance should be required like car insurance. They are two different things.

Yours respectfully,

Nikki

Paying $40-$60/month for auto insurance is a small sacrifice. Trying to squeeze your already-tight family budget for a $1,000/month (or more) premium is not.

They're both called 'insurance' but the similarity ends there. As you so rightly point out, the government mandate is for liability, not your own property or body and you don't have to drive anyway. Auto insurance differs from health insurance in that it is, by definition, catastrophic. You can only use your car insurance for damage incurred as the result of an accident. You can't use it for oil changes or other routine maintenance, and you can't use it to correct a flaw in the design or manufacture. Health insurance is really more like a warranty than car insurance in that sense. Also, with full-coverage auto insurance, the older the car is the less coverage you need. And your auto insurance premiums tend to go down the older you are. The opposite is true with health insurance. Basically, the longer you are alive the higher the likelihood there is that you will have an expensive health care need. Under the best of circumstances, the chances that you will use your health insurance for something is about 100%. You can drive for 50 years and never make a claim on your auto insurance. That's why I, a 40 year old female with no accidents (and okay a few tickets), am paying about 50 bucks a month for auto coverage that will pay out up to a million dollars in property and medical damages if I plow into a minivan full of kids.

Which is why health care should not be run by the glorified gambling industry. The house ALWAYS wins. Take the profit out of health insurance, or at least curtail it severely with caps or a solid public option that it has to compete with, and THEN think about imposing a mandate.

they wouldn't survive actuarily without them.

The mandate has nothing to do with being private or public it has to do with accepting everyone regardless of their precondition and not charging them any rate differentiation.

Which charges everyone a different rate based on gender, age, and other risk factors. The OP isn't about a mandate, per se, it's about the absurdity of comparing auto insurance to health insurance.

She is saying that her car is an option but her body is something that she must get fixed, an argument that suports mandates.


This sentence shows her contradictory argument


But, I have to have a body. I can't get away from that. Just by the very fact that I live and breathe, you are telling me that I have to buy insurance.


The reason that insurance plan has to be mandatory is precisely for the reason that virtually everyone will eventually need to use it.

If the Health Care Reform legislation compels insurance plans (whether or not they are public plans or private plans) to:

1) Accept all applicants without regard to preexisting conditions

2) Not have fee differentiation beyond smoking, age and family composition


then it follows by actuarial fact that you have to mandate inclusion or people will simply wait until they are in need and then sign up for it.

This is known as "adverse selection" and without a mandate would eventually cause a collapse of the system. This is why all single payer systems have mandates.

The topic is discussed in detail here: http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=132x8671777


The analogy to car insurance was never made by the President. It is a simple fact that if you are going to make insurance plans accept everyone without any filter for their preconditions and the insurance plan (public or private) has to charge the same fee then it simply won't work on a voluntary basis.

The HR3200 one allows insurers to charge 1.5 to 1 for smoking and up to 5 to 1 for age. Single payer would be a progressive tax based on income.

but not because you have cancer or are a heroin addict.


Some single payer systems are based on fees (with subsidies) and some on income taxes. While single payer systems are the obvious rational approach they also mandate involvement which is the point of the OP, they are not voluntary.

And acting like you can mandate the purchase of private health insurance in the same way you do for auto and it will work just as well. Your analogy of cancer or heroin addiction proves the point. AAA is not going to insure a broken-down Yugo, nor will it insure someone with 5 DUIs. The problem with the current private health insurance system is that it treats people like cars. Forcing everyone to buy it is only going to give those companies justification to jack everyone's rates to the sky because "gosh, we have to insure all those broken-down people and we still need to make our profits!"

:shrug:

What's the problem with that? Everyone knows that smoking is extremely detrimental to your health and since you'd most likely be needing far more medical care than non-smokers, it makes sense that people who choose to smoke should pay higher premiums.

The age thing is unfortunate, but at least Medicare becomes available when one turns 65.

As should people who engage in dangerous hobbies or work in risk-prone jobs. Drinkers, drug users, and people who eat fatty foods should pay more too. Young men should pay the highest rates just because they do stupid crap like car-surfing.

You are comparing bringing a child into the world and starting a family with poisoning your lungs (and stinking up everybody's clothes & hair in your immediate vicinity)? :eyes:

As Rep. Barney Frank would say, "arguing with you is like talking to a dining room table."

And arguing with you is like arguing with an insurance industry hack/teabagging troll.

Emergency room.

And it's why comparing auto insurance to health insurance is apples to oranges. Mandating private health insurance will not magically make it inexpensive. You have to do a lot of other things to reduce the cost of it and those things are not in any of the proposed health plans. A good public option will help, by forcing insurers to compete, but what Obama is proposing is an anemic version that will cover a tiny percent of the population and would have to be 100% self-supporting. IOW, it wouldn't be able to get the subsidies that private insurers could get.

:)

of health insurance, then they are looking at the wrong place in my opinion. After auto insurance was mandated, the rates began to rise. If your credit scores go down, you insurance goes up. If you lose your job and cannot afford to pay your auto insurance and park your car for over six months, then when you go back to try to get insurance you can count on paying up to twice as much for it. For a multiple reasons insurances can raise your premiums and make up some stupid excuse.

Yes, you can change insurance companies and get a better rate, but there is no guarantee that in six months they won't do the same. I sold my old car about a year ago because I could not afford its up keep, the insurance and licensing. I miss having a car, I hate having to depend on others to get me to doctor's appointments and other necessary trips. I hate not having my independence and there is no mass transportation here, and it is mostly small towns a few miles from each other.

I don't have to worry about health insurance right now because I have medicaid. I have medicaid because I am disabled. I am disabled because I could not afford preventive health care when I had no health insurance. I'm afraid there are a lot of people out there that are on their way to my same situation. :mad:

Im not a Constitutional lawyer, but I think it would violate the Constitution in some way.

(Mandatory auto insurance is only done at the state level.)

The federal government mandates many things, from forcing people to pay into Social Security & Medicare, requiring young men to register for the draft (and initiate a draft if Congress deems it necessary), employers are required to give employees up to 12 weeks off every year for family leave.

I don't think the 10th amendment argument would suffice and the mandate would survive a court challenge...UNLESS the conservative judges on the Supreme Court decide they want to embarrass President Obama.

All those items you list are government programs you are mandated to pay into.

Mandatory insurance is mandating a purchase from a private company.

DJ,

We all will have to pay for universal health care, whether it be in taxes to the government, premiums to private insurance companies (or a public option), or a combination of both.

The private insurance mandate preserves the free market health care system which will result in better coverage & services because of the competition, instead of having a government bureaucracy provide coverage without worrying about competition.

A weak or non existent public option incapable of pressuring insurance rates lower coupled with a legal requirement to buy the high priced for profit insurance.

Sure other countries use mandated private insurance, but they require non-profit private insurance with stiff regulations to prevent high prices.

We will end up with the worst of those systems at this rate, and if a bill is passed the public will blame the Democrats.

(If there is no "reform" this time around polling suggests the public is willing to mostly blame the GOP.)


If mandates are required do it in the tax code where the costs are graduated based on income, and make it pay solely for either a public option or only to non-profit insurers with stringent regulations to reduce costs.

Anything less will be a catastrophe for our party.

Funny how their government bureaucracy has set the price at about 98 dollars, while here it's about 4000.

I used to be an insurance agent. I know the drill. So laughable that you'd invoke competition and the free market when you KNOW that insurance companies are exempt from anti-trust laws. And a scary socialist government bureaucracy would not have to make a profit or answer to shareholders.

Kitty,

First off, I do NOT work for or have any stake whatsoever in the insurance companies. If we have a single-payer, government-run health care system, yes it would be non-profit, but here's the thing: the government will have to find ways to fund it. Considering how our government is completely incapable of balancing a checkbook always spending more than what they have, the health fund, just like S.S. & Medicare, will be underfunded which will result in waiting lists, rationing, etc. just like what has happened in Britain and Canada. No, the government wouldn't have to answer to shareholders, they'd have to answer to taxpayers, which are probably far worse. The average American throws a fit every time the tiniest new tax is proposed.

Having worked in the insurance industry, you should know that most of the money collected in premiums go to paying medical claims, not into the pockets of CEO's. The real problem is the cost of health care, which will take years (maybe decades) of research, etc. to force medical providers & pharmaceutical companies to get their prices down. In the meantime, we need to get universal health coverage for every American. Fixing the health care mess in this country will need to be done incrementally, it's far too complicated of a problem to do all at once. Let's start in 2009 with universal health insurance.

Jesus, the first paragraph of your post reads like every chain email sent by wingnut uncles across the land.

...I'm not a tea-bagger or an insurance company executive as you previously accused me of being.

I am a die-hard liberal Democrat who has learned the importance of being PRAGMATIC while pursuing progressive goals.

:dem:

Nice try.

I don't quite understand this. The government is trying to make sure that all its citizens have access to insurance for their health care, not just because that is the right and safe thing to do but because when someone who does not have health insurance gets seriously ill, the rest of us pay for it. They are offering to help you pay for it if you cannot afford the premiums. Most all of us pay high premiums currently on our health insurance. Most all of us wouldn't want to live without it.

Yet so many here rail at the notion of having to get it. During the primaries, I was fairly neutral between the idea of mandates and what Obama was then proposing: that we didn't need mandates because most people would want to buy it if it were affordable anyway. Yet I see post after post here that seems to demonstrate that people don't want to take up the offer and purchase insurance. I guess that was what made him change his mind.

You pay into Social Security (you have no choice). You pay into Medicare, and are required to sign up for it, or lose your Social Security (you have no choice). Yet somehow you think that this requirement for you to purchase insurance is somehow onerous beyond tolerance.

I sincerely ask: why don't you want to get health insurance? Do you think you are invulnerable? Do you think your pancreas cannot be invaded by cancer or that a bus won't hit you or that rheumatoid arthritis won't cripple you beyond all endurance? Do you not want to spend the money, even if assistance is offered to make it affordable for you? Is this just some libertarian intransigence, as when people bellowed that they didn't want to wear seat belts, that it was their choice?

By not wanting to get health insurance, don't you feel remorse that you are putting a burden on the rest of us who are sacrificing large portions of our income for insurance?

Thank you for saying it! To those who feel they should not buy insurance, I ask if they feel that hospitals should have the right to turn people away who have no insurance? That would be the only fair thing to do.

and patient portions that can send anyone to bankruptcy court in a flash of bad health. Why is that so hard to understand?

.... that there will be caps on out-of-pocket costs (both annual and lifetime).

So you would rather have NO insurance than have this health-care bill that will make it more affordable and secure for all? You make no sense. And I take it you haven't read much about the bills.

It still won't be "cheap" (if that is what you are looking for), but it will be much more fair (no one can be turned down or kicked off); more secure; and more affordable (with assistance to those whose incomes are up to possibly $88,000 per year for a family of 4).

Why is that so hard for you to understand? You'd rather WE paid for your health care?

PS: And don't tell me you only want single-payer. First of all, ain't gonna happen. Secondly, you would have costs, in the form of higher taxes, with that, too.

Are current medical debts factored into the formula? I've gone bankrupt before from medical bills and have racked up quite a bit more. On paper it looks like I could afford insurance, but in reality I'm in hock. There is no reason at all we should be having to pay hundreds to thousands every month for health insurance when other countries can get by with charging *much* less. The insurance companies are the problem and should not be part of the solution to the extent that they probably will be.

I addressed them in a post I did about the uninsured a while back. http://demopedia.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x6174218

Bottom line: The uninsured are adding, at most, 8% to your premium. Insurance company overhead and profits are adding 30%. Yet you think forcing people to buy private insurance from these bloodsuckers is the magical panacea. Even Paul Krugman, who flogged mandates throughout the primaries, is now expressing doubts that they will reduce the costs of premiums, especially if there's no public option with teeth to make insurance cos. compete.

Kitty,

I am in favor of having a public option. However, I realize that right now, in 2009, there is not enough support among the public nor are there enough votes in Congress to create one. Despite the polls showing that over half of Americans favor a public option, much of that support is very squishy.

One of the biggest obstacles to our efforts to reform health care is people's fear that governmental intervention could lessen the quality of health care in this country.

Given that, we have to play with the cards we've been dealt. So, let's pass a mandate now requiring everyone to buy health insurance. This will immediately achieve universal coverage AND end the shameful practices of pre-existing condition exclusions and cancelling someone's insurance if they become "too ill."

If your employer subsidizes your premiums (a common practice already), than you won't be adversely affected by the mandate to carry health insurance.

Then, if after say, 5 years, it proves to be nearly cost-prohibitive to buy private insurance, there will be a MUCH GREATER demand for a government-run public option. ;-)

"La la la I'm not listening! Mandates are Magic!"

By trying to pursue an achievable goal now, with the intention of continuously adding more meat to it as we move down the road.

Think about it...why are Republicans so against even a bill as modest as Baucus'? Because they know it could very well give us a base with which to grow and ultimately establish a strong, robust public option to compete with the insurance companies.

I posted earlier that my family insurance plan was $36,000/year. Since my family uses no more than about $3000/year for all of our benefits, I have to wonder where the rest is going.

We all want health insurance, like we all want to have defense.

Have insurance as part of our main taxes - sure. Have insurance as a mandate that you pay out and get fined/etc if you don't (and the money goes to private companies), uh no.


What you seem to be asking is 'why don't you want your money to be taken from you and given to a private insurance company? And why don't you want punished if we don't make you do it?'

When you take my tax dollars for roads/defense/social security/etc that is one thing. When you threaten to make me pay a fine because I won't give my money to Blue Cross that is another.

If you want to be forced, simply because you are alive, to give your money to some corporation that is fine with me - just don't expect me and others to jump on that band wagon.

--is to deny care as often as possible for profit. I wouldn't mind if it was single payer--that would be like paying taxes for the fire department. Pay the money, and if your house catches fire, they send a truck out. You will never be cut off from further fire protection, nor will your property tax triple. And can anyone think of even one good reason why a heart attack should be treated any differently from a house fire?

Assistance to make it "affordable" is even worse. That takes money that could be spend on green jobs and infrastructure renewal to waste on useless shitstain intermediaries who add no value whatever to health care.

First off with auto insurance you have a choice of coverge . If you own the car then all that is required is liability however say you do have an accident and you carry the min state required liability you injusre 4 people and your insurance pays out 30,000 you get sued for the rest , also your rates vary depending on where you live which is not fair either . Then you worry about un-insured drivers so that is added on just in case. So you see it depends yet you are not required to own a damn car the glitch is if you are walking and hit by a car the driver pays or does your medical insurance , I guess that depends too. I drive , have since 1966 and never had an accident so I have paid for all the others who have had one or more, is this fair?

No one has stated what they consider afforable , many people can't buy food or meds so then nothing above this is affordable.

Many talk and trust that there will be regulation to keep down the costs HMO's charge , yeah right. Who trusts this will happen .

I paid into my medical insurance an HMO for the last 20 years and that began when I was 40 , I used it once so I paid for others not me .

If it comes down to an issue of you get taxed or fined if you don't have medical because you lost your job or can't afford what is offered but have paid in for 20 years then that then should count provided you did not use it like I did and only for a small issue .

Look , these insurance corps are like a game of risk or a bet will it happen or will it not yet the insurance corps have made billions in profit so I say screw the force the people to pay , force the medical insurance profit makers to pay .

Also with SS people only pay up to 150,000 after that they do not pay a dime that is not fair either because most people make less and pay all year.

Yes shit happens to all of us but lets not forget who is getting rich off us and who makes billions in profit. I say you pay in and do not use it roll it over and if you are a risk because you create the risk the money is gone .

I want to hear what is AFFORDABLE not this crap about if you cannot afford it you are fined or taxed or whatever definition one cares to use that is forced robbery. Some people just cannot afford it period!!!!!!so I guess people here feel it's ok that they die until you can't afford it and your chid or wife or husband die do to no fault of your own other than bad luck or the luck of the draw OH you lost your job.

What makes the cost of your medical so damn high , the people who go to a emergency room who just can't afford what they wish they could or is it the high cost of the insurance creating massive profits because they are god damn crooks with a way around paying out for some pre-existing crap or any other countless, assorted reasons they create to protect their profit margin?

I have yet to see any actual figures here we need to find this out not just take some crooks word for it or sit here and climb onto I don't want to pay for someone else when you really don't know that is even the case or what it actually did cost , was it $10 per year on you or $1,000. Does anyone really know , I don't .

Nikki,
If you are in favor of ANY sort of health care reform there is going to be some sort of "mandate" attached to it. A single-payer system or a public option will require you and everybody else to pay higher taxes.

As for the choice to buy a car, unless you live in New York or some other huge city with an excellent public transit system, you have to own a car. In over 95% of America, a car is a necessity to get around.

And yet I know people here who don't drive. Lots of them. I also know that about 15% of our drivers don't have insurance. Uninsured motorists are a big problem here. I've often thought that the problem could be solved by eliminating the liability insurance mandate on drivers and replacing it with a surcharge on fuel and enhanced fines on traffic infractions, which would be put into a pool to cover what liability insurance covers now. Of course, that would cut out such great things as "profits to the insurance companies" and "giving you the runaround when you try to make a claim" and "making you hire a lawyer to sue the other driver's insurance company."

Oh yeah, I'd also like to see some decent public transit here, given that we're the 5th largest metro area in the country. But that's another story...

It is possible to have a health care that covers everyone and use privately owned insurance systems. Germany, Switzerland, and Japan use such a system. Everybody has health care and nobody goes bankrupt.

It is not one I prefer, but it works.

One other thing, we require everyone to have auto insurance who owns a car to protect society from the havoc caused by lack of insurance. Requiring health care insurance for all makes sure that diseases you carry can be dealt with before they are passed on to the rest of us. They make sure that your health problems don't become everyones.

Pelosi Says “F*&k You” to Trumka and the AFL-CIO
By: Jane Hamsher Saturday September 26, 2009 11:17 am
please read this in it's entirety............
http://campaignsilo.firedoglake.com/2009/09/26/pelosi-says-fk-you-to-trumka-and-the-afl-cio/
snip;

It's notable that among the Change to Win unions, only the Teamsters came out against the Baucus bill. (Whoever sold Hoffa on ditching the public plan is no doubt talking fast and trying to explain why he is now being kicked in the face.)

Incoming AFL-CIO President Richard Trumka has been outspoken in his insistence on the inclusion of a public option in any health reform bill, and has threatened to withhold support from Democrats who won't vote for it. Over the past week there was a lot of winking in reports that the White House was leaning on progressive groups to drop their support for the public option. It absolutely did happen, but the use of the word "groups" is probably misleading -- the organization they are talking about, the only one that matters, is the AFL-CIO.

Since other unions outside the AFL-CIO are working the yo-yo on the trigger, Trumka is the lone holdout. He's the mainstay, and there is tremendous pressure building within the AFL in response to arm twisting from the White House for him to cave. And if he falls, it's going to be difficult for the rest of the veal pen not to follow suit. So, he's being directly threatened.

The message is clear: "Get in line or we pay for your precious 'public option' by fucking you on health care benefits."

If Trumka suddenly starts singing the praises of triggers (even if they instantly "yo-yo" it back and insist he was misquoted), you'll know it worked.

If so, I agree that you should not be required to get insurance.

would need to be seriously reigned in with tough regulation and real penalties for a mandate requiring folks to pay them to work. The industry has already proven it does a piss poor job of providing access to care. Making them the legal gatekeepers to healthcare will be disasterous. We don't have the type of people in government that are capable of breaking the industry and forcing it to behave.

The system is going to collapse. It may collapse a decade later than it would have because a band aid is not reform. There are no real proposals that will control costs. An insurance industry that won't allow real reform today isn't going to allow any "incremental" reform down the road. Not with a legally mandated replenishable population to suck off of. And those subsidies, wall street won't be too happy with anyone who suggests a system that weans them off those taxpayer funded welfare payments.

Mandates only work with real reform. Most other countries don't allow for profit private ins. the 2 that do allow it require private ins. to follow the government program rules. I believe it's the Netherlands that redistributes excessive private profit from one private insurer to another that happens to insure sicker people. The government option is essential and always maintains control over the marketplace. It's not a level laying field as would be defined by our for profit vulture capitalists.

A mandate to private insurance in a country that cannot control never mind stop the massive transfer of wealth to the top we've experienced in the last 30 or so years will be just one more added misery for those at the bottom. Throw health insurance reform in the same anti-citizen heap that nafta, welfare reform and offshoring are piled up in. Really great for private business and wall street, really bad for human beings.