Saturday, March 31, 2012

Insurance Mandates

"Paul D. Clement, representing Florida and 25 other states objecting to the health care law, responded that 'it's a very funny conception of liberty that forces somebody to purchase an insurance policy whether they want it or not.'"
Quoted in a Washington Post article on Thursday on the final day of Supreme Court arguments about Obamacare.

“I’m in good shape, I don’t eat meat, I don’t drink excessively, I’ve never smoked,” said Mr. Lodor, 53, who estimates he would have to spend at least $1,200 a month to cover himself and his college-age daughter. “The last thing I’m going to do is not pay my rent because I have to pay for some state-mandated health coverage that I don’t think I need.”
Wayne Lodor, one of the (now only) 2% of Massachusets residents who do not have insurance under Romneycare, quoted in Wednesday's NY Times.

I need to hire Paul D. Clement.

New York State forces JABberwocky to buy Workmen's Compensation insurance for its employees.

New York State forces JABberwocky to buy Disability Insurance for its employees.

If I owned a car, New York State would force me to have insurance for my car.

My LIC apartment building forces me to have insurance with a specified liability coverage (if my washing machine floods the downstairs neighbor, the building wants to be sure I get to fix up my downstairs neighbor's apartment). My apartment building also required that my contractors and my movers had insurance.

State Form forced me to buy a business policy to wrap around my homeowner policy for my older apartment because they decreed the business was too big to be covered by a home office rider on the homeowner policy.

A prospective landlord for the JABberwocky office insists I show certificates for my workmen's comp policy and my business liability policy, which I will have to upgrade to have a higher liability limit in order to suit the landlord, costing me money.

I am annoyed that Paul D. Clement can make the most outrageous statement about liberty and insurance, and that there are justices on the Supreme Court who think he's living anywhere close to the real world, where I am made constantly to have insurance policies whether I want them or not -- and in some instances made to do so by state actors as opposed to private companies or citizens that have more freedom to require things of one another as part of their dealings.

And I'm sure Mr. Lodor takes the most wonderfully good care of himself, but is he willing to sign some kind of binding statement that if he falls off a ladder or has a bagel cutting accident in the coming days or weeks that he will 100% totally agree to pay for his emergency room care, at whatever inflated rates the hospital will give him vs. what they've negotiated with an insurance company, and that if for some reason he can't pay he won't max out and then bankrupt out of his credit card bills or do anything else at all that will force the rest of us to pay to heal his broken ankle or severed thumb? And that the same will apply if his daughter is standing on a baseball field, gets plunked by an errant throw that was supposed to go to the manager on the pitching mound, and gets a concussion (this just recently happened to one of my nephews, just as an aside I was quite impressed with the seriousness with which everyone was concerned about this, which is sea change for good from five or ten years ago). Mr. Lodor, as one of the 2% in Massachusets without insurance, should be every bit as ostracized by the Occupiers and by all the rest of us as the 1%.

Mind you, I agree that Mr. Lodor shouldn't have to pay so much money for his insurance, but Obamacare is the best chance we've got at getting those costs down, at least so long as we're going to remain tethered to our current health care system. I am happy to debate with anyone all of the so-called market-based solutions to health care, which are generally as untethered from reality as Paul D. Clement's statement that forced insurance is tyranny.

And if the Court accepts Paul Clement's argument, how do they chop down the mandate in Obamacare in a way that still guarantees Workmen's Compensation insurance for my employees, or mandatory auto insurance for car-owners, or a gazillion other things that we are required to do in the public sphere to protect one another? Under classic libertarianism, we wouldn't have a lot of these things, and I can respect the consistently principled classic libertarian even if I don't always agree, but the consistently principled classic libertarian is a rare bird.

Many of you reading my blog are fans of sf/fantasy. Every so often we in the sf/fantasy community are called upon to make donations to the SFWA Emergency Medical Fund or privately to help some writer who's met up with illness. I want to live in a place where we don't keep having to do that, because it's understood by everyone that the health and well-being of our citizenry is a shared obligation we all have to one another.

If that would happen, we wouldn't need a law that requires people to buy broccoli.

Public mores can change over time. The reaction to my nephew's concussion is an example of that.

Another example, in my time on Earth attitudes have changed a lot toward drunk driving. In the 1960s, who would have envisioned that the movie "Say Anything" would have a keymaster to model proper hosting of a teen alcohol bash. The term designated driver came to the US only in the late 1980s.

I could see a lot of good coming to the US not through forced legislation but through an understanding of the shared common good if we understood that health care was a shared common obligation of the citizenry. This in turn can lead to a long discussion of externalities and market costs, but we can have that discussion another day.

1 comment:

  1. We have National Insurance in the UK. We tend to forget that it is actually compulsory insurance, because it's been around so long we forget what it's for. It comes directly out of our pay cheques and goes towards the National Health Service (God bless the Labour government that came up with that brilliant idea) and Social Security benefits for if/when we get ill/incapacitated to the point where we can no longer work (been there) or are unemployed for one reason or another (been there too). I hadn't, until now, realised that it is, in fact, compulsory insurance. But that's what it is and we all deal. I'm sure when it first came out it wasn't particularly popular, but as you say, time changes a lot of things.

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