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GUEST COMMENTARY: The 'freedom' to refuse health insurance

Thursday, July 19, 2012 | 6:00 a.m. CDT

As the writer Anatole France once said, "The law, in its majestic equality, forbids the rich as well as the poor to sleep under bridges."

The right to refuse to have health insurance — something Republican leaders tout as a fundamental freedom — is a lot like the "right" to sleep under bridges. No one wants to exercise it.

GOP leaders are framing the requirement that every American get health insurance as the gravest assault on our liberty since the British burned the White House in 1814. But even the most hard-core teapartistas tend to freely choose the very insurance coverage whose imposition they decry as socialist tyranny. Few conservatives insist on paying their own medical expenses because they're rugged individualists.

More than 50 million Americans have no health insurance and nearly 30 million more have such bad policies that they're officially "underinsured." Is the Affordable Care Act a dreadful imposition on them? Nearly all uninsured Americans wish they had medical coverage, and the underinsured wish they had more.

People are uninsured and underinsured for two reasons: Either they can't afford coverage, or insurance companies refuse to insure them. "Choosing" not to have health insurance because you'd prefer to feed your children isn't a real choice.

One cornerstone of President Barack Obama's health care reform is that the government will offer subsidies to many people who face this dilemma. They won't have to choose between hunger and health any longer.

And there's nothing un-American about making people purchase health services or insurance. Consider these examples of how the government can legitimately force you to do the right thing:

Children must go to school, unless their parents are among the 3 percent who opt for home-schooling. And children must be vaccinated before they enter the classroom. That means the government makes you pay for a vaccine, or you get a subsidized one at a clinic. We consent because we don't want the risk of epidemics. It's not an assault on our liberty — just an illustration of how, because we live in society, we can be made to buy things when necessary for the well-being of society as a whole.

And, if you want to drive, you must buy liability insurance. Our society recognizes you don't have the right to be irresponsible — to do something inherently risky to others, like driving a vehicle, without being able to provide compensation if and when you cause an accident.

Health insurance is no different. The Affordable Care Act won't let you behave irresponsibly at other people's expense. You can theoretically "choose" not to have health insurance. But you can't choose never to get cancer or have a heart attack, or never to incur crushing medical expenses. And since we're not yet the kind of society that will let people die in the gutter outside of a hospital because they don't have money or insurance, a "choice" not to be insured is really a choice to make others pay for the medical expenses you or your kids will very likely incur at some point.

We have a responsibility to pay our dues in a free society, and the government isn't assaulting liberty by making us live up to our responsibilities. We don't have the right to a free ride. But what else do you call the act of letting everyone else pay our medical bills — particularly when the collective burden of uninsured individuals and families imposes an enormous cost on our entire national medical system and a grave burden on our economy?

The truth is that no one wants to be without health insurance. The Affordable Care Act isn't going to make it available to everyone — an estimated 26 million Americans will still be uninsured by 2020 — but it's a big step in the right direction. The Supreme Court made the right choice when it upheld the law.

Mitchell Zimmerman is an attorney who lives in Northern California. Distributed via OtherWords. Questions? Contact Opinion editor Elizabeth Conner.


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Comments

Michael Williams July 19, 2012 | 7:40 a.m.

"GOP leaders are framing the requirement that every American get health insurance as the gravest assault on our liberty since the British burned the White House in 1814. "

Me: Well, kinda hyperbolic don't ya think?
____________

"But even the most hard-core teapartistas tend to freely choose the very insurance coverage whose imposition they decry as socialist tyranny."

Really? How can the author know this when ACA is not yet in place? Seems to me the "choosing" is yet to come.
________________

PS: So long as we attempt to live together as a society, a certain amount of socialism is necessary, to wit: police, fire, government, roads, etc. Even conservatives accept this. The question is where to draw the line.

Conservatives see a "mission creep" towards increased socialism that goes beyond our line, and that's the reason for resistance. Liberals who laud certain types of freedom are sure happy to give up other freedoms for a perceived "collective good."

It absolutely fascinates me to see support for increased US socialism at a time when we are witnessing the financial collapse of exactly the same excesses in Europe. Europe is ahead of us in this matter, and we need to pay attention...after all, we're not so special and/or different as human beings. Socialism spends a nation to death...always has, always will...regardless which side of an ocean you live on.

(Report Comment)
Gary Straub July 19, 2012 | 10:52 a.m.

Michael, I actually agree with you on this, but probably for different reasons. I find that to be forced to buy a product from a private company to be a huge infringement on our rights. If we are forced to have insurance then those that force us should provide it as a single payer, IE: something like Medicare or the VA. To force us to buy products from the private sector is the wrong path to take and is nothing less than a humongous windfall to those companies. This makes it difficult to understand why the "profit at any cost" crowd is so vehemently opposed to it. What are your views on forced purchased of auto insurance?

(Report Comment)
mike mentor July 19, 2012 | 12:08 p.m.

Gary, let's be clear. They do not force you to buy car insurance. If you choose to drive a car, then you need to buy car insurance. So, you can choose to not drive, many do in large cities, and thus "opt-out".

Far more importantly though, is when they do make you buy car insurance, they do not make you buy insurance for yourself and your car to make sure you are covered for your own financial well being. They only require you to buy liability insurance to cover any damage you do to someone or something else with the several thousand pounds of steel you are choosing to operate. Big Difference!

The examples this person gives all fall short of any logic. He mentions vaccines in schools. Again, there to protect others and not yourself.

Then, he talks about forcing people to be responsible. This is where his progressive roots show big time!
Hey dummy lawyer! If you make someone else have health insurance and I have to pay for it, how are you requiring anything that resembles responsibility out of that person. It sounds like you have no idea what personal responsibility is!

Oh, the web of enabling the progressives weave...

(Report Comment)
Sally Willis July 19, 2012 | 12:59 p.m.

How about this why should I have to fit the bill with my taxes to pay for all those people who run into the hospital without insurance yet they can turn around and buy new cars, boats, harleys? I work in a hospital. Don't say it ain't so I see it first hand all the time.

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Ray Shapiro July 19, 2012 | 1:19 p.m.

Having some kind of health insurance is not the same as having a good health care delivery system.
Our country evolved into a multi-tier health care delivery system which the Dems had an opportunity to improve, but chose instead to pander to the poor, uneducated and their progressive socialistic followers for a governmental bureaucracy which maximizes cash flow, citizen dependence on the government and secures votes from those who think like the French.
Do the masses really understand that the end-game is that our health care system will become "monochromatic" with maximum federal control via the Internal Revenue Service and Health and Human Services at the helm?
Instead of improving our health care system by delving into the AMA and how medical professionals become medical professionals with providing more options for government sponsored health care professional training and service, allowing municipalities such as New York City's Health and Hospitals Corporation to flourish, passing legislation to foster nonprofit clinics, dental care facilities and mental health counseling. Improving the HHS and VA health systems not by looking to monopolize the health care industry but by acknowledging and improving the tiers which currently exist, including the Churches which operate hospitals and health care facilities as well.
Instead, the socialists look to overtake the insurance business, when they could have tweaked the system to produce more health care professionals, tax break incentives to medical supply manufacturers and pharmaceutical companies.
What can we expect next from these bureaucratic, big-government progressives?
Messing with the banks? The real estate market? The stock market? The automobile industry? Energy? Food? Education? Illegal Aliens from Mexico/Our borders? State rights? Gun control? Religious freedom? The Boy Scouts of America?
("However, insurers soon realized that ObamaCare would violate every actuarial principle of insurance and demonize them to boot—and yet barley a peep of dissent was heard from them.")
The Failure of Health Care Reform:
Forbes-
http://www.forbes.com/sites/merrillmatth...

(Report Comment)
Richard Saunders July 19, 2012 | 1:33 p.m.

Funny, back before healthcare was federalized, I remember it being affordable enough that one didn't need insurance in order to simply see a doctor.

What's coming next will only insure it will be unaffordable to ALL, creating the next crisis for them to "solve."

Healthcare has been turned into a wealth extraction service that creates poverty everywhere it's present. The only people it serves are those within the large corps that have set themselves up to ride this latest gravy-train.

Anyone who has to rely on this system is indeed suffering from ill health.

(Report Comment)
Mark Foecking July 19, 2012 | 1:38 p.m.

"But what else do you call the act of letting everyone else pay our medical bills"

I've never been convinced that this is a big driver of health care costs.

85% of people have insurance, generally through employers. Other choose not to, but still are able to pay for part or all of any bills they have. So we're left with perhaps 10% of people that don't pay their health care bills. Indigent care in many hospitals is covered in part by taxpayer funds, so this means even less impact on direct health care costs.

Whatever we do with this mandate, it won't have a significant effect on health care costs.

DK

(Report Comment)
Mark Foecking July 19, 2012 | 1:43 p.m.

Richard Saunders wrote:

"Funny, back before healthcare was federalized, I remember it being affordable enough that one didn't need insurance in order to simply see a doctor."

That has very many causes other than "federalization", whatever that means.

Technology, complex billing procedures, malpractice insurance and defensive medicine, high health care salaries, and mostly patient expectations all play a role in cost far beyond any influence the government has. The problem is much more the cost rather than who pays it.

DK

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Ray Shapiro July 19, 2012 | 2:05 p.m.

@Richard Saunders:
My dad drove a cab for a living, in New York City, and had little money for anything but the basics.
We had a doctor, who would bring his little black bag to our house whenever I had a childhood illness. My dad was able to pay out of pocket for the doctor's house call.
Hospitals were for catastrophic emergencies and the health department and school nurses provided vaccines and basic medicines. Every time I'd have a headache or a fever, they'd recommend an aspirin or an antibiotic. Now they send you for blood tests, MRI's and any other test they can think of.
Seniors are living out their lives in hospital clinic doctor office waiting rooms, seeing a different "specialist" every other day. They're getting tests, tests and more tests. All the while, consuming all kinds of drugs with all kinds of side effects.
Our children are being over medicated with drugs meant for adults.
Our young adults can get heavy-duty psychoactive meds from college clinic doctors for symptoms normal for college students, such as shyness or nervousness, instead of being referred to counseling & support group meetings and classes, assertiveness training, church groups, Cognitive Behavioral Training and Emotive Behavioral Therapy groups or family counseling. So they become dependent on prescription drugs which change their brain chemistry, for ever.
And the beat goes on. And the beat goes on...

(Report Comment)
Richard Saunders July 19, 2012 | 2:33 p.m.

@Mark:

ALL of the factors you state are very heavily influenced by the decrees emitted by Rome on the Potomac. And they are heavily influenced by armies of lawyers who not only promote these laws, but write them as well.

There is no logical basis that a lawyer in DC is better suited than I am to decide what my healthcare options "should be." To insist upon such, is to get the very disaster that we have today, where connected crony mega-corps (like the one owned by the Frist family for instance) are ensured guaranteed revenue streams under the guise of serving the public.

Without this ongoing scam, we wouldn't have unaffordable health care (nor a shortage of doctors thanks to the cartel known as the AMA, which has the monopoly on them), but rather we'd have a sustainable system driven by human need, rather than human greed.

Unfortunately, wishful thinking and its subsequent evil-do(good)erism trump the benefits of logic in our sound-byte driven world.

As always, the devil is in the details.

(Report Comment)
frank christian July 19, 2012 | 3:27 p.m.

Imo, this sentence illustrates the problem, Mr. Straub and the liberals among us have with our system of well over 200 years. "This makes it difficult to understand why the "profit at any cost" crowd is so vehemently opposed to it." He refuses to recognize that the "crowd" he refers to are the American people. That He is part of a small crowd here.

Everyone has learned that profit is the best thing that can happen to one striving to meet a goal. Everyone, save his little group which for good or bad, feel they must be empowered to assist we rest. The only thing they seem to have learned is that when those masses are allowed to work and turn a profit as they wish, the people no longer need these liberals. The problems with our economy, since JFK have been with liberal Democrats trying to control our people so they may "help" them. Imo, even if we can replace enough Democrats to right our sinking ship of state, this election, the next time they are allowed in control, no matter what we are told, they will start up where they left off.

(Report Comment)
Michael Williams July 19, 2012 | 3:52 p.m.

"Gary: What are your views on forced purchased of auto insurance?"

Me: It's a state issue, hence I have no problems with it.

I agree with you on the forced purchase of insurance from private companies.
___________________

Mark: "I've never been convinced that this is a big driver of health care costs....Whatever we do with this mandate, it won't have a significant effect on health care costs.

Me: I believe that each in every dollar in commerce eventually pays a salary. No one stuffs mattresses anymore and dollars remain in circulation, even if they are deposited in a bank. I, also, do not understand what is driving health care costs...unless it is just like tuition at universities that responds upwards in direct correlation to the amount of taxpayer money put into it.

Or are salaries the driver? I'm not necessarily talking about doctors and nurses. I'm talking about those that make MRI and CT machines, heart valves, needles, saline, Kleenex, pharmaceuticals, lab tests, malpractice insurance (suing is a career path), sheets, pillows, scalpels, and all the other things you see in a hospital/doctor's office.

I agree completely that ACA will have no significant effect on health care costs other than "up".

(Report Comment)
Richard Saunders July 19, 2012 | 4:29 p.m.

"Support the ACA, because every American should have the right to a hundred dollar aspirin."

(Report Comment)
Ray Shapiro July 19, 2012 | 4:54 p.m.

I was traveling from New York City to Columbia, MO via Greyhound Bus a number of years ago.
Sitting next to me was an old lady who was having some difficulty opening up her "childproof" bottle of over-the- counter headache pills.
Finally, with shaking hand and too much wrist action, she managed to open the bottle only to have her pills spill all over the bus's floor.
In frustration, she began to shout, (with her NYC accent), "My aspurns...my aspurns!
Naturally the bus driver yelled back, "Lady, if your aspurns, please just stick it out the window."
Is that worth a dollar or what?

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frank christian July 19, 2012 | 5:55 p.m.

"Funny, back before healthcare was federalized," written by Richard S. M. Wms. - "I, also, do not understand what is driving health care costs.." Neither do I, but have put together my experience with healthcare. Boring, but shows hc costs on average (or below) Americans since 1955.

First hospital/Dr, bill was birth of my son. I had savings from time in service and paid with it. My thought was, can't keep doing that, so I purchased least expensive hospitalization policy I could find and collected on Daughter, Son, broken leg, wife tonsil removal, thyroid opr, two collapsed lungs (not at same time, hee), hysterectomy. I don't remember my % of those bills but there was no thought of bankruptcy to avoid payment and they all were paid on time. Medicare came along in 1965, but not until early 80's, did my private policy with a "disappearing deductible" begin raising premiums every year. My deductible was near zero (no claims each year), when I started increasing deductible to offset premium increases. Then came Medicare. Did Medicare cure my problem, or cause it?

(Report Comment)
frank christian July 19, 2012 | 6:22 p.m.

Mark F loves to reject any thought that government has to do with our economic problems.

The 1994 Republicans/Clinton corrected our welfare system beautifully with a simple work requirement for welfare recipients. Far fewer problems and far less taxpayer money spent.

We had heard that prez Obama has ripped the work requirement out of the law! Fox Business guest. Rob't Rector who claims to have been forefront among writers of the law, states that this action is an illegal one, because they wrote specifically that the work requirement may not be removed. If this prez is allowed to stay in office Another draft,taking tax payer money out the window will be opened.

(Report Comment)

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