Thursday, June 28, 2012

Why the Supreme Court got it right on Obamacare

There are very few guarantees in life.  One of the only sureties is that at some point in our lives, we are going to become sick, and at some point in our life we are going to die.  Medical costs are extraordinarily high.  There are many reasons for high cost of medicine; some that could be addressed, and some that could not.  The reality, though, is that someone needing emergency heart surgery could easily need $100,000 or more to cover it.  Most Americans do not have or have the means to quickly obtain $100,000 for an emergency operation.

Most Americans, as people, believe in helping others at least to a small degree.  Our laws dictate that we do not withhold life-saving medical treatment, regardless of a patient’s ability to pay.  That means every day people without insurance or adequate savings enter emergency departments around the country, receiving hundreds of thousands of dollars of treatment that they will never be able to pay for.  This raises the cost of medical treatment for all of the patients who do have insurance, or other means to pay.

Most states require anyone who wants to drive a car, to obtain liability insurance to legally do so.  This is because we need assurances that if someone injures another person or damages property while driving, they will have the means to pay for the damages.  Obviously, someone can avoid paying for auto insurance by choosing not to drive a car.

People cannot choose whether or not to participate in health care.  At some point in life, everyone will need it.  Requiring every American to carry medical insurance is the only way to ensure that every American has the means to pay for at least the majority of the medical care they receive.  Without this requirement, those of us who have insurance, continually subsidize the emergency medical care of those who do not have insurance or other means to pay.

Insurance, of any type, is all about risk sharing.  Because we can’t possibly know who will need what type of care or when they will need it, it only makes sense for everyone to chip in to the “risk sharing pool”.  This is the only way to ensure that everyone has access to life saving care, and the ability to pay for it so that others don’t have to pick up the tab.

In time, many benefits will be seen.  For one, the overall cost of medical care should decrease as all patients are paying their bills as opposed to just the ones who have insurance.  Additionally, with the requirement that all plans include preventative care, expensive health problems will be caught earlier.  This will decrease the need for expensive procedures necessitated by late diagnosis.  Lastly, government subsidies and state-sponsored health care exchanges will make insurance affordable for millions who previously wanted to have it but simply couldn’t make room in the budget.

If someone still has a fundamental problem with health insurance, they can choose not to purchase it.  The penalty is that they will have to pay a fine.  This is fair and just, as individuals who forego insurance are taking the risk of future medical bills that they will not have the ability to pay.  In exchange for the possibility that the government (read: us) will later end up with the bill for their emergency health care, it is only appropriate that they pay us for assuming that risk.

Nobody likes being told what to do, especially by the government.  In this case, however, the government got it right.