do you think that rights come with responsibility
Is that from Spider Man?
the only way this can reasonably be paid for is that everyone pays their share. If some people "opted out", it would likely affect the rates of everyone. if insurance companies were allowed to cherry pick, people with chronic illness may lose coverage.
it has been argued that if one has a health savings account, they should be able to opt out of insurance - they better have a huge account if they plan on ever getting sick.
As I've said (and you've agreed), the issue is that costs have unreasonably increased and the current law does absolutely nothing to change that. The "bending the cost curve" line he was so fond of is a great idea; the problem is that this law will not do that.
imo the mandate for health insurance is analogous to statewide mandates on car insurance. yes, I realize we are comparing federal vs state, but I'm looking at this on "the right thing to do"
Can't afford/choose not to buy car insurance? Take the bus. Can't afford/choose not to buy health insurance? Pay a tax. That's doesn't sit well with me.
no - the point was that if you expect someone to take care of you in an emergency, you need to pay your share if you could afford it.
can't afford insurance? that's what medicaid is supposedly for.
don't want to buy insurance? what should we do with you when you get sick? Have a heart attack?- take some aspirin and call me in the morning. Get cancer? Go to Tahiti and enjoy your last days. Or, go to the hospital, sell your house and go bankrupt to pay the bills.
I think there are (at least) 2 parts to health care reform. One is making sure everyone is covered. I think this bill did a reasonable job with that. The problem is that if you started your own country, and wanted to provide health insurance, I doubt anyone would decide an employer based model. I also think that doing away with an employer based model would be politically would be very, very difficult.
The other part is, like you and I agree, is somehow reducing costs. Part of the problem with the high cost of medicine is that it is, well, expensive. Labor intensive with highly trained individuals who have spent a great deal of time and $ on this training. New drugs are expensive (costs about 800 mill to get something to market). New technology is expensive. Yes, we need to somehow reform the payment model, but imo the reason why single payer systems in Europe are having difficulty paying the bills isn't because they are government run, but because health care is expensive.
This bill takes a shot at it with ACOs and other things to make health care more efficient which should bring down costs. They need to reform the payment system and the torte system. Pay for performance is being phased in (independent of this law). Hospitals will get paid more for good outcomes, less for poor outcomes (for certain conditions). This will only get bigger in time.
Personally, I think that figuring out ways to reduce cost will take time, I don't see this bill (or any bill) as the final answer, just a starting point to figure out what works.