Although it wouldn’t take a genius to figure out where I fit on the political or religious spectrums, as a rule, Pink Slip avoids politics and religion.
Why dive into those particular ponds of commentary when there’s so much in the realms of business, the economy, culture, sports, and general-purpose oddball stuff to keep a blogger occupied.
Still, while I have turned off the talking heads for the last week or so – no Rachel, no Chris, no Lawrence, no Ed* – there’s still plenty of talking in my head and it keeps whispering screeching “individual mandate.”
Wherever The Supremes come down on this one – and, obviously, the goodies like pre-existing condition coverage that just won’t work without it – I’m coming to the conclusion that it may be time to ask those who don’t want health insurance to put up or shut up.
Let those who want to participate in not-so-universal-health-coverage do so. Let those who want to opt out, opt out.
Yes, this will no doubt remove some of the healthy young adults from the pool, raising costs for the rest of us. But, once we point out few things to them, and they still choose to opt out, well, let ‘em.
What might we point out to them?
For starters, we will explain that insurance works by spreading risk. And that everyone who’s fortunate enough to have insurance and good health is, in effect, subsidizing those who have insurance but not good health. But that, if and when our personal time comes, we’ll be taken care of. Of course, we’re also subsidizing those who have neither insurance more good health. But that, as we’ll explain to the opt out-ers, is about to change.
If you want to opt out and, a few months later, you get diagnosed with Some Dread Disease, you won’t be able to purchase coverage for a pre-existing condition. You have to wait a while – 12 months, 18 months, 24 months, forever. We’ll let the insurance companies figure that bit out.
If you – quite sensibly – decide that you don’t to wait around while Some Dread Disease does you in, your options will be explained to you. Not by a death panel – shudder, shudder – but by a liberty panel. They will lay out the medical treatment options – and the associated costs – and you’ll get to pick the one that matches your pocketbook. Because that free care pool will have been drained.
Maybe you have to choose the radiation course over the more costly (but better outcome) chemo-radiation treatment. Maybe you have your operation at a community hospital where the surgeon sees one case like yours a year, rather than at the high priced medical center where the surgeon invented the procedure and does a couple a week.
As far as paying goes, you will be free to choose whether to sell your house. Agree to have your pay garnished until you pay off your medical bills. Have your friends organize a “time” for you.
Perhaps the liberty panels can have a travel agent on them, who can explain the medical tourism options.
Maybe the Koch brothers will set up a foundation that those without insurance can apply to.
Maybe charities will form that cover the medical costs of those risk-takers who gambled and lost. (Note to such charities: lose my address and number.)
Obviously, we’ll still cover children. Can’t blame them for their parents bad choices. (Which is not to say we won’t go after the parents to recoup the costs. Unlike the personal option we will grant adults, we won’t let parents elect for their children to die so that they can buy an RV or re-do their kitchen.)
Oh, yes, bankruptcy won’t wipe out medical debts.
If someone’s in an accident we will, of course, do what we can to save their life. But when they come to, the liberty panel will be there to explain the next steps.
Personally, I hope that I am able to continue to pay a hefty amount for health insurance that I never have to draw on.
But, these days, as my husband, having just survived Cancer #1, takes on Cancer #2, we’re pretty darned relieved that there’s next to nothing coming out of pocket. Sure, Jim is on Medicare, but he does have good supplemental, and so far the costs – 65 radiation treatments since last fall, 5 rounds of chemo, a couple of doctor visits each week, countless tests and minor procedures, a trip to the ER, an overnight stay on the oncology floor – have been limited to less than $100 in prescription co-pays. And, sure, we think it would be entirely reasonable if there’d been some co-pays or deductibles or whatever on all the treatment Jim has been getting. Yes, there are indigent elderly who can no doubt afford nothing, but – not that we’re going to volunteer to pay – you’d think that folks who could afford to would be asked to fork over five or ten bucks a visit, wouldn’t you? (Something in Medicare really does have to give…)
After all, we should be looking out for the common good, and not just for Number One. Isn’t that what being a member of a society is all about?
But if there are folks out there who really believe that having to buy health insurance is trampling on their liberty. And they’re willing to die for it. Well, let them.
It might take a generation or so, but I suspect most people will come around to the wisdom of crowds.
I’m Maureen Rogers, and I approved this message.
------------------------------------------------------------------------------*What did I tell you? It is just so darned easy to tip your political hand.
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