what is Romney Care?

[dcarrigg]

Re: Medical insurance not like auto insurance

I only need auto insurance to operate a car on a public roadway. Many people in large cities don't own a car and aren't required to buy insurance. Every car on a roadway is some risk to the other cars.

Since there's not a person I know that lives their lives without using hospital service, the uninsured are functionally free-riders who drive up insurance rates for those who purchase it and cost the government (taxpayers) money when they use emergency services for which they don't pay. Short of forcing the medical profession to give up on the Hippocratic Oath, there is not a free market solution to this. In the car scenario, pedestrians ultimately insert risk into the equation as well, and are factored into auto insurance rates.

As for mortgage insurance, we had to pay it when our loan to value ratio was high. When we lowered the LTV, we stopped paying it. There may be some other insurance hidden in the monthly payment, but I've never been able to figure that part out.
I am not required to borrow money ---I can pay cash for the house or rent. So I find mortgage insurance much less intrusive.
If interest rates were rational, they would just price in the borrowers risk, with no need for "insurance".

You're correct here. And I do understand your argument. This is what makes the Supreme Court case so interesting. The states have the right to compel citizens to make purchases - their rights are unenumerated. Does the Federal Government have such a right? Is a tax penalty the equivalent of compulsion? These are actually hard questions for all but the most ideologically rigid among us. We shall see what happens.

[Polish_Silver]

Re: Medical insurance not like auto insurance

Short of forcing the medical profession to give up on the Hippocratic Oath, there is not a free market solution to this. In the car scenario, pedestrians ultimately insert risk into the equation as well, and are factored into auto insurance rates.

How is controlling physician behavior a free market solution?

The oath does forbid abortion, which they do anyway.

If you are worried specifically about emergency care, why not fund it from general revenues, and make non-poor people pay back what they owe? That's how fire deparments work. They come to my house whether I have insurance or not.


Insurance is not the only way to pay for hospitalization, and medical care includes more than hospitalization.
If someone doesn't pay, then garnish thier wages from that point on.

How do people pay for houses: some combination of savings, borrowing and current income. There is no reason medical expenses shouldn't be paid the same way.
Insurance only makes sense for rare and catastrophically large expenses---like a house burning down.

[dcarrigg]

Re: Medical insurance not like auto insurance

How is controlling physician behavior a free market solution?

I don't know what you mean. I said that I didn't see a free-market solution.

The oath does forbid abortion, which they do anyway.

This ol' yankee doesn't get into abortion debates.

If you are worried specifically about emergency care, why not fund it from general revenues, and make non-poor people pay back what they owe? That's how fire deparments work. They come to my house whether I have insurance or not.

That's a solution. It's not a free-market solution. Hence me saying that there's not a free market solution.

Insurance is not the only way to pay for hospitalization, and medical care includes more than hospitalization.

True.

If someone doesn't pay, then garnish thier wages from that point on.

This is also not a free-market solution. Plus there's ways around it. If I were someone who got hit hard (six figures), I'd be working under the table or not reporting income. So would everybody else. Garnishment only affects the honest. Set the system up to be too mean, and the system will cease to have meaning.

How do people pay for houses: some combination of savings, borrowing and current income. There is no reason medical expenses shouldn't be paid the same way.

Microecon 101: Chapter 5: Elasticity.

Insurance only makes sense for rare and catastrophically large expenses---like a house burning down.

You have a point. What we call 'health insurance' is really managed care for a fee with pooled costs.

[c1ue]

Re: Medical insurance not like auto insurance

Insurance is not the only way to pay for hospitalization, and medical care includes more than hospitalization.
If someone doesn't pay, then garnish thier wages from that point on.

The focus above is on the payments side; a big part of the problem in the US is the cost side.

My greatest criticism of ObamaCare is that it does not do anything to even attempt to address the cost side.

The point of having health care as a public good is that the cost of delivery then comes into the domain of government oversight, as well as the overall benefit of any given course of treatment.