Health Insurance Reform ... how about a real opt-out option?
The most recent and virulent opposition to Health Insurance Reform has seemed to center on the idea that requiring people to buy insurance is tyrannical. I have some small sympathy for this argument. People who own and drive cars are required to buy car insurance, so that if they hurt themselves or others, any damage will be reliably paid for. In the health care realm, people with no insurance who are injured or sick have the right to treatment ... emergency treatment anyway ... and then they get billed. In the end, if they just can't pay the bill, the bill doesn't get paid, and we all pay a little in higher costs to make up for the loss. If everyone pays upfront for health insurance, then the cost will be paid upfront, fairly, and we all don't get left holding the bag for people who WILL get treatment and most likely will never pay for it themselves.
On the other hand, people don't have to own or drive cars if they really don't want to pay for car insurance. According to the health insurance reform bill, simply existing in the US will require one to buy health insurance, unless you get it through Medicare, Medicaid, or your employer. There's no practical way to opt out, so in effect, you're required to buy a product whether you want to or not. Hence the tyranny. But is it any fairer to expect everyone else to pay for your accident or illness just because you didn't want the cost or hassle of buying insurance?
I think we should seriously discuss a way that people who truly and across-the-board hate being told to do anything they don't want to do, to opt out of a whole slew of society's "requirements". In return though, they should have to sign some kind of ironclad waiver saying that they are opting out of modern society, and therefore they don't expect society to give them anything at all ... no emergency care, no search and rescue, no income assistance, no matter what. If someone is philosophically or constitutionally allergic to being a part of this complex modern society, with all of it's hassles, they should be able to accept the responsibility for that decision. To a large extent, this is what the Amish do, and some people who go "off the grid". Maybe it would be a good idea to provide a formal way of recognizing this. I suspect that if we did, a very small but determined minority would accept it, and the rest of us could get on with our social contract without contending with or violating the rights of the true purists, misanthropes, dissenters, and luddites.
Monday, March 22, 2010
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2 comments:
What you are discussing here is one instance of individual vs. societal rights. What about my right not to have lepers living nearby when they could be treated? How about TB? What if my neighbor's dog gets rabies? Unless you can move to your own island, it is impossible to opt out of society without affecting other people.
Andrew, I really appreciate this post. I'm on facebook, and one of the things I've discovered since reconnecting with friends from high school and some friends from college is that my 'network' of friends is sharply divided between the left and the right. And many of them are quite vocal in their FB posts. I've been torn because I personally don't find FB an effective place to sound off politically, yet I'm irked by some of the comments made by conservative friends who see this reform as the first step to the destruction of either our healthcare system or our whole country. I'm frustrated by the sharp divisions in our country, and then I turn to my little FB account and see how sharp the divide is there and wonder if/when there might be change and how that change might come about. I think what's lacking is true discussion that doesn't dig at key politicians or the ideologies of either party. I think posts like this one start to address the real discussions that need to be placed. Healthcare is a difficult topic because there is virtually no way to keep politics out of it, but there's got to be a better way than the majority of the rhetoric I hear which is mainly categorized by sound bites and sniping. Thank you.
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