# Fines for no health insurance **URL:** \ **Category:** Great Debates\ **Created:** [September 9, 2009, 5:43am UTC](https://boards.straightdope.com/t/fines-for-no-health-insurance/509395 "2009-09-09T05:43:27Z")\ **Posts on this page:** 16\ **Page:** 4
**Author:** ![Grumman](https://avatars.discourse-cdn.com/v4/letter/g/43a26b/32.png) [@Grumman](https://boards.straightdope.com/u/Grumman)\ **Post date:** [September 10, 2009, 5:09pm UTC](https://boards.straightdope.com/t/fines-for-no-health-insurance/509395/61 "2009-09-10T17:09:22Z")
> [@Cyberhwk](#): > > Wait. So even if there ends up being a affordable policy for you and providers are required to accept your pre-exiting conditions , you’re still going to refuse and instead leech off the rest of us? 😕 Those are mutually exclusive objectives. Assuming the law will similarly prohibit charging a higher price for people with pre-existing conditions, an insurer can only accept pre-existing conditions and not go bankrupt by charging everyone according to the _average_ risk, rather than the risk the individual faces. For anyone who faces below-average risk (i.e. those who _don’t_ have pre-existing conditions), this means being charged more than the service is worth. ---
**Author:** ![Magiver](https://avatars.discourse-cdn.com/v4/letter/m/4491bb/32.png) [@Magiver](https://boards.straightdope.com/u/Magiver)\ **Post date:** [September 11, 2009, 12:05am UTC](https://boards.straightdope.com/t/fines-for-no-health-insurance/509395/62 "2009-09-11T00:05:11Z")
> [@Grumman](#): > > Those are mutually exclusive objectives. Assuming the law will similarly prohibit charging a higher price for people with pre-existing conditions, an insurer can only accept pre-existing conditions and not go bankrupt by charging everyone according to the _average_ risk, rather than the risk the individual faces. For anyone who faces below-average risk (i.e. those who _don’t_ have pre-existing conditions), this means being charged more than the service is worth. Accepting someone with a pre-existing condition is not the same thing as charging everyone the same price for insurance. It’s just like car insurance where you pay more if you have a bad record. Part of the problem with pre-existing conditions is that people are often refused insurance without any form of negotiation. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [September 11, 2009, 12:26am UTC](https://boards.straightdope.com/t/fines-for-no-health-insurance/509395/63 "2009-09-11T00:26:38Z")
> [@Magiver](#): > > Accepting someone with a pre-existing condition is not the same thing as charging everyone the same price for insurance. It’s just like car insurance where you pay more if you have a bad record. > > Part of the problem with pre-existing conditions is that people are often refused insurance without any form of negotiation. But pre-existing conditions are not a matter of choice, in the way bad driving records and smoking are. If the premium for a pre-existing condition is unregulated, insurers can effectively deny coverage to anyone with a pre-existing condition through pricing. Since any company who accepts them would become uncompetitive, they’d still be excluded. In the short term the insurers will have to handle the additional risk - but if they all do equally, it should not affect much. In the long term, with everyone covered, company X getting a person with a pre-existing condition means company Y loses one, so it should be stable. My daughter just went off our insurance, and we got a letter from the company certifying that she was on ours, and so must be taken by a new company even if there was a pre-existing condition. I don’t know if this is California law or federal law - I must admit I was unaware this was the case. ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [September 11, 2009, 6:56am UTC](https://boards.straightdope.com/t/fines-for-no-health-insurance/509395/64 "2009-09-11T06:56:06Z")
> [@Magiver](#): > > Bought stamps lately? The same reason the government outlaws monopolies should be applied doubly to administrators whose only qualification was winning a popularity contest. Are they not still cheaper than FedEx & UPS? ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [September 11, 2009, 7:46am UTC](https://boards.straightdope.com/t/fines-for-no-health-insurance/509395/65 "2009-09-11T07:46:09Z")
> [@DanBlather](#): > > it comes down to several choices: > > - Pay for health insurance through general taxes like we do for roads, education, and parks. > - Leave it up to individuals amd let them die if they are uninsured. > - Leave it up to indiiduals and expect everyone else to pay for the freeloaders. > - Or require individuals to have insurance with some sort of penalty for not doing so. > > The irony is that the last option, which will so enrage conservatives, may come about because of their insistence that universal health insurance not be paid by the govt. I think you can tell what I think. If a healthy society is enough a public good that we mandate insurance, it’s enough a public good that we index the amount a citizen pays into the system to his income. > [@Magiver](#): > > We don’t allow monopolies because they can operate in a vacuum with no care to cost. The same applies to government run agencies. They are run by people whose only qualification (literally) is that they were elected or appointed by elected officials. Maybe that was true when all civil service positions were patronage jobs; but we have a professional civil service now, & there are actually strict requirements for some of those jobs–and they aren’t simply fired by a governor at will, either. ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [September 11, 2009, 7:48am UTC](https://boards.straightdope.com/t/fines-for-no-health-insurance/509395/66 "2009-09-11T07:48:34Z")
> [@Magiver](#): > > The problem with health care is not a national one. We’re talking about 15% of the population at most. One in seven persons is not significant? > [@](#): > > If the government creates it’s own program for part of the population it will likely morph into a national quagmire like social security did. This was a program for a very small portion of the population when? > [@](#): > > and it is now mandatory for everyone except government workers (sound familiar). It allows for private retirement investment but the money taken in the process represents a huge loss of personal investment. Social Security is a total loss of control of the money withheld. So why aren’t you trying to abolish FICA? 😕 ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [September 11, 2009, 7:54am UTC](https://boards.straightdope.com/t/fines-for-no-health-insurance/509395/67 "2009-09-11T07:54:32Z")
> [@Magiver](#): > > There are many ways medical costs can be reduced and they have been discussed at length in other threads. I pay my doctor in cash which knocks about 40% off the bill. I buy generic drugs. I adjusted my deductible to match my needs and bank the difference as hedge. Useful personally, but I’m having trouble seeing its application to national policy. > [@](#): > > From a regulatory standpoint we can reduce medical lawsuits, work with drug companies to cover research costs with longer patents in return for lower prices. Longer patents? Yeesh! Our patents already run longer than Canada’s. Let some competition in! And the NIH already helps cover some research costs. Why, if we put more public money in, would we strengthen patent for what would just be a glorified manufacturer? ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [September 11, 2009, 8:00am UTC](https://boards.straightdope.com/t/fines-for-no-health-insurance/509395/68 "2009-09-11T08:00:21Z")
> [@jtgain](#): > > I find it incredibly offense that in a free country, that I should be “allow[ed]” to do or not do something with my own money for retirement. That’s where the whole comparison about socialism starts to creep into these discussions. Is it my money, or do we collectively own the money so that we get to make decisions about what each person should be “allowed” to do when planning his finances? > > While I agree with your statement about making risky investments, shouldn’t individuals have that right to decide? Oh, but since I might be on the dole, then it is acceptable to take away this freedom? To me, that’s the best reason ever for not having a public welfare system. Would you prefer to have the government mandate an Individual Retirement Account & an Individual Health Savings Account for you–telling you how to spend your money, without any additional benefit, nor membership in a larger risk pool? Because that’s the kind of “innovative policy idea” the right was been coming up with for 20 years. It seems like they say “freedom” but offer less freedom in the name of more individualism. ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [September 11, 2009, 8:06am UTC](https://boards.straightdope.com/t/fines-for-no-health-insurance/509395/69 "2009-09-11T08:06:23Z")
I don’t mean to make a straw man; but of the two, I’ll take the welfare program. ---
**Author:** ![Magiver](https://avatars.discourse-cdn.com/v4/letter/m/4491bb/32.png) [@Magiver](https://boards.straightdope.com/u/Magiver)\ **Post date:** [September 11, 2009, 8:30am UTC](https://boards.straightdope.com/t/fines-for-no-health-insurance/509395/70 "2009-09-11T08:30:04Z")
> [@foolsguinea](#): > > Useful personally, but I’m having trouble seeing its application to national policy. It’s not a singular solution, it’s one of many examples of how to save money on health care. Applied on a national level means focusing on generic drug cost efficiencies, health insurance instead of HMO’s and the direct involvement of patient and doctor. > [@foolsguinea](#): > > Longer patents? Yeesh! Our patents already run longer than Canada’s. Let some competition in! Canadian corporations are free to compete in drug development. I have no idea which country leads the world in the advancement of medicine but I imagine the United States is well represented. > [@foolsguinea](#): > > And the NIH already helps cover some research costs. Why, if we put more public money in, would we strengthen patent for what would just be a glorified manufacturer? It’s a trade of lower prices on newer drugs. It allows for greater risk in the development of new drugs. There is a relationship between innovation and the ability to recoup the investment. As an example, If you personally spend $100,000 to certify something and it is re-engineered the following week in China then your entire investment is gone. Negotiating a longer patent in return for lower costs is a way of bringing down the cost of new drugs. Recouping development costs can take many forms. If the cost of certification is transfered to the publlic then risk is reduced and the price of the product can be lowered. I personally know of a simple plastic airplane part that was developed at private expense to the tune of $100,000. Virtually all of the money was in the certification process. The part was $1 worth of molded plastic. It sells for $90. To break even the person has to sell over 1100. In an industry where planes are sold in small quantities that is a risky venture. ---
**Author:** ![Magiver](https://avatars.discourse-cdn.com/v4/letter/m/4491bb/32.png) [@Magiver](https://boards.straightdope.com/u/Magiver)\ **Post date:** [September 11, 2009, 8:32am UTC](https://boards.straightdope.com/t/fines-for-no-health-insurance/509395/71 "2009-09-11T08:32:01Z")
> [@foolsguinea](#): > > One in seven persons is not significant? It’s not significant enough to screw the other 85% with a one-size-fits-all NHS system. That is the context I meant that statement. It doesn’t mean you don’t address the 15%, it just means you don’t do it at the expense of everyone else. ---
**Author:** ![Grumman](https://avatars.discourse-cdn.com/v4/letter/g/43a26b/32.png) [@Grumman](https://boards.straightdope.com/u/Grumman)\ **Post date:** [September 11, 2009, 12:17pm UTC](https://boards.straightdope.com/t/fines-for-no-health-insurance/509395/72 "2009-09-11T12:17:06Z")
> [@foolsguinea](#): > > I think you can tell what I think. If a healthy society is enough a public good that we mandate insurance, it’s enough a public good that we index the amount a citizen pays into the system to his income. Insurance is a service that lets people pay a premium to receive a greater value of mitigated risk in return. With real insurance, _everyone_ is made better off, because risk mitigation is not a zero-sum game. But once you’ve decided you can charge people more than the service is worth, by force, _it is no longer the same product_. Once you are forcing part of your customer base to make themselves worse off by buying your product, you are not selling insurance, you’re selling welfare, and it is incredibly dishonest to try to claim you’re still helping everyone when you’re just ripping off Peter to pay Paul. ---
**Author:** ![foolsguinea](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/foolsguinea/32/14751_2.png) [@foolsguinea](https://boards.straightdope.com/u/foolsguinea)\ **Post date:** [September 12, 2009, 7:10am UTC](https://boards.straightdope.com/t/fines-for-no-health-insurance/509395/73 "2009-09-12T07:10:07Z")
“ripping off Peter to pay Paul.” What I’m sorely tempted to say: > [@the demon on my shoulder](#): > > Yeah, we do that already with funds for the medical care of those born before 1945. Supposedly they “earned” this entitlement when they were younger & burning through what should have been our great-grandkids’ oil supply. :rolleyes: > > The difference between the rathole that is Medicare today & a new single-payer system is that we’d be spending money on actual working-age, potentially more productive persons, instead of telling them to suck it up & subsidize the half-dead. 😉 > > I’ll take opposition to single-payer seriously when you get over your neurotic bleeding-heart obsession with stealing from the working class to fund your senile grandparents. 😛 What I should say: > [@my better angels](#): > > Public funding of health care, like public funding of schools, is a matter of investing in the health of our economy by investing in the well-being & development of our citizens. It is a communitarian investment. > > It is not a simple transfer of wealth, nor is it from taxpayers to an arbitrary class. ---
**Author:** ![The\_Tao\_s\_Revenge](https://avatars.discourse-cdn.com/v4/letter/t/73ab20/32.png) [@The\_Tao\_s\_Revenge](https://boards.straightdope.com/u/The_Tao_s_Revenge)\ **Post date:** [September 12, 2009, 8:32pm UTC](https://boards.straightdope.com/t/fines-for-no-health-insurance/509395/74 "2009-09-12T20:32:21Z")
So what happens to the pay to pay check people who can’t afford insurance or government fines? They get their stuff confiscated, then jail time? ---
**Author:** ![The\_Tao\_s\_Revenge](https://avatars.discourse-cdn.com/v4/letter/t/73ab20/32.png) [@The\_Tao\_s\_Revenge](https://boards.straightdope.com/u/The_Tao_s_Revenge)\ **Post date:** [September 12, 2009, 8:36pm UTC](https://boards.straightdope.com/t/fines-for-no-health-insurance/509395/75 "2009-09-12T20:36:14Z")
> [@Magiver](#): > > It’s not significant enough to screw the other 85% with a one-size-fits-all NHS system. That is the context I meant that statement. It doesn’t mean you don’t address the 15%, it just means you don’t do it at the expense of everyone else. Nah what screws everyone else is horrid effects the idiotic current system has on the economy. Including taxes to support healthcare, which company is burdened with greatest hardship. The UK one, or the American one? ---
**Author:** ![E-Sabbath](https://avatars.discourse-cdn.com/v4/letter/e/e19adc/32.png) [@E-Sabbath](https://boards.straightdope.com/u/E-Sabbath)\ **Post date:** [September 13, 2009, 2:02am UTC](https://boards.straightdope.com/t/fines-for-no-health-insurance/509395/76 "2009-09-13T02:02:12Z")
> [@The\_Tao\_s\_Revenge](#): > > So what happens to the pay to pay check people who can’t afford insurance or government fines? They get their stuff confiscated, then jail time? Isn’t it great? Thank you, Republican Plan! [Previous page](https://boards.straightdope.com/t/fines-for-no-health-insurance/509395.md?page=3)