Lower Health Care Costs with Health Care Pooling

[Scott]

In my recent philosophy of politics article, Ways to Lowering Health Care Costs, I explained my top 5 suggestions. Please use this thread to specifically discuss the forth suggestion about health care pooling.

Do you agree that the health care costs per capita of a plan decrease when there is more people in the plan--that for example per capita it is cheaper for a group of 1,000 people to get coverage than for a group of 3 people or an individual (assuming the coverage per person is the same of course)?

Do you support a health care mandate requiring everyone to get coverage? While I think it would obviously lower health care costs, I would only support this mandate if it is combined with a non-subsidized public option. That would be a decent compromise in my opinion, but forcing everyone to do business with the for-profit monopolies is intolerable to me.

Do you support the idea of allowing individuals, small businesses and non-profits to buy into the state employees' or federal employees' plans? Remember, these plans are not paid for or run by the government, but bought from private health insurance companies for the employees as a big pool. Do you agree it would lower health care costs?

Do you have any other ideas for increasing health care pooing?

First of all, there should be no "public" plans in the first place. "Government" employees should be required to get their own care, just as "unions" for government employees should be considered "monopolies" and in violation of anti-trust laws. But that's for another topic, isn't it?

Second, not only does 'pooling' make sense, as that is the most basic and simplistic tenant of insurance, but it makes sense that we should have access to EVERY market in EVERY region of EVERY State in the Union. Closing off markets with laws only INCREASES the opportunity for monopolistic behavior, and so is anti-competitive and anti-consumeristic.

Third, "forcing" anybody to buy anything will not solve the problem. Think about it; car insurance is "mandatory", and yet people drive every day without it. Many will always go uninsured. And if you just "buy" it for everyone with the tax dollars of a few, all you do is incentivize the 'few' who pay for their own care to NOT provide for themselves any longer. Why pay for your own care if it's free for everybody else?

Once this "free" care is utilized by all, how great do you think the quality will be? Would this not guarantee a monopoly by the Federal Government? Am I seriously the only person who sees this?

[Scott]

First of all, there should be no "public" plans in the first place. "Government" employees should be required to get their own care...

I'm not sure I understand. Are you suggesting that benefits not be provided to government employees, that you only want to pay them a base salary? Business-wise, I don't think that makes sense. There is a reason why big businesses choose to offer benefits and that is because that get more bang for their buck compensating employees part with benefits and part with weekly paychecks. I'm not sure what affect it would have on health care costs, but it would increase the overall cost of government programs.

Second, not only does 'pooling' make sense, as that is the most basic and simplistic tenant of insurance, but it makes sense that we should have access to EVERY market in EVERY region of EVERY State in the Union. Closing off markets with laws only INCREASES the opportunity for monopolistic behavior, and so is anti-competitive and anti-consumeristic.

Assuming I understand this paragraph, I think I agree.

To be clear, would you thus say you support health care pooling bills that would allow individuals, non-profits and small businesses to buy into the state employees' health care plan (not receive subsidized health care but pay their own share of the per capita premiums for private insurance collectively bought for the state employees who enroll in it)?

Third, "forcing" anybody to buy anything will not solve the problem.

That depends on what you mean by solve the problem. Though I may not support it, I think it's obvious a health insurance mandate would significantly lower health costs. I also think it would be fairer than the status quo, which offers expensive government-funded care in emergency rooms to people who chose not to buy insurance for themselves, not get checkups and risk it. Regardless of whether or not you would support it, don't you agree a health insurance mandate that everyone must have basic health insurance would reduce health care costs?

Once this "free" care is utilized by all, how great do you think the quality will be?

I don't understand. Who's suggesting "free" care?

I know I'm proposing quite the opposite--that people buy affordable health insurance, get checkups for which the insurance will help them pay, and when they need expensive emergency care it can be paid for by the insurance coverage and the patient. This is opposed to the status quo, in which many people do not get coverage (either because they can't afford it or they choose to gamble knowing they can rely on emergency rooms), do not get checkups, and let the rest of us pay for their care when they use an expensive emergency room. When all these gambling people who choose not to get coverage knowing they can use the emergency rooms for which the rest of us pay we then among other cost-raising problems have less people in the health care insurance pool which raises costs.

I'm not sure I understand. Are you suggesting that benefits not be provided to government employees, that you only want to pay them a base salary? Business-wise, I don't think that makes sense. There is a reason why big businesses choose to offer benefits and that is because that get more bang for their buck compensating employees part with benefits and part with weekly paychecks. I'm not sure what affect it would have on health care costs, but it would increase the overall cost of government programs.

I'm saying that Government is not big-business, and that Government should not be in the habit of providing jobs that require extremely competitive salaries and benefits. For instance, Congressmen/Senators should not receive better-than-average health care, as they are public servants who create public law, and so should be required to live according to the rules of the system they are responsible for establishing.

To be clear, would you thus say you support health care pooling bills that would allow individuals, non-profits and small businesses to buy into the state employees' health care plan (not receive subsidized health care but pay their own share of the per capita premiums for private insurance collectively bought for the state employees who enroll in it)?

Considering that I detest the existence of any state employees' health care plan, if it must exist, then yes, I would support this program, as it encourages competition and further improves the freedom of choice for consumers. GEICO [Government Employees Insurance COmpany] did something similar with auto insurance.

Third, "forcing" anybody to buy anything will not solve the problem.

That depends on what you mean by solve the problem. Though I may not support it, I think it's obvious a health insurance mandate would significantly lower health costs. I also think it would be fairer than the status quo, which offers expensive government-funded care in emergency rooms to people who chose not to buy insurance for themselves, not get checkups and risk it. Regardless of whether or not you would support it, don't you agree a health insurance mandate that everyone must have basic health insurance would reduce health care costs?

I think it would be fairer to not "force" people to pay for the emergency care of those who chose not to take advantage of the opportunity to obtain health care utilizing either the free market or the social programs already in place. And, should a hospital choose to care for a person without adequate insurance, I think it would be fair for THEM to absorb the cost, and not transfer the responsibility to me. I was not the one who required or provided the care, so why am I obligated to finance it?

Once this "free" care is utilized by all, how great do you think the quality will be?

I don't understand. Who's suggesting "free" care?

I know I'm proposing quite the opposite--that people buy affordable health insurance, get checkups for which the insurance will help them pay, and when they need expensive emergency care it can be paid for by the insurance coverage and the patient. This is opposed to the status quo, in which many people do not get coverage (either because they can't afford it or they choose to gamble knowing they can rely on emergency rooms), do not get checkups, and let the rest of us pay for their care when they use an expensive emergency room. When all these gambling people who choose not to get coverage knowing they can use the emergency rooms for which the rest of us pay we then among other cost-raising problems have less people in the health care insurance pool which raises costs.

"Insuring" everybody, at least for cataclismic events, requires 'forcing' everybody to get insurance. "Forcing" everybody to get insurance necessitates companies offering less-than-adequate premiums for the risks they are required to insure. Are homeless people required to be insured as well? How about low-income families who must choose to be either insured or eat this week? In this case, these particular groups' care would have to be subsidized for free.

Once this happens, what's to stop others from demanding the same care? How would you justify charging them for the care of the homeless or the 'disadvantaged'? How would you define 'disadvantaged', and who would have the right to dictate and interpret your definitions?

I understand your frustration and share in it.
Unfortunately, since there is no utopia, you are going to have to either continue to be a contributing member of our society and share in the support of those that do not contribute, or move to some other society that is more willing to watch as the bodies stack up on the road sides. I have great hope that our society will not digress to the type that you are advocating. I've seen those images on the news and am willing to do my part so as not to see it here.
You're already paying for them anyway. Why not see if it can be done a little more effiently?

[Scott]

To be clear, would you thus say you support health care pooling bills that would allow individuals, non-profits and small businesses to buy into the state employees' health care plan (not receive subsidized health care but pay their own share of the per capita premiums for private insurance collectively bought for the state employees who enroll in it)?

Considering that I detest the existence of any state employees' health care plan, if it must exist, then yes, I would support this program, as it encourages competition and further improves the freedom of choice for consumers. GEICO [Government Employees Insurance COmpany] did something similar with auto insurance.

I think we agree on this issue.

I have personally gone door-to-door in support of such a health care pooling bill here in the state of CT. But the wealthy special interests, in this case the insurance companies, won that battle here for the time being despite the fact that most voters support it.

That depends on what you mean by solve the problem. Though I may not support it, I think it's obvious a health insurance mandate would significantly lower health costs. I also think it would be fairer than the status quo, which offers expensive government-funded care in emergency rooms to people who chose not to buy insurance for themselves, not get checkups and risk it. Regardless of whether or not you would support it, don't you agree a health insurance mandate that everyone must have basic health insurance would reduce health care costs?

I think it would be fairer to not "force" people to pay for the emergency care of those who chose not to take advantage of the opportunity to obtain health care utilizing either the free market or the social programs already in place. And, should a hospital choose to care for a person without adequate insurance, I think it would be fair for THEM to absorb the cost, and not transfer the responsibility to me. I was not the one who required or provided the care, so why am I obligated to finance it?

Considering your libertarian ideals, I assumed as much. Needless to say, the vast majority of people do not feel the same as you. They are not going to let people starve to death on the streets even if it is caused in part by their own previous foolishness. This is why people are required to get retirement insurance and disability insurance in the USA. They're not going to let old people and disabled go poor because they couldn't or stupidly chose not to save for their retirement or in case of disability, in which case its fairer and less expensive to force all people to get insurance than to pay for the disability/retirement later.

You could say that refusing to treat people who can't afford it and not sending ambulances to people who can't afford it would lower costs. You'd be right. Under such a system, people will choose to get coverage who currently choose to not get coverage and don't get checkups because they know under our current system if and when they come down with an expensive ailment the rest of us will pay for it for them. But this is an unrealistic policy to support. And poverty--which I believe is caused at least in part by government infringement on freedom in other areas--makes it cruel. So I wouldn't support such a system until we first ended poverty.

So, as far as I can see, that leaves two general options for the near future: Either we can keep the status quo which entails subsidizing the emergency room visits and emergency services (e.g. ambulance rides) of uninsured people who could have less expensively gotten checkups before the condition worsened, or we can require these people to get and pay for their own insurance beforehand. Acknowledging that you would prefer neither option, if you had to choose between these two, wouldn't you prefer a health insurance mandate over the status quo?

Once this "free" care is utilized by all, how great do you think the quality will be?

I don't understand. Who's suggesting "free" care?

I know I'm proposing quite the opposite--that people buy affordable health insurance, get checkups for which the insurance will help them pay, and when they need expensive emergency care it can be paid for by the insurance coverage and the patient. This is opposed to the status quo, in which many people do not get coverage (either because they can't afford it or they choose to gamble knowing they can rely on emergency rooms), do not get checkups, and let the rest of us pay for their care when they use an expensive emergency room. When all these gambling people who choose not to get coverage knowing they can use the emergency rooms for which the rest of us pay we then among other cost-raising problems have less people in the health care insurance pool which raises costs.

"Insuring" everybody, at least for cataclismic events, requires 'forcing' everybody to get insurance. "Forcing" everybody to get insurance necessitates companies offering less-than-adequate premiums for the risks they are required to insure.

Why would companies have to offer less than adequate coverage? I am not proposing forcing the companies to take customers at whatever level the customer is able to pay. I am saying that for now I may be able to support requiring people to have basic health insurance coverage as a way to lower costs being paid by all of us.

Are homeless people required to be insured as well? How about low-income families who must choose to be either insured or eat this week? In this case, these particular groups' care would have to be subsidized for free.

It doesn't have to be. I would hope that it is regardless of whether or not there is a mandate for everyone to get coverage. The point of having people get coverage is so that we do not have to choose between subsidizing lower-income people or leaving them in poverty later when they come down with an expensive ailment they can't afford while uninsured. This is the same reason why people have to have pay for disability coverage and retirement coverage. If it's subsidized, it's cheaper for the taxpayer to require all people to get coverage beforehand and subsidize those who can't afford it. If it's not subsidized at all, it has no affect on the taxpayer but it can still lower overall costs via health care pooling and because people will get cost-reducing checkups more often if they have coverage. The issue of whether to subsidize low income people or leave them to die is irrelevant. Either way the proposal lowers costs to taxpayers unless every form of subsidization for health care including emergency rooms, ambulances, health care tax breaks, etc. was abolished.

If it's simpler to consider, consider a health insurance mandate from which poor people (i.e. those who cannot afford health insurance) would be exempt. The mandate is geared towards people who can afford coverage but choose to game the system because the status quo provides free coverage via emergency services.

Once this happens, what's to stop others from demanding the same care? How would you justify charging them for the care of the homeless or the 'disadvantaged'? How would you define 'disadvantaged', and who would have the right to dictate and interpret your definitions?

Those are questions to be asked about subsidization of poor people. But that is not the subject of this thread. I am not suggesting we subsidize health care anymore than it already is. I am suggesting ways to lower health care costs. I believe the proposals I have suggested would not only reduce overall costs but would specifically reduce the costs to taxpayers who already greatly subsidize needlessly expensive health care coverage.

Let me say this again, I am not proposing that we give people free health care or that we increase the subsidization of health care coverage. Under the status quo, people already get free health care or partially subsidized coverage. I am suggesting that instead of keeping the status quo we make these people, many of whom are not poor but are just gaming the system, pay for coverage ahead of time which reduces overall costs rather than subsidize them later when they come down with an expensive ailment after not getting checkups. Don't you agree this would cost less than the status quo and is much more preferable than the status quo--even though you may want to go even farther and deny people an ambulance if they can't pay for it?

Considering your libertarian ideals, I assumed as much. Needless to say, the vast majority of people do not feel the same as you. They are not going to let people starve to death on the streets even if it is caused in part by their own previous foolishness. This is why people are required to get retirement insurance and disability insurance in the USA. They're not going to let old people and disabled go poor because they couldn't or stupidly chose not to save for their retirement or in case of disability, in which case its fairer and less expensive to force all people to get insurance than to pay for the disability/retirement later.

You're right, Scott. People probably wouldn't let those bad things happen, especially here in America. Which is why we don't need a Federal government to impose programs involuntarily upon us. Families, Friends, Communities, Churches, Volunteer Organizations, Charities, and if none of these could handle it, at worst the local governments, could very readily take care of these problems WITHOUT the forcibly imposed mandates of the Federal government.

You could say that refusing to treat people who can't afford it and not sending ambulances to people who can't afford it would lower costs. You'd be right. Under such a system, people will choose to get coverage who currently choose to not get coverage and don't get checkups because they know under our current system if and when they come down with an expensive ailment the rest of us will pay for it for them. But this is an unrealistic policy to support. And poverty--which I believe is caused at least in part by government infringement on freedom in other areas--makes it cruel. So I wouldn't support such a system until we first ended poverty.

We can't end poverty by expanding social welfare programs that progressively tax the businesses that create the jobs that would assist the "poor" in making money, now, can we though?

So, as far as I can see, that leaves two general options for the near future: Either we can keep the status quo which entails subsidizing the emergency room visits and emergency services (e.g. ambulance rides) of uninsured people who could have less expensively gotten checkups before the condition worsened, or we can require these people to get and pay for their own insurance beforehand. Acknowledging that you would prefer neither option, if you had to choose between these two, wouldn't you prefer a health insurance mandate over the status quo?

I disagree. I think, as I mentioned above, that we can leave the care of the irresponsible folks without insurance to those other organizations I mentioned. We have done this before insurance companies existed, you know? Catholic/Christian/Religious/Other Charity Hospitals used to exist; Ron Paul [I hope you know who he is] was a Doctor at one in the 1970s, in fact. If all of the options I mentioned are expended, then I really believe the individual deserves whatever his irresponsibility has resulted in. At some point, people have to be accountable for themselves.

I know I'm proposing quite the opposite--that people buy affordable health insurance, get checkups for which the insurance will help them pay, and when they need expensive emergency care it can be paid for by the insurance coverage and the patient. This is opposed to the status quo, in which many people do not get coverage (either because they can't afford it or they choose to gamble knowing they can rely on emergency rooms), do not get checkups, and let the rest of us pay for their care when they use an expensive emergency room. When all these gambling people who choose not to get coverage knowing they can use the emergency rooms for which the rest of us pay we then among other cost-raising problems have less people in the health care insurance pool which raises costs.

And I'm saying that we should end all social welfare programs, freeing up companies of the ridiculous taxes that they're required to pay. Our corporate gains taxes are higher than the Europeans and the Chinese!!! This is why wages/benefits aren't as good as they could be. If we stopped all the damn government spending and lowered taxation, PEOPLE WOULD HAVE MORE MONEY TO USE TO PAY FOR THEIR OWN DAMN CARE. In that case, it would be up to them to be responsible for themselves.

"Insuring" everybody, at least for cataclismic events, requires 'forcing' everybody to get insurance. "Forcing" everybody to get insurance necessitates companies offering less-than-adequate premiums for the risks they are required to insure.

Why would companies have to offer less than adequate coverage? I am not proposing forcing the companies to take customers at whatever level the customer is able to pay. I am saying that for now I may be able to support requiring people to have basic health insurance coverage as a way to lower costs being paid by all of us.

If companies have to accept less money while providing more care to more people, the QUALITY OF THAT CARE WILL DECREASE. It's a simple concept. I understand what you are thinking; that if more people had insurance and DIDN'T use it we would have more money in the system and therefore would have the potential to lower costs. But with the required acceptance of pre-existing conditions [including Cancer, AIDS, etc.] we would have companies taking in people with much higher needs for not enough money. So they would be providing MORE care for LESS money. This results in LOWER QUALITY of care.

Let me say this again, I am not proposing that we give people free health care or that we increase the subsidization of health care coverage. Under the status quo, people already get free health care or partially subsidized coverage. I am suggesting that instead of keeping the status quo we make these people, many of whom are not poor but are just gaming the system, pay for coverage ahead of time which reduces overall costs rather than subsidize them later when they come down with an expensive ailment after not getting checkups. Don't you agree this would cost less than the status quo and is much more preferable than the status quo--even though you may want to go even farther and deny people an ambulance if they can't pay for it?

I think I've made my point on how "pooling" generally lowers costs, but not if it's mandated by a government with the rules they're proposing to force upon companies.

Once again, to lower health care costs, I would recommend the following:
1) Create a tax-haven for all health care expenditures.
2) De-regulate "anti-trust exemptions", and allow for cross-state sale of insurance.
3) Limit payouts on tort suits. This means actual losses only, none of this obscure, objective, jury-defined "Pain and suffering" payout crap.

And I'm open to more.

[Scott]

We can't end poverty by expanding social welfare programs that progressively tax the businesses that create the jobs that would assist the "poor" in making money, now, can we though?

That is an irrelevant question. Nowhere in this thread am I suggesting progressive taxation.

And I'm saying that we should end all social welfare programs, freeing up companies of the ridiculous taxes that they're required to pay. Our corporate gains taxes are higher than the Europeans and the Chinese!!! This is why wages/benefits aren't as good as they could be. If we stopped all the damn government spending and lowered taxation, PEOPLE WOULD HAVE MORE MONEY TO USE TO PAY FOR THEIR OWN DAMN CARE. In that case, it would be up to them to be responsible for themselves.

I also think tax breaks can be used as a way to reduce poverty. But what does that have to do with the topic of this thread, health care pooling?

Once this "free" care is utilized by all, how great do you think the quality will be?

I don't understand. Who's suggesting "free" care?

I know I'm proposing quite the opposite--that people buy affordable health insurance, get checkups for which the insurance will help them pay, and when they need expensive emergency care it can be paid for by the insurance coverage and the patient. This is opposed to the status quo, in which many people do not get coverage (either because they can't afford it or they choose to gamble knowing they can rely on emergency rooms), do not get checkups, and let the rest of us pay for their care when they use an expensive emergency room. When all these gambling people who choose not to get coverage knowing they can use the emergency rooms for which the rest of us pay we then among other cost-raising problems have less people in the health care insurance pool which raises costs.

"Insuring" everybody, at least for cataclismic events, requires 'forcing' everybody to get insurance. "Forcing" everybody to get insurance necessitates companies offering less-than-adequate premiums for the risks they are required to insure.

Why would companies have to offer less than adequate coverage? I am not proposing forcing the companies to take customers at whatever level the customer is able to pay. I am saying that for now I may be able to support requiring people to have basic health insurance coverage as a way to lower costs being paid by all of us.

If companies have to accept less money while providing more care to more people, the QUALITY OF THAT CARE WILL DECREASE. It's a simple concept.

Why would a mandate that requires individuals to get coverage or pay a penalty (from which poor people could or could not be exempted) make "companies have to accept less money while providing more care to more people?" Please note, nowhere in this thread or the original article have I suggested forcing insurance companies to accept people with preexisting conditions at no extra charge. (In fact, I do not support that proposal and one of my other proposals encourages companies to charge more to people with self-caused preexisting conditions such as obesity or damage caused by cigarette-smoking.)

***

All those straw-man issues aside, let me simplify my last post. I see three general options regarding health care reform and the proposed individual insurance mandate:

A. The status quo - People who can afford health insurance choose not to buy insurance and not get checkups because they know they can rely on taxpayer-funded emergency services if they come down with a very expensive injury or illness that would have been less expensive to deal with using checkups and preventative care.

B. A health insurance mandate - All individuals who can afford coverage are required by law to buy it. The insurance they pay for themselves helps them get checkups and preventative care, which lowers costs. And if and when they still need to use emergency services, it will be paid for by them and their own insurance, rather than taxpayers.

C. No universal emergency services - People who do not have insurance and cannot afford to pay for their own emergency care are not given the emergency care. Access to ambulances, hospital emergency rooms, etc. would be denied to people who stupidly gambled by not getting insurance or for some other reason do not have insurance or cannot pay for the services.

From what I understand, whitetrshsoldier, you prefer C more than A or B. But don't you at least agree that at least for now C is unrealistic and that the vast majority of people would strongly oppose it--that they do not want to think their or anyone else's access to 911 could be cut off as easily as their cable? Regardless, option C aside, don't you agree that B would lead to less overall health care costs than A and that B would be fairer than A?

Thanks!
Scott

***

All those straw-man issues aside, let me simplify my last post. I see three general options regarding health care reform and the proposed individual insurance mandate:

A. The status quo - People who can afford health insurance choose not to buy insurance and not get checkups because they know they can rely on taxpayer-funded emergency services if they come down with a very expensive injury or illness that would have been less expensive to deal with using checkups and preventative care.

B. A health insurance mandate - All individuals who can afford coverage are required by law to buy it. The insurance they pay for themselves helps them get checkups and preventative care, which lowers costs. And if and when they still need to use emergency services, it will be paid for by them and their own insurance, rather than taxpayers.

C. No universal emergency services - People who do not have insurance and cannot afford to pay for their own emergency care are not given the emergency care. Access to ambulances, hospital emergency rooms, etc. would be denied to people who stupidly gambled by not getting insurance or for some other reason do not have insurance or cannot pay for the services.

From what I understand, whitetrshsoldier, you prefer C more than A or B. But don't you at least agree that at least for now C is unrealistic and that the vast majority of people would strongly oppose it--that they do not want to think their or anyone else's access to 911 could be cut off as easily as their cable? Regardless, option C aside, don't you agree that B would lead to less overall health care costs than A and that B would be fairer than A?

Thanks!
Scott

Hey Scott,

You're right that I prefer C, but that most people prefer to disregard the virtue of accountability, instead choosing reliance on big-government.

My biggest problem with B, however, is;

1) The government deprives us of liberty unconstitutionally and unethically, by either taxing us or throwing us in jail if we don't get care.
2) If people MUST PAY for insurance, don't you think they'll use it more?
3) If they use it more, how does it save money?

Additionally, what of the people who can't afford it, but are still required by law to have it? This is where I get my "it will be free" focus from. I can guarantee that, at some point, [considering we already have more than 7 free health care programs that I can think of], those who "prove" they can't afford to abide by the law will be included in some provision guaranteeing them care free of cost.

Plus, you're now criminalizing those who don't buy something. Do you really support the criminalization of non-consumerism? Do you realize how much this would "cost" the government [or maybe "make" it?]. Either way requiring people to obtain any service IS A VIOLATION OF THEIR RIGHT TO LIBERTY, and only creates bigger government, that now will claim a bigger right to invade individual freedoms. I cringe to think of the "war on the uninsured". Imagine how much that would cost the taxpayers.

Is this really so far-fetched of a concern? Don't you think that would come?

Anyways, those are my objections. Let me know what you think.

[Scott]

whitetrshsoldier, don't your criticisms of option B apply even more to option A? Isn't option A essentially a universal government-funded health care and/or emergency services plan paid for by taxes in which all citizens are automatically enrolled? The difference is that option A is more expensive, more unfair (in that people who can pay for coverage instead choose to make taxpayers pay for their health care by expensively relying on universal, government provided emergency services), and more unhealthy?

For instance, most ambulance services are universal government-run, government-funded insurance plans. One does not pay for an ambulance when they call 911. They pay for it by taxes. They are forced to buy into the ambulance plan. This is how much of the health care system is run in terms of emergency rooms, emergency services and taxpayer funded health care. I'm suggesting making people buy insurance coverage who are not too poor to buy it so that they do not rely on emergency services instead of having government-funded and/or government-run universal health-care like we have now. It's the so-called lesser of two evils--the greater evil being the status quo.

Additionally, what of the people who can't afford it, but are still required by law to have it?

Poor people are already subsidized greatly. They could be subsidized more or less regardless of whether or not there is a health insurance mandate.

Granted, if subsidization is not available for poor people to enable them to buy an insurance plan using welfare money, then I think it would make sense to exempt them from the mandate. The discussion of whether or not providing government subsidies to poor people to enable them to buy insurance (and then require them to do it like everyone else) would save money for the taxpayer or not could be had.

If they use it more, how does it save money?

We won't save health care costs by encouraging people to not go to the doctor. In fact, the way it saves costs is by getting people to go to the doctor, get checkups and get preventative care. Overall costs are increased by people who could afford coverage but choose not to get coverage, choose not to get checkups and choose not to get preventative care. Illnesses and ailments that could have been much more inexpensively prevented or treated early on turn into expensive ambulance rides and emergency room visits (often paid for by the taxpayer).

For instance, non-poor people who could pay $100 of their own money to get checkups and preventative care choose to let their conditions worsen and become emergencies so that the taxpayers will pay $1,000 for what could have been fixed for $100 of the person's own money. The person saves money, but overall costs have actually increased.

In other words, it saves money because failing to get checkups, preventative care and early treatment costs more.

Additionally, what of the people who can't afford it, but are still required by law to have it?

Poor people are already subsidized greatly. They could be subsidized more or less regardless of whether or not there is a health insurance mandate.

Granted, if subsidization is not available for poor people to enable them to buy an insurance plan using welfare money, then I think it would make sense to exempt them from the mandate. The discussion of whether or not providing government subsidies to poor people to enable them to buy insurance (and then require them to do it like everyone else) would save money for the taxpayer or not could be had.

This is really the point that I'm trying to make, Scott. The poor are already subsidized. People who can't afford insurance already have the means to obtain medical care. It's ultimately why I'm against implementing any more "reform" that doesn't involve tort reform/tax-reduction.

If they use it more, how does it save money?

We won't save health care costs by encouraging people to not go to the doctor. In fact, the way it saves costs is by getting people to go to the doctor, get checkups and get preventative care. Overall costs are increased by people who could afford coverage but choose not to get coverage, choose not to get checkups and choose not to get preventative care. Illnesses and ailments that could have been much more inexpensively prevented or treated early on turn into expensive ambulance rides and emergency room visits (often paid for by the taxpayer).

For instance, non-poor people who could pay $100 of their own money to get checkups and preventative care choose to let their conditions worsen and become emergencies so that the taxpayers will pay $1,000 for what could have been fixed for $100 of the person's own money. The person saves money, but overall costs have actually increased.

In other words, it saves money because failing to get checkups, preventative care and early treatment costs more.

So you're telling me that if they go to the doctor to get checkups for $100 every 6 months or so, and receive preventative medication/care [MRIs, CT Scans, X-Rays, Blood Tests, etc.] every once in a few visits, it's cheaper than one or two major medical emergencies?

I'd have to disagree with that math.