This oped is by Richard Davis, a registered nurse and executive director of Vermont Citizens Campaign for Health.
GUILFORD — Twenty states have filed lawsuits challenging the constitutionality of the newly passed federal health care reform law. They contend that requiring people to buy insurance, as will be the case in 2014, violates the U.S. constitution.
The issue is complex, but most of the articles I have read indicate to me that if the issue makes it to the Supreme Court, there is a good chance the law will be upheld. There is also the possibility that these cases may be determined to lack merit and that they will never make it to the highest level of appeal.
Libertarians, Tea Party types and those who are pushing for minimal government intervention in all of America’s business, have taken up this issue to make the case that the health care reform bill is a government takeover of health care. In order to get a proper perspective, it’s important to understand what happens when people are required to buy health insurance and why the bill includes this provision.
Mandatory insurance is really about preserving the integrity of the insurance system. The bill does not have a public option and it clearly does not set up any new government entity to assume risk for insurance, such as would be the case with a single payer system.
Private insurance companies will be providing most of the insurance under the new law and, by requiring people to buy their product, they may be rewarded with 41 million new customers, according to some estimates.
The reason that a mandate is so important to the financial viability of insurance companies has to do with risk. Insurance is about minimizing risk. In the case of health insurance, it is important to include as broad a spectrum as possible to minimize financial risk for the insurance companies.
That broad spectrum must not only include people who need to use health insurance benefits frequently but also those who may never, or hardly ever, use their insurance such as people in their 20’s, who are often referred to as “young invincibles.” That way, the premiums of the healthy help to subsidize care for the less healthy.
Some argue that the healthy should not have to pay for the sick. This issue leads into the broader discussion of shared social responsibility. These are far from clear, black and white issues.
Then there is the often heard mantra “I don’t want some government bureaucrat in charge of my health care.” The alternative has always been that your health care will continue to be controlled by an insurance company bureaucrat. The new health care bill doesn’t change that. Although the insurance industry will be subject to some new regulations, the insurance industry will still be in charge of most of our health care decisions.
If a public option had been included in the bill, it would have meant that millions of Americans would have had a chance to experience what it would be like for the government to have more control over their health insurance, not their health care. It would have meant that millions of Americans could have had a chance to experience something similar to the excellent coverage, access and affordability of those who now receive Medicare and Medicaid benefits.
The insurance companies understand that once the public has a taste of what “government run health care” is really all about, there would be no turning back. How many people do you know who would willingly give up their Medicare or Medicaid benefits?
Mandatory insurance would not be as great a hardship for individuals and society at large within a system that eliminated the profit needs of insurance companies. If all Americans became eligible for a Medicare-like system we would all have a basic package of benefits at a price we could afford. I would be willing to bet that such a government takeover of health insurance would not be a difficult pill to swallow.
Getting past the heated rhetoric and sound bytes is the hard part.