Obamacare

What Does the Individual Mandate Have to Do With Free Riders?

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Supporters of mandatory health insurance have argued that the purchase requirement is necessary to promote "individual responsibility" and prevent "free riders"—individuals who show up at emergency rooms, get care, and don't pay. This is part of the argument that Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius have used to make the case for ObamaCare's mandate. It's also the argument made by Mitt Romney in support of the mandate he signed into law in Massachusetts. But as The Examiner's Philip Klein points out, there's a strong argument that that's not really what the individual mandate is about:

In reality, the mandate has always been about forcing healthy people into the insurance pool, to offset the distortion in the market created by the related provision requiring insurers to cover those with pre-existing conditions.

Tuesday's oral arguments on the constitutionality of the mandate illuminated this better than ever before.

Mike Carvin, who represented the National Federation of Independent Business before the court, explained that the uninsured and those who show up at hospitals without paying are different populations.

"It is clear that the failure to buy health insurance doesn't affect anyone," Carvin said. "Defaulting on your payments to your health care provider does. Congress chose, for whatever reason, not to regulate the harmful activity of defaulting on your health care provider."

As Klein points out later, the law's essential benefits requirements make it even tougher to make the case that the mandate is simply a response to free riding. Those requirements do not merely force individuals to purchase insurance covering catastrophic care expenses, but also set guidelines, to be fleshed out by the states, as to what sorts of benefits must also be covered. 

It's been clear for a while that the law is, at minimum, designed to do quite a bit more than zero out the free-riding problem. Estimates used by the administration suggest that national uncompensated care costs ran about $43 billion in 2008. But the law is set to spend about $200 billion or more each year on insurance subsidies by 2017. 

NEXT: A. Barton Hinkle on Three New Polls That Show Americans Don't Like Being Bullied by Their Politicians

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  1. Supporters of mandatory health insurance have argued that the purchase requirement is necessary to promote “individual responsibility” and prevent “free riders”?individuals who show up at emergency rooms, get care, and don’t pay. This is part of the argument that Attorney General Eric Holder and Health and Human Services Secretary Kathleen Sebelius have used to make the case for ObamaCare’s mandate.

    Does anybody else remember when helping the uninsured was the reason for ObamaCare?

    How’d the uninsured go from being the problem that requires the solution–to being cause of the problem?

    You know who I blame for the Obama Administration’s expansion of Medicaid and its stubborn refusal to bring Medicaid and Medicare spending under control?

    I blame Barack Obama.

    Scapegoating uninsured sick people for his own shortcomings–how much more cold-hearted could he be?

    1. We will help the poor by making them buy insurance that they don’t want. And, because of community rating, make them buy insurance that makes no economic sense for them to buy.

      1. We will blame poor people and sic the IRS on them–because they’re the cause of a problem besetting poor people.

      2. But if they are too poor or live on an Indian reservation, they are exempt from the insurance requirement.

        1. So the whole point is to fuck the lower middle class; those who are poor enough to make buying insurance a burden but not so poor they qualify for the subsidy.

          1. Yes, Charlotte. The bright side, really rich people who pay for their own healthcare out-of-pocket, like Rush Limbaugh, now are required to pump up insurance company balance sheets.

        2. The working poor don’t qualify for that.

          You’re right in that people who are on government programs are exempt from some of this, but working people who are getting by?

          I thought ObamaCare was supposed to make it easier for people who are currently uninsured. I don’t think most people realized it was just for welfare queens–and the working poor would be scapegoated.

          1. I don’t think most people realized it was just for welfare queens–and the working poor would be scapegoated.
            I do not share your notion in the slightest.

            1. Oh not.

              Lower middle class voters thought this was going to help them.

              Not all of them! But a lot of them thought somebody was finally going to help them get insurance. …instead of insurance in 2014, they’re getting a letter from the IRS in 2015.

              1. Exactly Ken. Most people have no idea how this is going to work. All they heard was “insurance for all”.

                1. Free money!

                  Where do I sign up?

                  1. Even the people who signed on to ObamaCare becasue they thought it was going to help poor working people get health insurance are getting screwed here.

                    It should be painfully obvious to everyone by now, ObamaCare is no longer about helping anybody. Obama isn’t even arguing it with the best intentions of the working poor at heart. It’s all about helping him stay in the White House.

                    Did I expect anything else?

                    No. He’s a disgusting politician, and anybody that abdicates their own responsibility and trusts any politician to look out for our interests is a child or a fool.

    2. You know who I blame for the Obama Administration’s expansion of Medicaid and its stubborn refusal to bring Medicaid and Medicare spending under control? I blame Barack Obama.

      I blame Bush

        1. Me too.

      1. I blame Bush for what Bush did.

        I blame Obama for what Obama did.

        I blame uninsured working people for what they do.

        I don’t blame uninsured working people for what Obama did.

        I know, it’s like I’m crazy!

        1. I blame you, Ken.

    3. I remember that too. Before Obamacare the uninsured went to a hospital that had to take them under EMTALA (thanks people on the other day thread) and were cared for. If they didn’t have insurance, they were sent a bill. If they didn’t pay the bill everybody else did.

      Obamacare fixed that. Now people who don’t have insurance get fined/taxed, unless they cannot afford insurance then they get a waiver. If they need healthcare, they go to an EMTALA hospital and are cared for and everybody else pays for them.

      1. See above. The people who are really screwed by this are lower middle class young people, who would probably be better off not buying insurance but have too much money to get the subsidy.

        Most of them are probably Republicans anyway. So that is okay.

        1. They still don’t have to buy insurance – or pay the penalty if they adjust their tax witholding allowances low enough so that they never get an income tax refund from the IRS.

          The only enforcement mechansim the law authorizes the IRS to do to collect the penalty is take it out of tax refunds. If you don’t get a refund, the IRS can’t make you pay.

          1. But after 5 years of all healthy young people adjusting their witholdings, and the IRS fines pililng up, is a retroactive plan to garnish wages to combat the NEW free rider problem.

            If that’s all it takes to avoid the fines, I do declare that this will most likely be cited as reasoning for a future bill to steal the wages somehow. Gov’t action begets gov’t action.

            And so it goes.

  2. I thought the point of the law was to “bend the cost curve”? Even if you zero out the “free rider problem”, you have done nothing to cut costs. The costs are still there. They are just being paid by someone else.

    At this point Obamacare supporters are left arguing that the point of the mandate is to make the poor and the uninsured contribute more to their health care costs by being forced by law to buy insurance. A reasonable goal I suppose. But a far cry from all of the “Hope and Change” during the passage of this bill.

    1. Is that why they have means testing? Thy are not forcing anybody below the poverty line, or anybody whose insurance would be greater than 8% of their income, to purchase anything.

      All they are doing is forcing people of means who do not need or want insurance to buy insurance.

      1. Exactly. The cost shifting and free riding will still exist pretty much as they do now. This is just rearranging the deck chairs.

        1. Whilst increasing the cost of each deck chair.

      2. There’s actually a nifty little catch in that 8% rule. The rule is that you are exempt if self-only insurance would be more than 8% of your income. You are not exempt if family coverage is over 8% of your income, so long as self-only is less than 8%. Of course, family coverage is usually about 3 times as expensive, and you have to buy it if you, you know, have a family.

  3. Not having car insurance doesn’t affect anyone. Defaulting on a judgment in a car accident case is harmful. For some crazy reason, states require car insurance instead of just enforcing rules against defaulting on a tort judgment.

    Of course, driving is a choice, and needing urgent health care isn’t. When it comes to medical care and the insurance to cover it, we are all, effectively, “behind the wheel” 24/7.

    1. The STATE requires car insurance. The federal government has no such power.

      And the point of making you have car insurance, is to keep you from victimizing other people by your mistakes. The mandate is no different. The point of it is to make the poor and uninsured contribute more to their health care costs by buying insurance.

      Again, that may be a reasonable goal. But since that is the goal, please shut up in the future about Obamacare being passed to help the poor and the uninsured.

      1. Defaulting on a judgment in a car accident case is harmful. For some crazy reason, states require car insurance instead of just enforcing rules against defaulting on a tort judgment.

        Some states do not require insurance and if you are found liable, but do not pay, they pull your license. Not sure if they pull registration too.

        1. And some states require you to insure for your own injuries and your own car damage.

          Self-government. How does that work?

          1. It works by changing your state or moving to a better one.

            1. maybe try winning an election

      2. We covered this at length in the earlier thread, and you lost, Corday. Stop trying to steal bases. If Zombie Lochner is going to be the “new rule” under the Roberts Court, so be it, but you’ve got nothing under the present rules.

        1. We covered it at length yesterday and you were reduced to screaming scoreboard and various obscenities and saying “because I said so”

          Beyond that you miss the point of my post, which is that the main effect of Obamacare is to make the working poor pay more for their health care, a fact which puts lie to everything that was said about the bill when it was passed.

          Do you understand what a bubble you live in? How weak an ill informed your arguments are? It is one thing to make a fool of yourself. Everyone does that sometimes. It is quite another to make such a fool of yourself and not even understand that you are doing so.

          1. I never defended ObamaCare as good policy. It is a Heritage-Foundation-cooked-up corporate sop from the movement-conservative 1990’s, now reheated and served up by centrist-triangulating Democrats. I maintain only that it is constitutional under current doctrine, with the correctness of current doctrine being a wholly separate matter.

            I am a Medicare-for-all Democrat, and that is all I have to say on policy.

            1. I am a Medicare-for-all Democrat, and that is all I have to say on policy.

              So you’d prefer a proven failure to an untested potential failure. Got it.

              1. Medicare’s only failure is that it puts the elderly in a separate risk pool. Push the young and healthy into the same pool, and you’ve got an actuarially viable program.

              2. So you’d prefer a proven failure to an untested potential failure.

                Hey, when I’m paying for failure, I EXPECT to receive failure. I’m not taking any chances with my money.

            2. It was a Heritage Foundation cooked up sop that was written by Nancy Pelosi and Senator Bachus, passed without a single Republican vote through procedural chicanery and signed into law by a Democratic President who haled it as his signature achievement.

              Are you really that stupid or do you think the rest of us are? Come on.

              1. Wise up, Charlotte. The facts are always just a Google click away…

                http://tinyurl.com/876y4c4

    2. Your analogy breaks down much quicker than that.

      Requiring people to buy car insurance–in case they hit other people’s cars–is ridiculous.

      You should insure your own car. If you take the risk of driving around in a BMW, that doesn’t mean the government should require me to insure your BMW for you.

      If you want to engage in a risky behavior with your BMW, which driving around is inherently, then you can buy yourself insurance against uninsured drivers. It’s the cheapest part of your policy–and always has been.

      Insure your own car. Don’t use the government to force poor people to insure your car for you. Just because that injustice has become commonly accepted doesn’t make it okay. It isn’t.

      1. Requiring people to buy car insurance–in case they hit other people’s cars–is ridiculous.

        If you hit someone else’s car you are liable for all damages you cause. If you’re wealthy, you can self insure. But for most people, insurance is necessary to cover the financial risk of causing harm to others.

        Since the state owns the roads (standard libertarian disclaimer) and permits vehicles to use those roads (standard libertarian disclaimer), then they can demand that users post bonds (self-insurance) or buy liability-only insurace to use the roads.

        1. Now if the state wants to force individuals to buy medical insurance so that the jackass two cubicles over has to cover my medical bills when he gives me a communicable disease because he’s too fucking stupid to stay home from work when he’s sick, then we could start having a rational discussion.

          1. That’s the proper analogy between state compelled acquisition of “car” insurance and state compelled acquisition of “health” insurance.

        2. If you’re uninsured?

          People drive Lamborghinis and Ferraris in my neighborhood.

          You take your car out in public where it might get hurt? You better insure it against people who can’t afford to fix your car.

          You take the risk; you insure yourself against that risk.

          Not me. I am not responsible for your property. If you can’t afford to insure your property against uninsured drivers, that doesn’t mean the government should get to impose your will on everyone else to benefit you…

          It means you can’t afford to drive around in an expensive car. You take the risk anyway? That’s your choice. My freedom from government interference isn’t subject to your convenience.

          1. Not me. I am not responsible for your property.

            You are if you damage it through negligence or intentional wrongdoing.

            1. If you choose to put something of yours at risk–knowing full well that other people may not have insurance and may not be able to cover the cost of an accident–then you have assumed that risk.

              Insurance against uninsured drivers is widely available. The cheapest part of your insurance–and it’s been that way since long before my state starting requiring people to buy insurance.

              If you choose not to insure yourself against uninsured drivers, that’s your choice. Not Ken Shultz’s who wasn’t a party to the accident. Not some high school drop out, who’s struggling to put food on the table–and was NOT a party to the accident.

              Go look at your insurance bill. I’d bet dollars to doughnuts, it’s the cheapest line item for insurance on the bill.

              1. I know this idea has become increasingly unfashionable since TARP, but I maintain that the people who are best equipped to take responsibility for the choices they make? Are the people who made the choices.

                You choose to take a risk? Don’t look to make poor working people everywhere somehow responsible for your choice.

                1. You choose to take a risk? Don’t look to make poor working people everywhere somehow responsible for your choice.

                  That way lies socialism.

              2. If you choose to put something of yours at risk–knowing full well that other people may not have insurance and may not be able to cover the cost of an accident–then you have assumed that risk.

                Doesn’t work quite that way, Ken.

                Assumption of the risk is a defense that the defendant puts up when they are sued for damages.

                Under your theory, nobody could ever recover for damages in a car accident because the plaintiff, by driving his car, assumed the risk of an accident.

                Assumption of the risk is a defense against the defendant having any liability at all. And I don’t think you can say that uninsured drivers should not have any liability at all, but insured drivers should.

                Nope, the fact that you took your car out of the garage means that you assumed the risk of an accident, period, full stop.

                1. I have to buy all sorts of insurance for our properties.

                  It doesn’t matter whether it’s our fault or someone else’s.

                  We’ve got this thing called bankruptcy. Regardless of what they law says, if I want to protect my property in case of loss, then I’m responsible for insuring it.

                  Using the government to abdicate my responsibility to insure my own property against loss is fundamentally unfair to people who for whatever reason can’t afford the insurance and are not a party to the accident.

                  1. If somebody does something to destroy part of our property, and it isn’t may fault? You think my investors are gonna come to me and say, “Well, that’s okay!”

                    “…The government should force everyone to insure themselves against destroying our property anyway!”

                    The real world doesn’t work that way. If the legal world works that way (and I’m not convinced it does), then the legal world is wrong.

                    Even in the legal world, just because a judge finds in my favor doesn’t mean I’m gonna get paid. I need to insure my own property against such losses anyway.

                2. I don’t disagree that if I cause an accident I should have to face the consequences. But I didn’t make Tony buy a Rolls Royce. Why should I have to carry insurance coverage for your hundred thousand dollar car?

              3. It’s only the cheapest because law requires liability coverage, so the risk to the insurer is small. In no fault insurance states (where you pay for damages to your car regardless of fault), insurance rates are through the roof. I wonder why? maybe because the responsibility for paying damages is completely divorced from the person causing the damage. So who cares if you cause a fender bender a month. You could drive a 3/4 ton truck, cause a wreck a week, and never see your rates go up a bit.

                YOUR method of insuring yourself against the negligence of others is socialism in this case because you’re asking society to pay for the negligence of a few.

                Liability insurance isn’t really “insurance” at all. It’s a bond protecting the ability of those who are victims of your negligence to be able to recover losses from you.

                1. It’s only the cheapest because law requires liability coverage, so the risk to the insurer is small.

                  That argument would carry more weight with me if I hadn’t been driving before liability insurance was required in California, and I didn’t remember full well that insurance against uninsured drivers was a relative pittance back then, too.

                  1. It’s only the cheapest because law requires liability coverage, so the risk to the insurer is small.

                    Incidentally, and the following is mere speculation, admittedly, but, wouldn’t we expect uninsured motorist coverage to cost less in a competitive market?

                    When insurers are pricing the risk of insuring you, shouldn’t we expect insurers to be more concerned about the likelihood of you being a particularly bad driver than they are about a particularly bad driver hitting you?

                    1. Let’s say the chances of a good driver getting hit by a particularly bad driver are 100-1…

                      If you’re a particularly bad driver, then shouldn’t we expect the chances of you hitting someone else and it being your fault to be much higher than 100-1? Maybe they’re 10-1.

                      If that’s the case, and it seems likely it is, then we should always expect uninsured motorist coverage to be priced significantly lower than the price of insuring you for your own driving.

                      If you might be a worse than average driver, then there’s a better than average chance that you’ll get into an accident and it will be your fault, but given the logic I just outlined, why shouldn’t we expect the chance of an average driver getting hit by an idiot to always be lower relative to that?

                2. maybe because the responsibility for paying damages is completely divorced from the person causing the damage.

                  I’m not talking about divorcing the responsibility for an accident from the person who created the accident. The courts are still there.

                  Are you even aware that you’re advocating the same kind of harm in the opposite way? It’s just that instead of divorcing responsibility from the person who caused the accident, you’re assigning responsibility to everyone else in society–who had nothing to do with the accident.

                  Struggling high school drop outs who have never and will never hit your car? Owe you nothing. If you’re afraid of them, then the solution is to insure your own damn car against them. The solution is not to try to force everyone else in society to insure your car for you.

          2. You know there’s a reason car loans require you to insure against uninsured drivers.

            When an uninsured driver with no assets to speak of totals your car? that does not mean they’re responsible for making your car payments.

            You chose to sign the loan. You chose to drive it in public. You took the risk.

            Not me. I’m not responsible for your choices.

          3. Mandatory insurance is liability only.

            You are not required to cover your own losses if you cause an accident or if an uninsured driver causes an accident.

            You are only required to insure against harm you cause others.

            1. How would you feel about the government forcing people to buy fire insurance–just in case they accidentally burn someone’s house down?

              Is there any other form of insurance you think the government is supposed to force people to buy, or is auto insurance the only one?

              1. So are you being deliberately dense?

                For better or worse, the state owns and controls access to public roads. This gives the state the authority to put conditions on accessing those roads. So the state forces people to show that they can cover the damages that they might cause through insurance or self-insurance.

                So this makes auto liability insurance different than every other kind of insurance. This is why all attempts by liberal weasels to link state-mandated auto liability insurace to federally-mandated health insurance are bullshit.

                I think that state-mandated liability insurance is a bad thing because it short-cuts normal tort laws. But that doesn’t change the legitimacy of the state’s authority to impose it.

                1. So the state forces people to show that they can cover the damages that they might cause through insurance or self-insurance.

                  I didn’t say the states don’t have any logic; I said their logic is wrong.

                  The state restricting people’s freedom, impounding their cars, forcing them to buy things–becasue of accidents they haven’t yet caused?

                  Is absurd and wrong.

                  I buy insurance for all sorts of things–covers me regardless of whether it was somebody else’ fault.

                  This was rent seeking by insurance companies to force people to buy more insurance–they wouldn’t have bought otherwise.

                  If you’re too poor to insure your own car against damage from uninsured drivers, then it’s your choice whether to take it out on the street.

                  1. Millions of responsible people buy insurance for dozens of different things–to insure their own stuff. ..regardless of who’s at fault, every single day.

                    I’m sorry you’re one of the people who’s been fooled into thinking that it’s everyone else’s responsibility to insure your property for you, but that doesn’t make it so.

                    People who haven’t hit your car owe you nothing–and your stubborn refusal to respect their freedom is costing them hundreds of millions of dollars.

                    I’m not allowed onto the street unless the government says so? And this is your idea of a free society?

                    Here’s mine: take care of your own shit and leave me out of it. I don’t you car insurance. The government forcing people to pay for each other is not an example of freedom.

      2. You fail to understand the reason for mandatory car insurance. It’s not to protect you if you smash up your car….it’s to protect the other guy if you smash his car up and/or injure him. YOUR insurance company has to pay HIM.

        Regardless, car insurance has nothing to do with the healthcare mandate. It’s State apples compared to Federal oranges.

    3. something like this has been tried in many states- it’s called no-fault insurance. it was a complete disaster.

    4. Re: There is no “we” you wee-wee,

      Of course, driving is a choice, and needing urgent health care isn’t [sic].

      Healthcare turns people into robots! You heard it here first!

      When it comes to medical care and the insurance to cover it, we are all, effectively, “behind the wheel” 24/7.

      It takes a village to pay for someone’s broken leg, right?

    5. No, we aren’t.

      Repeal EMTALA and the ability of the uninsured to impose health care costs on others goes away.

      In addition, billions of dollars in unenforceable judgments are filed every year across ALL industries. If those judgments can’t be enforced, the harms and costs they represent are “passed on to other consumers” every bit as much as health costs are. Why don’t we require comprehensive insurance for every last activity on Earth?

      Answer: Because it has never been about uncompensated care. It’s about forcing young, healthy males who would never even MAKE A CLAIM and who are NOT CAUSING any uncompensated care pay for community-rated insurance that rips them off. The mandate only adds new money to the system because a huge percentage of the people the mandate will be imposed on really don’t have significant health risks that require insurance.

    6. “For some crazy reason, states require car insurance instead of just enforcing rules against defaulting on a tort judgment.”

      Suffice it to say, the auto insurance mandate is a lousy justification for the ObamaCare insurance mandate for a number of reasons…

      Among them, just because the states have been unfair in their auto insurance practices for years is no justification for being likewise unfair at the federal level. It’s just that people have been so snowed into believing the states’ auto insurance mandates are fair, it’s become a standard… That belief is absolutely wrong and should be questioned anytime someone brings it up.

      1. I’d also add that the auto insurance mandate by the states, if I understand this correctly, can be tied to their registration or licensing requirements.

        If you agree to insure or register a car, there may be a point where you agree to carry liability insurance? Healthcare isn’t like that. I don’t need a license to be born and breathe (yet), so the comparison between auto and health insurance breaks down there, too.

    7. You only have to buy liabilty insurance for the potential harm you do to someone else. You are not required to buy insurance to cover your own costs.

      You’re peddling an invalid analogy.

  4. Ask Romney and the Heritage Foundation. They invented the concept.

    1. What do you expect from a bunch of christfags like that.

      Also – they “invented” it. lulz! Yeah – no one had ever come up with the concept before them. GENIUSES, I SAY! VISIONARIES!

      1. Also – they “invented” it. lulz! Yeah – no one had ever come up with the concept before them. GENIUSES, I SAY! VISIONARIES!

        Hello?

        1. That’s just stupid. The problem isn’t that people don’t want health insurance, it’s that they can’t afford it. If it were that easy, I could just mandate that everyone buy a house and that would, uh, you know, solve the problem of homelessness.

        2. Good idea, Hilldawg! +1!

        3. NOPE.

          HillaryCare was like Single-Payer. Heritage and Dole, etc came up with mandates as an alternative.

          Mandates are like vouchers!

          1. So Obama was taking his orders from Bob Dole and the Heritage Foundation? It is a good thing no liberals voted for the bill and it was passed with mostly Republican support, right?

    2. And the Democrats made it a law.

    3. shrike|3.30.12 @ 11:40AM|#
      “Ask Romney and the Heritage Foundation. They invented the concept.”

      Why is purple, shriek?
      See, two can play the ‘irrelevant comment game’.

  5. Ima go WAAAAAAY out on a limb here – SLD-to-the-Max’s Mom right up front – and say:

    I could ALMOST support some form of “mandate” or something – almost – if it were truly aimed at just addressing the cost issues presented by the free riders. Cause, yeah, it distorts medical-care and insurance costs (as in “makes someone else pay for it”). I don’t really believe that such a mandate would REDUCE costs, which is where I back down and say NFW.

    What I WOULD do is repeal the “must-care-for” laws (yeah, I said it) and make care for the indigent voluntary. That’s why I give money to charities – to handle shit like this. Not to pawn it off on every fucking hospital and doctor and medical supply company – let guys like me pay for it voluntarily.

    Like that would EVER happen in this or any other universe. So fuck it.

    1. Well, this all really does boil down to our lack of balls. We aren’t willing to see the truly cheap, lazy, and stupid tossed out of the hospital because they can’t or won’t pay.

    2. We could always return to the glory-days circa 1804 when we let free-riders die in the streets.

      1. EMTALA was passed in 1986.

        And I remember the scare stories it was passed in response to.

        And it never was about people dying in the streets outside of hospitals.

        It was about ambulance ride times. People often rode in the ambulance longer to get to a hospital that accepted charity cases than they would have ridden if all hospitals had to take charity cases.

        It wasn’t about people not getting care at all.

        So we destroyed the health care system and created our current problem in response to a handful of cases that involved long ambulance rides.

        1. Just channeling Ms. Lithwick for chuckle. But you knew that of course.

      2. AND I would bet that since emergency rooms are now debilitatingly overcrowded because of EMTALA, the number of people who got faster emergency care due to the reduction in ambulance ride times for charity cases is probably more than outweighed by the number of people since then who got slower emergency care due to overcrowding.

        1. Not being able to just waltz into any emergency room you choose and get free care, just might affect your willingness to seek care. And thus forced care just might contribute to the over crowding of emergency rooms.

          See my point above about what happens once you start valuing things above liberty. Once we said it was okay for people to essentially steal from hospitals by demanding treatment they had no way to pay for, there was no stopping going down the road to complete government control.

  6. Congress chose, for whatever reason, not to regulate the harmful activity of defaulting on your health care provider.

    WTF?

    Congress has created and/or perpetuated a gigantic clusterfuck. If only Congress would pass some more laws, they could fix everything.

    1. The problem of defaulting on a provider is one that can be handled (a) on the back end, by ordinary collection practices (which, BTW, Obamacare significantly restricts) and (b) on the front end, by allowing providers to deny care if they don’t think they will get paid (which Congress made illegal for hospitals).

      This is a problem that was certainly not created in its entirety by Congress, but Congress has rarely missed an opportunity to make it worse.

  7. The combination of the mandate and “essential benefits” creates free riding.

    To the extent that I pay for “essential benefits” that it is anatomically impossible (OB, contraceptives, etc.) for me to use, then the people who may use those benefits are free riding on my premium. Because that portion of my premium is not, and cannot, insure any risk that I am running but is used in its entirety to fund other people’s risk.

    1. When you think through the effects of this, you realize women and those on welfare benefit from it. And men and the working poor get screwed. It is almost as if the Democrats wrote it with the idea of rewarding their constituencies at the expense of everyone else.

      1. Yeah, its almost like they did that.

  8. Once again Congress has to pass laws to “solve” the problem caused by Congress passing laws.

    1. True. Medicare is the root problem. The guy stacking cans on a shelf pays for it. Smooth that problem out somehow – and don’t say kill Medicare because its politically impossible.

    2. Congress has to pass laws to “solve” the problem caused by Congress passing laws.

      Now, that is “free riding”.

  9. Y’all are examining this and poking at the details and discussing the possibilities…..but for me it just boils down to this;

    Mandate.

    I say fuck mandates. I am sick of masterminds who fuck up everything they touch mandating to the people they are supposed to serve. I dont give a rat’s ass if the world burns because of it, if it lessens the liberty of the american people, then they can stick it up their asses.

    1. I say fuck mandates.

      But, mandates are WHAT WE DO!

    2. And now that I am pissed off and on a roll I will add that I never had, and do not have now any intention of cooperating with obamacare in any way. If the supremes strike it down, good for them. If they dont, fuck them. Either way I will crawl off in a ditch and die before I participate in this over-the top exercise in absurdity. I will not pay the fine and if they come for me, they will be the ones needing medical care.

      1. if I didnt have a family…I would be right there with you.

      2. Either way I will crawl off in a ditch and die

        At least your body won’t be piled up in the streets. Very Considerate.

  10. I love how now that Obamacare has been proven to be a complete disaster that is likely unconstitutional, the bill is now a Republican bill. Wow.

    1. WE don’t make mistakes!

  11. I want to self insure. I’ll cover everything lol. But I guess now the government will dictate what an “approved’ insurance company is. Next, what an approved journalist is.

  12. The purpose behind the mandate is the same as the purpose behind pre-existing conditions.

    Basically, the law NEVER stopped pre-existing conditions.
    It just made it illegal for the individual to be able to be held to pre-existing conditions in the first place.

    In other words, no matter how you word it, spin it, or fluff it up.
    The mandate is just making the government become the enforcers for the Insurance industry.

    All they can do is refuse to pay for you. But the government can fine you and if necessary put you in jail if you do not pay that fine.

    yea! nice law.
    Don’t you Progressives love becoming the Insurance industry’s bitch.

  13. This is just a different, better description of the free riding problem. People who don’t buy “insurance” until they need it.

    If health care were a pay-as-you-go model, then this wouldn’t be free riding, but instead it’s supposedly an insurance model, so people who distort their ratio of payment/service are indeed free riders.

  14. I also love the totally dumb argument that not buying insurance affects costs for everyone else. No shit. Not buying something that’s available on the market always affects the price. Duh.

  15. Better dead than Red

  16. Since when has the Left been concerned about slackers getting something for free? IMO the Left can’t give away enough free stuff and has proven, over time, that they couldn’t care less if the people who get most of the welfare are slackers.

    Therefore, I’m not buying the Left’s faux outrage that we need a mandate to ensure slackers pay their fair share. It’s just more Left wing propaganda to get people to vote for the Left’s vile programs.

  17. The only reason there are “free riders” is because people are allowed to not pay their medical bills. In any other industry you would be charged with a crime for taking a product or service and not paying for it.

    We should scrap the entire government involvement and just use the IRS to garnish wages of those with medical bills who do not make payment arrangements with healthcare providers. THey can shave a few percent off as a collection fee to fund the extra work and we can all enjoy lower healthcare and insurance costs as a result of no longer having to pay other peoples bills.

  18. Today, everybody is admitted, and everybody is responsible for payment. And many without insurance do pay out of their own pocket. And hospitals have payment plans. And there is a huge market for elective procedures that are not covered anyway. Also the individual mandate would have raised premium rates–if you have to buy, you are a captive customer, like that $5 can of Pepsi in the hotel minifridge. But without the mandate, the insurance companies have to price premiums competitively to get the marginal customer.

  19. Definition of an entitlement: Something a person gets that someone else has to pay for.

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