My feeling is that if more healthy people join the pool of insureds, the premiums will become more affordable for everyone. But if people feel like they need to get some “value” out of their health insurance policy, we end up in a cycle that continues to perpetuate itself… basically, the more we utilize health care, the more our policies pay out in claims, and the more premiums increase. And as premiums increase, more people are unable to afford coverage and drop their policies, which in turn triggers rate increases for the people who remain insured.

There aren’t any easy solutions…

A family earning 88K a year would definitely not need assistance. However, I am envisioning a young single person just starting out in life. Some of my friends are earning in the low 40′s and paying over $400/month in student loans,(That’s a whole other issue), trying to save for a house, and starting families. Living in Chicago, the sales tax is 10.25%, the highest in the nation, rents, and the cost of living are exorbitant. An added monthly bill could be a budget buster for some. (Others can afford it.)

I really think the pharmaceutical industry needs to be reigned in, tort reform needs to occur, and the admin costs/waste needs to be cut in the healthcare industry. That coupled with a mandate might lower the costs across the board. I’m not an expert. I’m also wondering if at least some of recent the rate hikes are partially a result of the insurance companies strategy to push for a mandate that would result in a glut of new healthy customers who pay in but take very little out. Just some thoughts.

Thanks for your comment – you make some good points. There is some fundamental unfairness to any sort of health insurance system. People who make their health a priority (eating well, exercising daily, not smoking, driving the speed limit, etc.) will always be subsidizing care for people who don’t… and yes, that’s a frustrating subject for me too. But not all health problems are self-inflicted, some are just bad luck. If we don’t restrict the ratios in terms of how much higher premiums can be for older/sicker people, then we’re sort of defeating the purpose of health insurance. The idea is to spread the costs of care across a large population, not to place the burden of payment on the people who currently need care. And none of us knows when we might be in a situation that requires significant medical care. Could be tomorrow, could be 20 years from now.

I think a mandate would require a shift in how people think of insurance. I’ve never used my health insurance for anything more than a physical, and I’ve always paid premiums; paying them on my own without an employer’s help for the last seven years. But I don’t consider that money to have been a waste. What it gives me is peace of mind, knowing the IF something happens, my family won’t be bankrupted.

We pay for things like auto insurance and homeowners insurance, hoping that we won’t ever have to use them. But for some reasons, people look at health insurance differently, and we often hear people saying that the policy isn’t doing them any good if they don’t use it, or if they have a high deductible. We need to get back to the mindset of what insurance is all about – it’s not supposed to be something that we use. It’s there just in case, as a safety net.

From what I’ve seen, it looks like a family of four would qualify for subsidies with an income up to $88,000/year. It’s hard for me to picture a scenario in which a family earning more than that amount would be unable to afford monthly premiums.

Those who will really be screwed are those that make too much money to qualify for subsidies but too little to afford the monthly premiums. I am healthy and young. If my premiums skyrocket, I’ll make it my goal to over-utilize our healthcare system because after all, what’s the point of throwing extra money away every month and getting very little in return?