The political catfight that always ensues during a presidential election year is well underway, and health care seems to be mentioned at every turn. Each candidate has a different view of how to fix the mess, although it’s hard to untangle true intentions from lobbyist influence and political alliances.
One issue that has generated quite a bit of interest is the idea of making health insurance mandatory. Critics of mandatory health insurance claim that it is too much of a burden on families to require them to buy health insurance. But is it not too much of a burden to endure cancer or a heart attack without health insurance?
The dollar figures on health care spending are sobering. Nearly a quarter of Americans are in families that will spend more than 10% of their income on health care in 2008 (Jay and I are among them), and about 6% of Americans will spend more than 25% of their income on health care this year. True, these numbers amount to a significant part of the budget for a good number of Americans. But what about our other expenses? A SmartMoney article from last fall noted that car expenses eat up 18% of the average American household budget. Most people are not driving 10 year old, fully paid-for cars. Instead, a huge number of people view owning a new or fairly new vehicle as a necessity, and will make multi-hundred dollar car payments every month, with little complaint. The same can be said of eating out (food is a necessity, but restaurant meals are not), shopping regularly for new clothes (clothing is also a necessity, but we actually need only a few items of clothing – the rest is purchased because we want it), and the vast majority of any household’s entertainment budget (we love to comment on how much movie ticket prices have gone up over the years, but every Friday night there’s a line at our local AMC, filled with people willingly forking over $10 for a ticket plus money for monster-sized popcorn).
So why is it that a family that will happily spend $460/month on a new SUV (and let’s not forget the car insurance premiums, registration, and gasoline) will balk at spending the same amount on health insurance? I wonder what percentage of the 47 million uninsured Americans drive vehicles less than five years old?
Psychologically it’s tougher to get ourselves to spend money on something that we hope we don’t have to use than to buy something that provides immediate gratification, like the SUV. And if you go long periods of time without needing medical care, health insurance premiums can start to feel like a waste. Jay and I are using our health insurance for the first time ever this year, after years of paying premiums without getting benefits. I have to say, we’d be pretty screwed without our health insurance policy right now.
Since it’s human nature to be more willing to spend money on stuff like cars and entertainment than on mundane things like insurance, the government has been known to step in from time to time. I’m sure that there are plenty of people (who currently have auto insurance) who would choose not to purchase liability auto insurance were it not mandatory – and many of them would cite cost as the reason, claiming that they cannot afford it. Just as the current critics of mandatory health insurance claim that people cannot afford the premiums. Most of the proposals I’ve seen for mandatory health insurance include provisions for government subsidies for families that earn up to 300% of the poverty level – about $60,000 for a family of four. A family of four earning $60,000 can afford health insurance (depending on where they live, they may not qualify because of pre-existing conditions and a lack of high-risk pool health insurance like Cover Colorado, but that’s another issue beyond cost). They may not be able to afford a brand new minivan and a 50 inch television AND health insurance, but they can afford health insurance.
We either have to move to a single-payer system whereby everyone pays more taxes and everyone receives “free” health care, or we have to mandate that everyone have health insurance. We simply cannot continue with a system that allows people to choose to go uninsured, continually shifting the burden of cost onto the insured population and increasingly turning our emergency rooms into primary care centers.