If your choice was to enroll in a health plan or remain on your own for at least five years, what would you do?

Eric Ringham February 9, 2011, 5:00 AM Feb 9, 2011

The health care law passed last year has drawn fire for its requirement that every American buy health insurance. Advocates say such a mandate is necessary because without it, only sick people will buy coverage. But other incentives might induce healthy people to enroll – for example, a five-year waiting period before those who at first opt out are eligible to buy coverage and enjoy any of the discounts or guarantees provided under the law. Today’s Question: If your choice was to enroll in a health plan or remain on your own for at least five years, what would you do?

About the blogger

Eric Ringham

eringham@mpr.org

Wade

Enroll, I’m not sure why this is such a big deal.

We just need to change the COBRA laws. If you don’t enroll for insurance and you don’t have cash or a credit card in hand as you walk in the ER/Hospital. You are refused service.

We need to stop giving free care to those that aren’t willing to pay for it. It’s not right those of us that are responsible have to shoulder the cost burden for those that choose to be irresponsible.

Shorelines

I would enroll for sure. I’m terrified to be without health insurance for my family.

@Wade – I hope we don’t go where you are suggesting we go. I wouldn’t want to be part of the society that would set policies like that.

Kristin

I would definitely enroll in the health plan. When it comes to health care costs, the adage is better safe than sorry. After all, you never know when you will get sick or hurt – why tempt fate?

Steve the Cynic

I relish the irony of this issue. The idea of requiring people to buy private insurance was first offered as a Republican alternative to Clinton’s attempt at health care reform and was first tried in Massachussetts, when Mitt Romney (R) was governor. Now it’s Republicans calling it a “socialist” idea and demanding that it be declared unconstitutional. Meanwhile, no one is seriously disputing the fact that it would be completely within Congress’ constitutional authority to levy a tax to pay for government-run universal coverage. I would be sorely tempted to gloat if the Supremes strike down mandatory purchase and that becomes the spur to move people to embrace a single-payer plan.

CHS

Steve the Cynic, I wouldn’t gloat, I’d breathe a sigh of relief…this coming from someone who believes that the mandate is unconstitutional. The government can’t force me to go buy into a 401k, but it’s okay for them to tax me for social security, it’s the same difference. The difference is that it’s not a private business. Forcing people to buy into a private business creates government picking winners and losers and creates the opportunity for lobbyists to regulate their own business interests into competitive advantages. Just taxing someone and giving them the service is well within the scope and power (and responsibility) of government.

As for the 5 year mark, I think that the same affect could be achieved with a 1 year waiting period. This would be enough incentive without being absolutely crippling if someone was forced into a situation where coverage lapsed.

April

I agree with Wade, to a point. I absolutely believe that hospital ERs should have the right to demand up front payment from uninsured and the copay from insured people in non-emergent situations. I don’t think the average Joe Citizen understands how many zillions of dollars are wasted every year by uninsured or Medicaid “frequent flyers” presenting to ERs for non-emergent problems. Pregnancy tests, STD testing, tooth pain (ERs do not have dentists on staff anyway). This doesn’t even include people who come in 20 times/month (I’m not making this up) with the same abdominal pain. People who have had so many CT scans that their risk for cancer actually goes up. Its a completely ridiculous waste of money. I think most normal people must not know the extreme extent that this is happening or there would be a revolt. Why should we be forced to pay for this kind of behavior? As it stands, there is little hospitals can do because of EMTALA. There have to be limits on this abuse or it will be impossible to sustain the health care system.

There has to be Tort reform so that physicians will stop ordering pages of unnecessary testing because they are terrified of being sued. I have personally seen more than one instance where a person had over 20 CT scans in a year and none of them showed anything wrong. People with what is clearly mental illness present to the ED with “10/10” abdominal pain, what is the physician to do? The patient clearly doesn’t need a CT scan but what if its real this time? What if you miss it and are sued? Will you be able to afford your insurance if this happens? Not to mention that almost every time your insurance company will settle with the Plaintiff even when you’ve clearly done nothing wrong. How does that look to others?

Making health insurance mandatory is only one piece of the puzzle and it won’t fix everything. I think it is a step in the right direction, but health care in this country is going to crash and burn if it isn’t repaired in the near future.

Rose

As someone who is over 60, I would prefer to stay on my own without a health plan or interference from doctors. I choose to stay on my own and pay any “tax” penalties for doing so.

I have come to distrust a doctor’s ability to “take care of me” rather than “sell me the solution of the day”. I have worked with elders who needed to make sense of their insurance coverage and submit claims for reimbursements. I have seen the doctor and health care invoices which are inflated and “wrong” and the amounts they submit to insurance for reimbursements.

I would prefer that the country’s health plan package recently passed by congress be viewed as insurance reform. Since the recent plan was passed by representatives elected to represent ALL the people (not just the ones who voted for that person), I resent the plan being referred to as “Obama Care”.

Kevin VC

Enroll.

I have been to the emergency room without insurance before.

If you felt you were in financial perfection before sure a visit you will suddenly feel the urge to file bankruptcy. You are talking a 10-100X (That is a multiplier, as in a really big number..) the cost of a normal doctor visit. A normal doctor visit would have been prefered, but again with out insurance the ability to pay for such a visit is ‘non-existent’ so it snowballs into a emergency room visit.

And guess what?!

Its not free if you’re without insurance.

And if you can’t pay and they wave the fee, it does not suddenly vanish. That cost is passed on to everyone else who HAS insurance. A major reason health care costs go up….

I would rather have insurance spreading the costs evenly and fairly. My only concern is costs ‘atm’ to those without a job. The law as it is written covers that.

Either you pay for the increasing health care by trying to not cover people, which guess what … you still pay for but at a substantially larger amount and with people STILL with a worsening condition….

Or we share in the pain and plan for it evenly and carefully.

This is why we are the 47th in the world on average for health care!!!! We suck!

Linda

We have been without insurance and it is the most scary thing in the world. I would enroll and be glad of the opportunity to do so. I assume all these tough guys who choose not to enroll and take their chances are young, healthy and DUMB.

Kevin VC

I would like to point out some finer points of the health care reform that seems to be missed or misrepresented:

* It already has save over 4 billion in costs to the government.

* It reforms a vast majority how Insurance companies treat patient’s care and billing.

* It removes a lot of abuse and misuse in the health care industry on each level.

* That pre-existing conditions can not be a reason to refuse coverage. We eventually pay for it in the end as end-users, just not the insurance companies…. So lets be honest with that.

* It should have given the ‘option’ for Public Coverage, as a competition tool against Insurance Companies to kick them into gear. Competition is good by the rules of capitalism after all.

* Most of the reforms have yet to even start kicking in. I have seen claims by some that the increasing costs were from the reform. Quite the contrary. They been increasing since HMO’s and for profit insurance came into being…

* That dispite the claims of no discussion were allowed for a alternative, no alternative from the opposition ever came into being, and they have had at the very least since Clinton’s presidency…..

Sorry, but one’s health and quality of life (Pursuit of happiness) should not be something that is looked upon as a ransom by people in Wall-street…

Kyle D.

I would enroll, in a heartbeat. I’m a financial counselor at a large downtown Minnesota hospital, and not taking health insurance you could have is an incredible risk. Without health insurance, everything that you have and ever will have is on the table– you could easily be crippled with debt for the rest of your life, through no fault of your own, if you are uninsured.

And CHS, the government has already chosen winners and losers in the health insurance industry. The companies are exempt from anti-trust laws and the market is dominated by an oligopoly. Insisting that people buy coverage and letting them pick who they buy it from doesn’t provide the companies with any benefit they don’t have now, except that the industry as a whole will have more customers.

kelsey

i know that i am only in my 20’s but the health care plan is a very bad thing!!!!!!

what’s about is that you are goin to pay money. See brfore the health care was even pushed you can walk in the ER and treated without paying right on the stop. Yes you will have to pay a bill, but you know what that can be paid by 5 dollors a week or less. but the health care is going to make you pay more. OH yea and you know what else you are going to have have a long waiting line. you might think that the Health Care is going to let have the same Health care that we have today, well it not. It’s going to be just like the Health Care in Canada and everywhere else. we were the number one place for Health Care but with this Health care bill, were not going to be
Lawrence

Most insurance plans (auto, home, life, medical) are proactive programs that ensure some manner of survival continues in the event an unplanned and/or unprevented accident occurs. It’s like eating healthy so that you don’t have to appear on the Biggest Loser some 5 years later to lose 50 – 200 lbs. In this case, the provision of Obama Care was passed was to PROTECT hospitals and current insurance pools from people that have to have medical care but don’t have a means to pay for it. Hospitals in general don’t refuse care, but the more people get free care, the higher insurance rates go up for those who do have and maintain health care insurance. Therefore, the prudent thing to do would be to sign up and support this measure of the bill. But, some people, notably some Tea Party people, don’t have the ability to acknowledge the reasonableness of having such a measure even though they argue the same thing with respect to taxes and other social programs.
Dianne

I would buy health insurance. I have seen the benefit of having insurance with annual exam coverage and with covered, recommended tests and shots. If I had had no health insurance last year, I don’t know how I could have afforded the costs associated with my breast cancer diagnosis and treatment.
Elizabeth T

enroll

My son was 3 weeks old (22 days) when he wound up in the hospital. 2 days later … I got a bill for $15,000, after IV antibiotics and an ultrasound. Was I supposed to keep my child out of the ER if I had been uninsured? But … the $15k is out of pocket price. The price to the insurance company was $8k.

A discrepancy you don’t see, since the statement from the insurance company only lists the price to them. I only saw it because there was a glitch in the paperwork & I got billed directly. I might as well buy into an insurance plan for no other reason than to get the lower price.
Tim from Rochester

I would opt for insurance without hesitation. I have been without health insurance in the United States. Even as a healthy, young family, it was worrisome. We postponed having a second child because we were not willing to risk a pregnancy sans insurance. We were more apt to wait to treat ourselves until we were very sick rather than being proactive about our healthcare. During this uninsured period, we experienced a few minor medical issues for which we were charged more than health care providers could charge HMO members because of their agreements with these companies . We were saddled with this medical debt for many years because of our modest, entry level incomes at the time. I would not wish that insecurity and financial drag on anyone.
Greg

Enroll. the stock market grows at about 10% year assuming no major recessions. Health costs have gone up double digit year over year for decades – regardless of market performance. You couldn’t invest well enough to beat out the increased cost of health care …. and one serious health event … could evaporate 20 yearts of savings in one shot. not a great gamble.
Joey

This solution misses the point for most 20-somethings, which is that they would purchase health insurance if they could afford it, but they can’t.
Renee

Completely depends on if we can afford it. Currently, we can not.
Renee

@Joey-

Exactly. And yes, we are 20-somethings!
Ron Hall

Before I became enployed by a larger organization, I never had health insurance and didn’t know I was missing anything. It’s horribly expensive, even with the employer paying half and with the insurance company negotiating lower rates. Before I had health insurance, it was not okay to get sick; I ate well and got exercise. So, to answer your question, if it were just me and no one else relied on me for health care (they do) I would go without. What America needs is a single-payer health care system where people are encouraged to become health care professionals as a way of “serving their country”, but with at least as much compensation and gratitude as we currently show those who die for us. Saving our lives should be at least as important a national priority.
Zariel

It’s great to read something that’s both enjoyable and provides prgamaitdsc solutions.