“We’re going to have insurance for everybody.” ~ Donald Trump
Donald Trump is not alone. The majority of politicians in Congress (of either party) and private citizens (of any political persuasion) believe that everyone should have health insurance. What they disagree on is who should pay for it, what it should cover, what deductible it should have, what limits it should have, and whether the government should require people to have it.
Right now the individual mandate of the Patient Protection and Affordable Care Act (PPACA)—Obamacare—requires that every American have health insurance or pay a penalty, unless he is covered by Medicaid, Medicare, an Indian Health Services provider, or SCHIP. One can get an exemption if he is in prison, homeless, belongs to a health-care sharing ministry, is an adherent of a religion that objects to the use of insurance, has an income that is so low he doesn’t have to file a tax return, has been abroad for more than a year, or qualifies for a hardship exemption because of a bankruptcy or an eviction.
For tax year 2016, the penalty, or “individual shared responsibility fee,” is the greater of $695 per adult and $347.50 per child (up to a maximum of $2,085 per family) or 2.5 percent of taxable income above a threshold (up to a maximum of the national average price of a Bronze plan sold through the Marketplace).
But even the most ardent foes of the Obamacare would probably still say that everyone should have health insurance.
But should they? Does everyone need health insurance? Some people do. Some people don’t. Should everyone want health insurance? Not necessarily: it is an individual decision that depends on a particular set of circumstances that an individual is in.
King James, His Bible,... Laurence M. Vance Best Price: $13.66 Buy New $17.66
The rich may not need or want health insurance. They may have enough money to cover any medical emergency or necessary or elective medical treatment.
The frugal may not need or want health insurance. They may be able to put aside enough money to cover any medical emergency or necessary medical treatment.
The poor may not need or want health insurance. They may qualify for Medicaid or free medical care from a neighborhood clinic where doctors devote some time each month to provide free services to the poor.
Children may not need or want health insurance. They may qualify for SCHIP or free medical care from a neighborhood clinic where doctors devote some time each month to provide free services to children.
The young may not need or want health insurance. Since they, statistically, will need far less medical care than anyone else in society, they may feel as though they are wasting their money if they buy health insurance.
The old may not need or want health insurance. They may qualify for Medicare. Or they may reason that since they have made it this far in life, there is just no point in getting or keeping health insurance.
The unmarried may not need or want health insurance. They may reason that since they have no family to take care of, they will just deal with any medical issues when the time comes.
The physically fit may not need or want health insurance. They may simply conclude that because they are physically fit, there is no point in having health insurance.
Those familiar with the Emergency Medical Treatment and Active Labor Act (EMTALA) may not need or want health insurance. It requires hospital emergency rooms that accept payments from Medicare to provide a medical screening examination (MSE) to individuals seeking medical treatment— regardless of their citizenship, legal status, or ability to pay.
The terminally ill may not need or want health insurance. They may just want to let nature take its course and not die in a hospital bed all drugged up so they don’t recognize their family.
The well may not need or want health insurance. They may just decide to forgo insurance until they get sick since, after all, no one can be denied insurance coverage for pre-existing conditions.
Physicians may not need or want health insurance. They may just want to treat themselves or have a fellow physician treat them.
The healthy may not need or want health insurance. They may reason that since they never get sick, then why bother having health insurance.
War, Christianity, and... Laurence M. Vance Best Price: $19.36 Buy New $19.95
Risk takers may not need or want health insurance. They may just want to take their chances. They may simply reason that, after all, the majority of Americans don’t get cancer, don’t have heart attacks, don’t have car accidents, and don’t get broken bones.
The reckless may not need or want health insurance. They may just say, “if I get sick or injured, then oh well,” and deal with it if it happens.
Nurses may not need or want health insurance. They may just want to treat themselves or have a fellow nurse treat them.
The self-sufficient may not need or want health insurance. They may think that they can just take care of themselves should they get sick.
The religious may not need or want health insurance. They may just decide to “trust God” to keep them healthy and safe. If they get sick or get in an accident, then it must be God’s will.
The cautious may not need or want health insurance. They may want to avoid hospitals at all costs because of the risk of infection or being given the wrong medication.
Friends of physicians or nurses may not need or want health insurance. They may be able to get their physician or nurse friend to treat them in most instances for little or no cost.
Determinists may not need or want health insurance. They may reason that since “whatever will be will be,” there is no point in having health insurance.
The point is, everyone may not need or want health insurance. That everyone should have health insurance is one of the great myths of health care.
Other myths abound:
Hospitals should have to treat anyone who comes into the emergency room.
The government should conduct or pay for medical research.
The government should fund clinical trials.
Insurance companies shouldn’t be able to deny people insurance based on their preexisting medical conditions.
The government should prevent people from selling their organs to the highest bidder.
The insurance industry needs to be regulated by the government.
The government should maintain a “safety net” to ensure that the poor have adequate health care.
War, Empire, and the M... Laurence M. Vance Best Price: $15.99 Buy New $13.54
Obamacare must be replaced with something else.
The government should provide health care for the poor.
The government should subsidize those who cannot afford health insurance policies.
The government should regulate medical schools.
The government should license physicians.
Medicaid and Medicare are not socialized medicine.
Health care is a right.
The government should regulate medical devices.
The government should make sure that health insurance is affordable.
The government should have a Department of Health and Human Services.
Employers should offer their employees health insurance.
Some Americans should be forced to pay for the health care or health insurance of other Americans.
Republicans have never supported the individual mandate, government subsidies to purchase insurance and a penalty for failing to be insured.
And perhaps the greatest myth of all: Republicans believe in a free market in health care and health insurance.