Republicans, what do you think happens to the uninsured?

[emailking]

Those with the misfortune of requiring chemotherapy and radiotherapy would likely appreciate if they could buy a cheap policy that only covered conventional treatment for life-threatening illnesses such as cancer, rather than being priced out of the market because their insurance is required to cover services they will never or rarely use such as maternity benefits, mental health, prescription drugs, laboratory work, etc.

The reason insurance works is because you are required to pay for services you will likely never or rarely use, thus subsidizing the costs for those who do need them.

So those with the misfortune of requiring chemotherapy and radiotherapy need to have been paying their dues all along, paying for things they probably would never need. And now that they have a need, it's the people who are paying for things they will probably never need that are covering the costs.

Otherwise, the costs need to be subsidized externally in order for it to work at all.

So maybe you think one shouldn't be required to participate. But the fact is not enough people would buy just catastrophic insurance for it to work with cheap premiums.

[emailking]

As a male, I can guarantee that I will never need pregnancy services.

But that doesn't mean it shouldn't be part of the insurance plan. "Never" is consistent with "likely never." It all falls under the umbrella of subsidizing the medical costs of others. Females can't get prostate cancer but are still subsidizing the medical costs for males who get it.
 

And no, insurance does not work by requiring people to purchase coverage for services they won't need.

That's not how I meant it. =P I'll rephrase. The reason insurance works is because you a pay for services you will likely never or rarely use, thus subsidizing the costs for those who do need them.

If I would rather accept certain death than be cruelly poisoned for what most likely would be an extra few months of torture, why should I pay for chemotherapy coverage?

Well that's a rather loaded question. Death by tumor is very much torture and chemotherapy can save your life. Regardless, your logic applies to any kind of medical coverage at all. Any possible treatment could hypothetically be passed over voluntarily, and thus why should it be part of a medical insurance plan?

There seems to be a general consensus that the poor should have some sort of health safety net, and thus I could see a role for insurance subsidies for those in bottom income tiers, provided that such subsidies match individual contribution (ensuring that the covered party has skin in the game) and that they are tapered off with increasing income (ensuring that the safety net exists without creating a marginal disincentive to acquiring a livelihood.)

So then we're talking about taxes to fund the subsidies, which is what the Individual Mandate is anyway according to the Supreme Court.

[emailking]

There seems to be a general consensus that the poor should have some sort of health safety net, and thus I could see a role for insurance subsidies for those in bottom income tiers, provided that such subsidies match individual contribution (ensuring that the covered party has skin in the game) and that they are tapered off with increasing income (ensuring that the safety net exists without creating a marginal disincentive to acquiring a livelihood.)

So then we're talking about taxes to fund the subsidies, which is what the Individual Mandate is anyway according to the Supreme Court.

Literally no one believes that besides John Roberts.

It doesn't matter. It was supported by 5-4 majority even if 4 of the 5 wrote dissents. So it's the interpretation of the law at present.

And it accomplishes the same result as having a tax, whether or not it actually is one.

[emailking]

That ought not to be the case either. If you want a safety net for life-threatening medical conditions, then advocate that, but do not call it "insurance".

I mean it is what it is. You're arguing semantics here. A safety net, a tax, insurance, whatever. Personally, I'd prefer England's system. But right now we have mandated insurance and I don't see why I should call it something else. It's effectively all of those things.

As an aside, I think women have considerably more control over whether they get pregnant than men do over getting prostate cancer. Fire insurance would be a lot more expensive if the insurance companies had to sell half of their policies to arsonists.

I suppose looking over the very minute fact that burning your home to collect the insurance money is illegal.

And almost all men get prostate cancer eventually if their health allows them to live long enough. So eventually they'll likely make a lot of medical claims for either that or something else.

There seems to be a general consensus that the poor should have some sort of health safety net, and thus I could see a role for insurance subsidies for those in bottom income tiers, provided that such subsidies match individual contribution (ensuring that the covered party has skin in the game) and that they are tapered off with increasing income (ensuring that the safety net exists without creating a marginal disincentive to acquiring a livelihood.)

So then we're talking about taxes to fund the subsidies, which is what the Individual Mandate is anyway according to the Supreme Court.

Literally no one believes that besides John Roberts.

It doesn't matter. It was supported by 5-4 majority even if 4 of the 5 wrote dissents. So it's the interpretation of the law at present.

And it accomplishes the same result as having a tax, whether or not it actually is one.

Except that by it's very nature it is a completely nonsensical and ineffective way to provide for insurance subsidies, since the more people who sign up for insurance and thus need subsidies, the smaller the amount available from the tax. The main reason for it was always as a penalty to get people to buy insurance, it's second use as one more revenue raising device among others almost an afterthought.

I thought his argument was that the amount was so small that it could be seen as a tax, regardless of what Congress had in mind when they wrote it. Regardless, it doesn't matter if it's ineffective and nonsensical. I don't really agree that is is. But even if it is, that's the SCOTUS interpretation of the law. We're all bound to it.

[emailking]

While the acts in and of themselves are dissimilar, the point is that both are fundamentally uninsurable events, as the party being "insured" has complete control over whether the event happens to them. If that analogy is too difficult to comprehend, would you prefer that I compare it to a casino that has latitude to change what cards are dealt after the bet has been placed?

I get the analogy as you intended it. The problem is that it is a very faulty analogy in that your scenario involves violent illegal activity.

[emailking]

A Circuit Court might be bound to that interpretation.  It shouldn't bind people generally in debate over policy or over the efficacy and justice of the law.

Well I'm not saying it does...just that I'm OK claiming it's a tax given that is what our courts have ruled.

I mean heck, you even pay the penalty on your tax form!