Are people who refuse to buy health insurance freeloaders?

[opebo]

Haha, 'individual choice'.  Americans are funny, eh?

[muon2]

A person who can afford health insurance, but chooses not to buy it? Does such a person exist? I'm sure out of 300,000,000 people that applies to somebody. Not a common circumstance though.

Well I obviously exist, so that answers that question. I do have accident insurance though (that would cover an ER bill in something like a car wreck).

I don't have it because it's cheaper to pay $80 the one or two times a year I have to visit a clinic than to pay a $20 co-pay plus a monthly premium (though my job started offering a cheap plan that would only deduct $25 a paycheck it's still not enough for me to come out ahead.)

Are you going to get health insurance in 2014 or pay the tax?

I'll get it since I'll probably get subsidized anyway. I just don't see a point in paying the unsubsidized costs prior to then. Obviously this is one of several major flaws in the current system that the upheld law fixes, so it's a good thing. I mean yeah we shouldn't make it beneficial for someone to stay out of the market as long as the market is private, but as long as it is I don't see any reason to change.

Also, what if you get a serious medical issue that isn't a car wreck?  Are you OK with bankruptcy?

Yeah I'm taking the risk that it won't happen, but I'm not willing to spend even $1000 a year against the remote odds I get cancer. At my age it's not much of a risk. Which of course is part of what's so messed up with the current system and why Obamacare is needed if there is no single payer.

But the Medicaid expansion mandate was thrown out by SCOTUS so for that large population Obamacare now offers little. Obamacare patched some of the holes, but left others. It was trying to protect some types of benefits for certain classes of individuals while scuttling others. It is really quite inconsistent and not at all a substitute for single payer or a Bismarck system.

[Brittain33]

But the Medicaid expansion mandate was thrown out by SCOTUS so for that large population Obamacare now offers little.

The latter doesn't follow from the former. Obamacare now "offers little" only in those states that decline the nearly 100% federal funding for Medicaid expansion, declining to something like 90% in a few years. Which some states undoubtedly will reject on principle, but they will be in the minority.

[anvi]

[It was trying to protect some types of benefits for certain classes of individuals while scuttling others. It is really quite inconsistent and not at all a substitute for single payer or a Bismarck system.

I certainly do agree with this.  The effects of the fragmentation of our system are enormous.  I'm a very lonely fan of Bismarck systems on the forum.

[Franzl]

[It was trying to protect some types of benefits for certain classes of individuals while scuttling others. It is really quite inconsistent and not at all a substitute for single payer or a Bismarck system.

I certainly do agree with this.  The effects of the fragmentation of our system are enormous.  I'm a very lonely fan of Bismarck systems on the forum.

I'm here.

[anvi]

[It was trying to protect some types of benefits for certain classes of individuals while scuttling others. It is really quite inconsistent and not at all a substitute for single payer or a Bismarck system.

I certainly do agree with this.  The effects of the fragmentation of our system are enormous.  I'm a very lonely fan of Bismarck systems on the forum.

I'm here.

Thanks, Franzl!   

Just to finish the point above, any legislation or framework that leaves the massive fragmentation of our system basically in place will inevitably be trading out one kind of benefit for another with respect to people in different parts of the system.  In a unified system, everybody basically gets the same basket of benefits, and people who want more than that have to buy them independently, or sometimes separately, from the rest of the system.  With regard to what sorts of physicians people can just go and see, when you couple this with automation of records and so on, systemic efficiency really sees some marked improvements.

[Small Business Owner of Any Repute]

A person who can afford health insurance, but chooses not to buy it? Does such a person exist? I'm sure out of 300,000,000 people that applies to somebody. Not a common circumstance though.

It applies to more people than you'd think. For most people aged 26 to 35, buying health insurance is a terrible investment. Over three years, they could easily wind up spending $10,000 on health insurance  -- more than enough to cover the kind of ER bill a person in that bracket might rack up. Further, even if they had health insurance, most types make them pay a part of their ER bill anyway.

Yeah I'm taking the risk that it won't happen, but I'm not willing to spend even $1000 a year against the remote odds I get cancer. At my age it's not much of a risk. Which of course is part of what's so messed up with the current system and why Obamacare is needed if there is no single payer.

Not that $1,000 would buy you a real defense against cancer anyway. Cancer drugs are stupid expensive, and any plan that cheap would have a cap on prescription drug benefits, yearly benefit caps, deductibles, and co-insurance. I don't get the point of buying cheap insurance, I really don't. I'd rather have nothing.

[milhouse24]

I'm not talking about people who legitimately can't afford it.  I'm talking about people who can afford the premiums but refuse to do so for whatever reason.

It's ironic how this seems like a very Republican idea to have, yet it is Democrats who tend to make it while Republicans fervently reject it.

This may shock you, but some doctors and hospitals actually take cash and payment plans so that you are billed by appointment and procedure. 

That is how some businesses operate, you only pay for the services you use, instead of relying on insurance for emergencies.

[milhouse24]

What about people who can afford health insurance but not a five-digit bill, and choose not to buy health insurance, knowing that emergency rooms will still treat them anyway if they get in a car wreck?

I know one person who fits this description. He is nearing retirement though as opposed to being someone young, and feels it is a waste of money to buy insurance if the hospital won't turn him away if he comes in seriously ill or badly injured without plans for paying. It kind of boggles my mind though since he is socially conservative and actively involved in contributing to community service projects. Perhaps he just happens to be an exception of sorts to the norm?

Everyone else I know without health insurance wants it but feels they cannot afford to buy it.

The person you describe could be in for a shock. You can't just walk away without paying. The hospital will bill you, and if the charge is too steep they will negotiate a payment plan. The only way to avoid payment is for that person to declare bankruptcy. Before the Great Recession half of all personal bankruptcies were for medical bills that could not be covered.

Yeah, these liberal posters have no idea how a hospital functions.  They send the bill to a collections agency and hurt your credit if you don't pay the bills. 

You can retroactively apply for medicaid, if the bills end up exceeding your salary or savings. 

[Link]

If the average cost of a person's health insurance premium yearly is $5,000, and the average ER visit is $1,300, factoring in deductibles, you'd have to go to the emergency room 5+ times a year to break even.

Errr... you are only looking at the cost of an ER visit.  Sometimes ER visits result in hospitalizations and those bad boys can cost over $100,000.

[Mercenary]

I could afford it but I chose not to. I guess you could say it was a gamble, but in the end it was the right choice as it saved me hundreds of dollars.

Honestly, I absolutely detest for-profit insurance and consider it a massive scam and would prefer no part in it. I'd be okay with non-profit insurance that was just about risk pulling and not about making money and finding ways to get out of paying claims.

I had a physical once during this time I paid out of pocket, and of course I was perfectly healthy. As I never took a cent of taxpayer money I don't know how in the world I was a freeloader.

The only time in my life I could be considered a freeloader is when I was in university and received pell grants, and subsidized loans.

[7,052,770]

Lots of insurance companies are non-profits or mutual companies.  You should check one of those out, especially after the exchanges are up and running.

[Queen Mum Inks.LWC]

Yes.  And I've been saying so for a while now.