Are people who refuse to buy health insurance freeloaders?

[Torie]

They are certainly running the risk of becoming freeloaders.  That is just an indisputable fact.

[Torie]

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

This illustrates one of the problems in the health insurance market. We've folded wellness care such as regular checkups with major medical. With car insurance I can buy a cheap policy to cover large claims only with a high deductible. It's hard to find an equivalent health insurance policy that only covers high-cost procedures with a high deductible. Part of that is due to state mandates on health insurance coverage that set a minimum standard for a policy.

At the end of the day, assuming someone has the means, what difference does it really make if they are substantially self insured up to a point (i.e., a high deductible) and have lower premiums, or with a low deductible and higher premiums?  I hear a lot of chat about how youngs should just be forced to get catastrophic coverage, but if they are not cross subsidizing others (an aspect of Obamacare I still find execrable), the additional cost in premiums of broader coverage should be very small, since their actuarial risk is so low. The main advantage of a high deductible regime for those with means, is that their will be more pricing policemen out there, but that hardly seems central to a viable health care structure to me.

[Torie]

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

This illustrates one of the problems in the health insurance market. We've folded wellness care such as regular checkups with major medical. With car insurance I can buy a cheap policy to cover large claims only with a high deductible. It's hard to find an equivalent health insurance policy that only covers high-cost procedures with a high deductible. Part of that is due to state mandates on health insurance coverage that set a minimum standard for a policy.

At the end of the day, assuming someone has the means, what difference does it really make if they are substantially self insured up to a point (i.e., a high deductible) and have lower premiums, or with a low deductible and higher premiums?  I hear a lot of chat about how youngs should just be forced to get catastrophic coverage, but if they are not cross subsidizing others (an aspect of Obamacare I still find execrable), the additional cost in premiums of broader coverage should be very small, since their actuarial risk is so low. The main advantage of a high deductible regime for those with means, is that their will be more pricing policemen out there, but that hardly seems central to a viable health care structure to me.

It shouldn't be central, but portions of the public expect certain services for their health care. They go to the state and push to have those services mandated on all policies. Before long it becomes impossible to get a simple, cheap policy because there are so many required add-ons. here's the IL list as an example.

Well, doesn't that get to the issue which cannot be finessed, as to what treatments will be subsidized for those without means, and what treatments will not?  That is the issue of course that nobody wants to talk about, except to call it all "death panels."