Where's My Safe Driver Discount?

I support the individual health insurance mandate and here's why: by allowing some folks to opt out of participation in the overall risk pool, we perpetuate an unfair tax on those who do purchase insurance in the form of cost-shifting. It's no different than getting into an accident with an uninsured motorist. When the uninsured show up in the emergency department, they are not turned away. The rest of us who pay our fair share for health insurance get the privilege of picking up the tab.

The most recent Census Bureau data I could find (2007) indicates that 40 percent of the nation's approximately 47 million uninsured come from households earning $50,000 or more annually. So it's not merely an issue of poverty. There's a huge cohort of "invincibles" who, for whatever reason, choose to forgo purchasing health insurance. Perhaps they work in a small business and it's not offered. Or, maybe, they don't see the value in it. Illness is what happens to someone else. They're young and immortal.

Whatever the reasons, the current non-system of health-care allows the perpetuation of an injustice. Here's what we ought to do: mandate individual coverage and verify it via the tax roster. For individuals living in poverty, coverage would be government purchased. For those working to escape poverty, but not quite there yet -- say up to 400 percent of the poverty level -- coverage could be government-subsidized in a tiered fashion if it's not offered at work. For those who want to purchase the least amount of insurance necessary, we would need clear definitions of minimum acceptable health plan benefits, say catastrophic coverage and slam-dunk type primary care and prevention (such as immunizations for the kids). And while we're at it, how about taking another lesson from the automobile insurance industry and stratify premiums based upon healthy behaviors? I'd like to see discounts for not smoking and maintaining a healthy weight.

By Raymond J. Zastrow  |  July 17, 2009; 10:42 AM ET  | Category:  Health Care Reform , Insurance
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