One of the things about the healthcare debate is contradictory examples, and the contradictory examples show why “one size fits all” is not a solution.
Scenario #1: Tom has normal health. He is self-employed and makes about $100K per year. He can afford private insurance, but he chooses not to pay for it. Tom gets cancer. He goes to get health insurance only now that he needs it. This is what people who are *against* the bill bring up for pre-existing conditions.
Scenario #2: Dick has normal health. He is also self-employed and makes about $100K per year. He can afford private insurance, but he chooses not to pay for it. He also goes through a catastrophic illness. He racks up hundreds of thousands in hospital and doctor bills with no insurance. So he a) goes bankrupt or b) lies about his income so he can get a charity waiver (a charity waiver that might have gone to someone who’s poor. Ironically, Republicans will use a story like this to say why “there’s no such thing as free healthcare” (even though Dick got it), and “people can manage on their own” (even though Dick didn’t). For those who support manndatory insurance, Dick is the guy they’re talking about.
Scenario #3: Harry has a genetic disorder. He has always had coverage through his parents or his wife. He *could* qualify for SSI, and spent some time on SSI, but he’s a conservative and doesn’t like living off the government. More importantly, he knows you can’t really live off what SSI pays, and he wants to contribute to society. So Harry works rather than go on government disability. He can’t qualify for Medicaid under his state’s regulations. He and his wife go through a period where neither one is working for more than 3 months. When his wife gets a new job, they’re outside the pre-existing condition limit, so he can’t get coverage under her insurance.
This of course is what those who support getting rid of pre-existing limits are talking about.
But Harry is also the guy that conservatives point to when objecting to mandatory coverage, since Harry can’t afford it.
As it stands, Tom and Dick are both leeching off society. They claim to be good self-sufficient Republicans, but they’re not. They claim to be exercising their freedom, but they’re doing so at others’ expense.
The whole theory of insurance is that healthy people pay into it *in case* they get sick, and those who aren’t healthy enough get the support of the healthy people without having to beg.
If the healthy people don’t pay into insurance, there isn’t enough money in the insurance pool to pay for those who are sick. If the healthy people wait until they get sick, they haven’t made their own reasonable investments ahead of time, and they’re leeching off those who’ve paid.
Of course, those who don’t have insurance by choice, and then try to weasel out of their medical bills, are also mooching off society. They’re either getting the debts discharged, at the cost of the medical professionals, or else they’re getting charity that could have gone to those who really needed it.
Our third group is stuck in the middle. On the one hand, they can’t get insurance. On the other hand, they can’t afford it if they did, unless they’re getting it through an employer program.
It is important to note that one of the reasons I chose to actively support George W. Bush during his second term was his campaign promise to provide greater incentives for employers to provide health insurance. And McCain talked about mandatory insurance, and tax credits to pay for it.
So I really don’t see why Republicans are objecting to mandatory insurance. Also, since health insurance is an interstate commerce issue (e.g., some people can’t get their insurance policies to cover out of state care) the 10th Amendment doesn’t really apply, although subsidiarity might.
The real problem with the Act, besides abortion and euthanasia-related matters, is that it was all passed as one lump, which shows it to be a powergrab by the Democrats, not a real attempt at reform.