Friday, March 18, 2011

Health Insurance Subsidies

There has always been one thing that bothers me about the health care reform debate - when people argue against reform on the basis that they don't feel like they should have to pay for someone else's health insurance through government subsidies.

But before everyone reads this and gets angry at me, I want to point out that I am in NO WAY pretending that I am an expert on health care reform; this post is merely my opinion on one simplified aspect of an incredibly complex topic. Take it as you want, and feel free to argue with me in the comments or in person (if I know you). I do love arguing.

Right now, in pre-Obamacare times, we ALREADY treat the uninsured, and those unable to pay for their health care. If someone shows up at an emergency room, they are treated regardless of their ability to pay. They will, of course, be billed after the fact, but if they can't pay, then who does? The hospital has to eat the cost - but many hospitals receive subsides from the government (read: taxpayers) for this type of charity care. So lots of people who otherwise can't afford any health care at all end up at the emergency room either for problems that could have been prevented or that could have been treated much less expensively in a doctor's office.

One of the ideas with health care reform is that by offering subsidies to people so that they can afford insurance, they will be able to see doctors for preventative care. This would ideally lower overall health care costs for these charity patients for a few reasons:
  • the patients' overall health would be better, requiring less care
  • preventative care would keep many chronic diseases at bay instead of declining to a crisis stage that MUST be treated in an emergency room (ex: diabetes)
  • non-emergency health issues and even many crises could be treated in their doctor's office.
Either way, we the taxpayers are paying for this person's health care, but we will be (hypothetically) paying less when we pay for someone's health insurance rather than for their emergency room visits.

So when people argue and say, "Why should I have to pay for someone else's insurance?" I want to respond, "Fine, don't - but if there's a plane crash and people are brought into the emergency room, don't expect doctors to try and revive any of them unless they have their insurance card or a huge wad of cash accessible in their back pocket."

The problem to me is that people want to have their cake and eat it too - people don't want to pay for other people (understandable enough), but the expectation is still that no doctor is going to turn someone away in the midst of a heart attack even if they won't be able to pay for it later - altruism or not, it's also against the law to do that.

So as a taxpayer (one day, I swear I won't be in school and I'll make money and know what it's like to be a taxpayer), if you're paying anyway, wouldn't you rather pay a small amount toward someone's health insurance rather than a huge amount toward that person's emergency room bill? Or if, as a taxpayer, you still don't want to pay, would you be willing to be the one standing at the emergency room doors to turn the sick and bleeding patients away?

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