“Gaming” the Universal Health Care System

Dean Baker has an interesting discussion of the differences between the health care plans of Barack Obama and Hillary Clinton. While ultimately, I think that either plan will necessarily undergo huge changes before it reaches any as yet unproduced bill, it is interesting from a nuts-and-bolts perspective to see what the real effects of each plan might be:

Beat the Press Archive | The American Prospect

Actually, even a mandate will not get to universal coverage, as Leonhardt notes. The purpose of the mandate is to prevent gaming of the system. If everyone has the option to buy into the system whenever they want, and to pay the same price regardless of any pre-existing conditions (a part of both candidates’ programs), then healthy people have no incentive to buy insurance. They can pay minor expenses out of pocket and hold off buying insurance until a point where they actually do have major medical expenses.

I don’t see this as a particularly huge concern in the first place, to be honest. I think most people would recognize that, even if you can wait a few more years before the Parkinson’s really kicks in, no such timeline exists for your next motorcycle accident. What might happen is that people stick with their current employer-provided health care systems until they realize those systems cannot pay for what they need and then swap over to the national system. THAT could be a real problem.

And beyond that, we need to begin to realize that we are all responsible for and we all pay for the health and wellbeing of our neighbors. This isn’t some fluffy-white-clouds Liberal ideal, but a very practical reality of our health care system. Universal Health Care is not an entitlement system, it is a nation-wide infrastructure in the exact same way roads and bridges are. In the exact same way that broadband and wireless Internet access aught to be considered, but that’s another story.

We don’t discriminate between who can and who cannot use the roads based on income, and all of us pay for the upkeep and maintenance of those roads. You don’t need to imagine what the costs might be if only those who can afford to pay for roads got to use them, you only need to walk into the emergency room.

By Tommy Belknap

Owner, developer, editor of DragonFlyEye.Net, Tom Belknap is also a freelance journalist for The 585 lifestyle magazine. He lives in the Rochester area with his wife and son.