First off, I acknowledge from the get-go the various reasons WHY our healthcare system has become so expensive. I also support individual-driven solutions to the growing problem (I'm being very vague at the moment on purpose).
However, I've recently been thinking about the individual mandate. I'd hate to be just another "fake libertarian" who claims libertarianism as his philosophy and yet commands a completely different set of ideas. Instead, I'm trying to focus on real solutions that will simultaneously benefit the group, as a whole, as well the individual.
Almost my entire family, from my father to my mother to my three cousins I grew up with, etc, are all nurses. They're feeling the brunt of the problem in their daily lives. For my father, his pay has actually been declining steadily ever since his hospital group began covering the costs of patients who do not pay.
My cousin Melissa and her husband Frank are both nurses in LA. Frank works at the county ER and sees immediately the problem of users and abusers. People abuse the system, in plain English. And this statement comes from a guy who wants some sort of universalized medicine. People receive a service, and they don't pay. Obviously, what happens next is the rest of America with health insurance end up paying higher costs for those who don't have any. This is a problem.
Which brings me to the mandate. We all know that in support of this mandate, advocates have also brought up the individual mandates on car insurance. Those mandates seem reasonable to the vast majority of Americans, and well, even to me. I have always supported a basic, bare-minimum insurance mandate for drivers because before the mandates were in place, lawsuits arising from no-insurance accidents caused a system-wide overload. Endless lawsuits also have a way of financially punishing third party participants. Libertarians, and myself included, strongly believe that laws should protect individual rights but must also consider the well-being of non-participatory third party members. In other words, person A and person B should be free to engage in a transaction of sex and money so long as it does not harm person C (a non-participatory third party).
If one can support the mandate on basic car insurance that would reduce the level of tort that financially injures third parties (in that case, the taxpayer), then it would be a logical extension to support the mandate on individual HDICs that would reduce the level of financial culpability that financially injures third parties (in that case, the middle class American who does carry insurance).
The only other option would seriously be to repeal the Emergency Medical Treatment and Active Labor Act, which requires all (or most) hospitals and ambulances to treat anyone regardless of national origin, race, or ability to pay. The EMTALA is an unfunded mandate that has existed since 1986. The individual insurance mandate being debated today would be the funding for the EMTALA. Otherwise, in order to be successful in our endeavor to reduce costs without denying care outright, this seems to be the only option.
Despite the fact that it encroaches on the individual's personal liberty, it at least ensures that all non-participatory third parties will not be seriously injured because of the careless acts of others. And yes, for the most part, many of these people who go without insurance are careless. But we can debate the merits to that argument some other day.
Any thoughts? [h=1]
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