As the battle over health care continues, one important question is whether health insurance should be mandatory or not. That is, should people be required to purchase such insurance?
On one hand, it can be argued that health insurance should be a matter of personal choice. After all, a person should be able to decide how to spend his/her money and also be able to judge whether or not health insurance is worth the cost. While health insurance seems like a good idea, as John Stuart Mill argued, we have no right to compel people to do what is good for them or even what would be a smart thing to do. After all, it would be good and smart for a person to exercise and eat wisely. However, it would seem that we should not force people to do either.
To use an analogy, consider renter’s insurance. It is a good idea to have such insurance, so if your stuff is destroyed or stolen, then you will (probably) be covered. However, people are not and should not be required to have it. After all, it seems to be a person’s right to asses the risk of loss and the value of their own possessions. The same, one might conclude, should be true of health insurance as well.
On the other hand, it can be argued that it should be mandatory. One reason is that people can be justly compelled to do what is in their own good-such as going to school or getting vaccinations. Of course, people do have arguments against these specific things as well as general arguments against forcing people to do what is good for them.
A second reason is that a person’s health is not just of concern to them. After all, if someone is sick or injured and cannot pay the medical bills, the burden falls on the rest of us. True, their financial life will no doubt be ruined, but the person will also burden the rest of us with the cost of the care. While we seem to have a moral obligation to treat the sick and injured, we do not have a moral obligation to support those who could have provided for their own expenses, but decided not to.
To use an analogy, consider automobile insurance. In Florida you cannot register your vehicle without proof of insurance. One very good reason for this is that drivers interact (and crash into) other people. Since a driver can do considerable damage to other people and their vehicles, they need to have insurance to cover such occurrences. Failure to do so would be irresponsible and also harmful to others. After all, why should I pay for an accident that is the fault of another? As such, it makes sense to require people to have insurance.
Likewise, when someone gets sick or injured, it would be irresponsible and harmful to others if they had to pay for the uninsured person’s medical care. So, if a person wishes to op out of insurance, then they should be required to pay for any services they receive. They should also be require to complete a legal document specifying that they refuse any treatment that they cannot afford to pay for. While this might seem harsh, that is the price of choice. If someone wishes to gamble with their well being in the hopes if saving money, that is their call. However, they cannot expect everyone else to bear the expense of their gamble. As with normal gambling, it would be wrong to expect other people to bear the burden of someone who risked big and found that his luck was not up to the challenge.
An obvious concern is that some people go without insurance not because they chose to save money, but because they cannot afford it.
From a moral standpoint, such people should not be denied essential medical care. After all, letting someone suffer and perhaps die because they were not fortunate enough to be able to afford insurance would be an act devoid of compassion and would seem morally wrong.
One way to deal with these matters is to require everyon to get health insurance while providing some options. People who can afford their own would have to get a minimal level (just as with automobile insurance). There could also be an option for hard core libertarians and free market foks so that people can voluntarily opt out of insurance. Perhaps they could even be given a tax break as well, so that they would not be paying to provide insurance for others. However, such folks would have to pay for their own medical care or be denied service, even if that means that they die (or are put down by the invisible hand, depending on how you want to see it).Of course, such folks would have to be tagged or chipped in some manner so that even if they were brought into a hospital while unconscious the admission folks would be able to check their finances to see if the person can afford his care. If not, then he would be sent away, perhaps to some free clinic.
Folks who cannot afford their own health insurance would get government provided insurance, presumably based on existing programs like Medicare. Of course, since they are not paying their own way, perhaps they should only be able to get basic services. This seems harsh, of course. But, suppose that you went to a restaurant and ordered a meal. After eating, your check arrives and you find that you have been billed for part of the meal that the folks behind you ate. Annoyed, you call for the manager, who informs you that you and the other folks who could pay their own bill were merely paying for those who could not pay for their own meal. Surely, he says, you could not be so petty and cruel as to deny someone a meal simply because they cannot pay for it? On the way home, you stop to get gas and find that you helped pay to fill the tank of someone who could not afford gas.
So, is this sharing the burden and doing your part for others who are less fortunate? Or are you being exploited? Or something else (no false dilemmas here, folks)?