Mandatory Health Insurance in California

Do you live in California and don’t have insurance? Well, if one part of Gov. Schwarzenegger’s plan is put in place you’ll be tracked down by either the state or a contractor, signed up to a plan and then fined until you start paying for the insurance plan they signed you up with.

People who refuse to obtain health insurance could be tracked down by the state or a private contractor, enrolled in a plan and fined until they pay their premiums under one proposal Gov. Arnold Schwarzenegger’s administration is considering as part of his vision for covering all Californians.

Can’t afford it? Too bad. Between jobs? Cry me a river. Of course it might not be that bad, the state might simply take the money from you paycheck before you get it.

Other proposals, which Schwarzenegger included in the first draft of his healthcare plan, are to attach the wages of people who don’t buy insurance and to increase the amount they owe in state income taxes.

The soft velvet over the hammer of the Nanny State isn’t all that soft now is it?

Seriously though if you are going to have universal health care this is nothing all that shocking in my view. After all, with hospitals legally required to treat people, health insurance for the healthy who have few assets insurance is a sucker’s game. Skip out on purchasing it and save the extra money, and if you do happen to need it just don’t pay. Sure, you’ll wreck your credit for awhile, but if you are young you can wait. So, force the healthy back into the market, force everybody to a pooling outcome so that the healthy can subsidize the unhealthy.

Peter Harbage, a senior program associate with the nonpartisan think tank the New America Foundation, said relatively few people would have to be forced to buy insurance. Schwarzenegger has cited the foundation’s research in helping to frame his plan.

“Most people are going to have insurance if the program is well designed and well constructed,” he said in an interview Tuesday. “And then you’re going to have some people who are bad actors, and that’s where you need some sort of tracking system.”

Absolutely right. If people are going to insist on letting the state dictate things to them, well then the state will simply have to crack down on these people. Fine them till it really hurts.

FILED UNDER: Economics and Business, Health, US Politics, , , ,
Steve Verdon
About Steve Verdon
Steve has a B.A. in Economics from the University of California, Los Angeles and attended graduate school at The George Washington University, leaving school shortly before staring work on his dissertation when his first child was born. He works in the energy industry and prior to that worked at the Bureau of Labor Statistics in the Division of Price Index and Number Research. He joined the staff at OTB in November 2004.

Comments

  1. Maniakes says:

    A concept I’ve been working on for dealing with care for the uninsured:

    If you need health care you can’t afford, the government will pay it for you. But you have to pay them back, like a student loan.

    Obviously, there are implementation issues like whether the government imposes reimbursement rates for certain procedures, what procedures get covered, and at what point do you stop lending money to someone who won’t be able to pay it back. But I like my framework better for providing a safety net for the self-insured than either the current system (mandatory emergency room care, and the hospital eats the bill if the patient defaults) or mandatory insurance.

  2. ken says:

    The solution is to pay for health care for everyone through a progressive income tax on all income without exception, including dividends and municipal bond interest. It is the only sensible and fair way to solve this problem. Plus, for the vast majority of people the tax will be significantly lower that the premiums they are now being charged by insurance companies.

  3. Triumph says:

    The soft velvet over the hammer of the Nanny State isn’t all that soft now is it?

    Arnie’s plan is swiped from Romney. The whole thing is nothing but a giveaway to the insurance industry.

    The beauty of single-payer is that patients choose their provider–not the feds or some insurance company.

  4. anjin-san says:

    All this talk about the “healthy” somehow getting shafted has a bit of a flaw. Even healthy, young people have accidents. They fall off ladders, they slip in showers. The statistics of accidents requiring medical treatment by age group would be interesting to look at, as people tend to get less reckless as they get older.

    The healthy can also suddenly become unhealthy. Those of us who have lived a bit longer know this all too well. I personally know several young, healthy people who developed serious, life-threatening illness in the last few years. They now need pretty much constant medical care just to stay alive.

    So lets figure in these facts into the rather simplistic view that the healthy are forced to carry everyone Else’s water.

    Maybe the health care equivalent of a “good driver discount” could be given to folks who are fortunate enough to need little medical attention.

  5. All this talk about the “healthy” somehow getting shafted has a bit of a flaw. Even healthy, young people have accidents. They fall off ladders, they slip in showers.

    …at which point they’re not classified as healthy anymore. It doesn’t change the fact that, overall, the healthy subsidize the unhealthy by definition. True, one never knows when one might move out of the healthy category. It still bothers me less, though, when the subsidy is optional and not forced.

  6. just me says:

    Anjinsan-also accidents, unless they leave permanent problems happen, but they are one time events-expensive in that one time, but eventually payable.

    Chronic health issues are what are being subsidized by the healthy.

    A one time fall from a ladder that results in a broken leg will run several thousand dollars to fix-and may not even surpass the amount in premiums paid over the course of a year. But somebody with severe asthma or diabetes runs that yearly.

    I am in the “healthy” catagory. I havent been to a doctor for anything other than physicals in the last 6 years except for one case of the flu.
    I have no chronic conditions, and I take no medications other than the occassional motrin/tylenol, which insurance doesn’t pay for anyway.

  7. spencer says:

    The unabrewer says the healthy subsidize the unhealthy.

    That is why it is called insurance.

    What do you think the purpose of insurance is?

    Why do you think your mortgage holder requires you to have homeowners insurance or the state requires you to have auto insurance?

  8. In reverse order:

    Why do you think your mortgage holder requires you to have homeowners insurance or the state requires you to have auto insurance?

    I’m not forced to either own a car nor have a mortgage. I suppose I’m not forced to stay alive either; I could commit suicide and avoid the health insurance requirement.

    The unabrewer says the healthy subsidize the unhealthy.

    That is why it is called insurance.

    What do you think the purpose of insurance is?

    Didn’t I already concede this by definition? I merely pointed out that I find a big difference between voluntary and involuntary.

    When I looked up the definition of insurance I kept seeing the word “contract” a lot. Mandatory insurance sounds like the kind of contract that either my signature or my brains will be on.

  9. Steve Plunk says:

    Having the healthy subsidize the unhealthy is not insurance, it’s just a subsidy.

    Insurance is paying premiums as part of a pool who share risk. Health care cost in America cannot be solved through our present insurance system. There are no incentives to shop smart and avoid going in every time the kid has the sniffles. There are no incentives for providers to think in economic terms.

    Basic health maintenance should be the responsibility of each individual not the responsibility of society. Insurance should cover unexpected costs not daily prescriptions. What many here are talking about is not insurance but plain old redistribution of wealth.

  10. just me says:

    Why do you think your mortgage holder requires you to have homeowners insurance or the state requires you to have auto insurance?

    I live in a state that does not require me to have auto insurance. So unless I choose to finance my car, I can go without, although I do assume the risk of having to pay if I am in an accident, but the risk assumption is my choice in the state I live in.

    It is obvious why mortgage holders and lein holders require insurance, because they don’t want to assume that risk, so if you want their money, you have to buy the insurance, and if I don’t want to buy the insurance, then I can choose instead to rent my home or in my state at least buy a car that I don’t have to take out a loan on.

    I will buy this comparison the day the government starts requiring that everyone have a car and buy their own home.

    The reality is that some healthy people do choose to assume the risk for their health needs. I have a self employed neighbor in his early 30’s-he doesn’t carry medical insurance because he doesn’t think the payment is worth the risk.

    I don’t think the government should force him to buy insurance if he doesn’t want to buy it. I don’t know that his assumption of risk is wise, I wouldn’t do it, but it is his choice to make.

  11. Andy says:

    I don’t think the government should force him to buy insurance if he doesn’t want to buy it. I don’t know that his assumption of risk is wise, I wouldn’t do it, but it is his choice to make.

    And so the taxpayers will end up paying for any serious injury or accident that befalls him. (Unless he happens to have a hundred thousand or so in liquid assets.)

    If we are to maintain the system of providing at least emergency care to any and all, there needs to be some accounting for the transfer of risk from the uninsured to the taxpayers. Otherwise, the uninsured are taking advantage of everyone else. If they can afford health insurance, they should be required to get it, because the other option, eliminating emergency care, is completely immoral.

  12. G.A.Phillips says:

    I got the solution, a new tax on registered Democrats and the other liberals to pay for all the goofy programs they come up with and give us sane people our damned money back so we can bail them out with our christian charity when they ruin their lives with the socialism. even better we could split the taxing system between the Conservatives and liberals each tax by his own to pay for his own for say like the next ten year and whoever comes out on top we will stick with that one, the only problem I see is getting the liberals to believe that their failings are not success and that’s gonna be harder the hitting the moon with a busted slingshot.

  13. Andy says:

    That’s quite clever G.A., but you forgot to blame Clinton in your nonsensical rant.

    But you should note that blue states tend to pay more in taxes than they receive from the federal government in spending, and the red states are recipients of quite a bit more federal spending than they pay in taxes.

    I’d be happy to cut the conservative welfare queens off from the tax spigot.

  14. anjin-san says:

    I guess GA is not upset about the half trillion Bush has blow in Iraq, or the endless river of Pork that flowed out of the GOP congress. After all Chevron & Exxon NEEDED a break.

    But something that might actually benifit a few average folks, well that pisses him off.

  15. G.A.Phillips says:

    I will always be nonsensical to those who understand nothing but hatred, and I am an average folk who blames no one but myself for my life, and you might want to put a little time into the study of charity and difference between it and the Marxist control of the masses. One more thing I am upset about all taxes, 95% of witch are not but legalised theft.

  16. And so the taxpayers will end up paying for any serious injury or accident that befalls him. (Unless he happens to have a hundred thousand or so in liquid assets.)

    Alternatives to that have been mentioned, like Maniakes loan program. Or just me’s neighbor could live (or not) with the consequences of his mistake. Or he could turn to charity.

    But I don’t think any of that will happen. In reality, just me’s neighbor would probably just end up paying for someone else’s pap smears, insulin, and tetracycline.

  17. Furthermore, what’s the difference? Mandatory insurance pools everyone’s money together and pays out catastrophic claims. Taxpayer bailout pays out catastrophic claims from pooled money.

  18. Andy says:

    Furthermore, what’s the difference? Mandatory insurance pools everyone’s money together and pays out catastrophic claims. Taxpayer bailout pays out catastrophic claims from pooled money.

    With “taxpayer bailout”, responsible taxpayers with health insurance pay for the irresponsibility of others through their high rates and high taxes. That’s why a tax penalty for those who choose to go uninsured is a reasonable penalty.

  19. That’s why a tax penalty for those who choose to go uninsured is a reasonable penalty.

    No, it’s not reasonable at all, because it starts with the assumption that they don’t pay their own medical bills when they acquire them.

    If there are uninsured people out there not paying their medical bills, solve that problem. There’s no need to punish just me’s neighbor, who sounds like he’s doing just fine.

    From the original article:

    People who refuse to obtain health insurance could be tracked down by the state or a private contractor, enrolled in a plan and fined until they pay their premiums…

    I just don’t understand how that can not put a chill down one’s spine.

  20. Andy says:

    If there are uninsured people out there not paying their medical bills, solve that problem. There’s no need to punish just me’s neighbor, who sounds like he’s doing just fine.

    What about police and fire protection?

    They are paid for out of general taxation, and they are available to all residents.

    Should we make people get police insurance? Fireman insurance (rather different from fire insurance)?

    We offer emergency care to the general public on the same basis as police and fire protection. Why are they billed differently?