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Thanks to the ACA, a larger share of Americans have health insurance than ever before because its compulsory. this shouldn't an argument for the ACAs effective

Thanks to the ACA, a larger share of Americans have health insurance than ever before because its compulsory. this shouldn't an argument for the ACAs effectiveness. I have to buy car insurance if i choose to drive a car on public roads. i have to pay income tax if i have income. now, by birth, i automatically owe the state. i'd like my freedom and right to choose back please. the fact this isn't the main argument from GOP shows their incompetence.

dlp211 10y ago
You pay for private insurance or you pay for public insurance via taxes. Any other solution is unworkable and you are a free rider.
- 67726e 10y ago
  Or you pay a hefty tax penalty. Hardly "free"
- thomasthomas 10y ago
  i'd like the choice to not have any insurance
  - mikeash 10y ago
    How will you ensure that paramedics won't take you to the hospital if you have a sudden event in the street?
  - d_e_solomon 10y ago
    Just to be sure - if you show up at the hospital w/o means of payment - even if in coma - are you going to be treated? If yes, then you have insurance and you're free-riding on the system. If no, then you're more barbaric than Reagan.
  - nyxtom 10y ago
    That's not a sustainable choice for our economy, it leads to too many people living like nothing could possibly go wrong until they need a doctor. The point of insurance is to distribute risk, not participating in that effectively negates the effectiveness of the industry.
    - MR4D 10y ago
      That's not quite true. For instance, life insurance takes a varying times for it to kick in (varies depending on type and amount, as well as which state's laws apply.) It's quite possible that your health insurance could be limited at first, and grows to cover more things and higher dollar amounts. And before anyone says you can't do this, go look at your dental insurance. Odds are that your coverage increases each year so long as you have two checkups annually and don't let a lapse of insurance occur. Note that as the ACA is __currently__ written, the situation the OP states probably exists.
      - dlp211 10y ago
        And what happens when you're 18 and get cancer? Building up may work for dental because even in the most catastrophic case, the costs have a ceiling, but your overall health doesn't have these kinds of ceilings. Also, every dental plan I have ever had has lifetime maximums, something else that doesn't work with health insurance.
      - mikeash 10y ago
        I've never heard of anyone getting hit with a million-dollar bill for dental work, so I don't think that's quite the existence proof you want it to be.
    - db48x 10y ago
      You're making the assumption that nobody could possibly pay for their health care out of pocket. That's just not true, even with health care as expensive as it is these days.
      - dlp211 10y ago
  - toodlebunions 10y ago
    You have that choice right now.
  - rrock 10y ago
    I'd like for you, along with everyone else, to pay an increased income tax to cover health care for everyone (the way every other industrialized country does it). And before you reject that notion, try asking someone from one of those other industrialized countries if they'd like to swap their system for ours.
- DougN7 10y ago
  The fact that we have to buy such expensive insurance is what burns me. Before ACA my family had good options for an individual plan (I'm self employed). Now we must pay $20K/year, and don't even get much benefit until we've spent another $5K out of pocket. The scope is what I don't like.
burkaman 10y ago
You actually don't owe the state anything if you can't afford health insurance. So similar to income tax, you can choose not to work and you won't have to pay the penalty. And of course, it's not by birth, you owe nothing if you're dependent on someone else.
nyxtom 10y ago
Choosing to not be insured is unsustainable for our economy the moment you have an issue and need a doctor.
- thomasthomas 10y ago
  so i shouldnt have the right to choose?
  - grzm 10y ago
    You've now made this same point three times in this thread without expanding your argument. Please make each comment each add substantively to the discussion.
    - thomasthomas 10y ago
      because i recognize the futility in expanding my argument which a philosophical one thats been going on for centuries. no ones going to change their minds. if you'd like my expanded argument you should start with 'the road to serfdom' by hayek but i wont attempt to summarize it for you here on HN.
      - grzm 10y ago
        It sounds like you do have something useful to contribute if you chose to do so. If you feel it's futile to contribute substantively, please refrain from doing so. Otherwise it's just noise and distracts from potentially useful discussion.
  - nyxtom 10y ago
    No, because at some point you will inevitable need care. We build care systems in place and pay into them to mitigate and distribute risk. You are effectively free-riding on everyone else's participation.
    - MR4D 10y ago
felipellrocha 10y ago
If, you chose to gamble with your life, and end up not being able to afford medical treatment in the future one of two things ends up happening. You actually notify your doctors before hand that you don't have money, and will elect to not receive any treatment and follow through with your gamble, or someone else will pay for your treatment for you. Most likely every other person who can afford to pay for their treatment via raised prices (which will, in turn, remove more people from the market, more people will gamble, raising prices further in a spiral). Which option do you think is more likely to happen?
- rrock 10y ago
  Which is, of course, exactly what happens: those with insurance subsidize those without. Why do you think a simple bandage or ibuprofen costs so much on insurance? To cover those that walk into hospital ERs, uninsured. It's a hidden tax, highly inefficient, but quite real.
runamok 10y ago
They definitely did push back against the mandate and that was one of the arguments that went to the supreme court. http://www.nytimes.com/2012/06/29/us/supreme-court-lets-health-law-largely-stand.html http://www.nytimes.com/2012/06/29/us/supreme-court-lets-heal... Furthermore all of us are consumers of health care at one time or another. I admit I am resentful against the many people that take terrible care of themselves but the fact is 40% of americans will get cancer. http://www.upi.com/Health_News/2010/05/06/41-percent-of-Americans-will-get-cancer/75711273192042/ http://www.upi.com/Health_News/2010/05/06/41-percent-of-Amer... Due to laws like this: https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an... and of course for ethical reasons hospitals can't turn you away when you can't pay. I do feel it all needs urgent reform but I do feel the ACA was an attempt to expand competition and fairness while not leaving it completely unfunded like so many government plans seem to.

dlp211 10y ago

You pay for private insurance or you pay for public insurance via taxes. Any other solution is unworkable and you are a free rider.

67726e 10y ago
Or you pay a hefty tax penalty. Hardly "free"
thomasthomas 10y ago
i'd like the choice to not have any insurance
- mikeash 10y ago
  How will you ensure that paramedics won't take you to the hospital if you have a sudden event in the street?
- d_e_solomon 10y ago
  Just to be sure - if you show up at the hospital w/o means of payment - even if in coma - are you going to be treated? If yes, then you have insurance and you're free-riding on the system. If no, then you're more barbaric than Reagan.
- nyxtom 10y ago
  That's not a sustainable choice for our economy, it leads to too many people living like nothing could possibly go wrong until they need a doctor. The point of insurance is to distribute risk, not participating in that effectively negates the effectiveness of the industry.
  - MR4D 10y ago
    That's not quite true. For instance, life insurance takes a varying times for it to kick in (varies depending on type and amount, as well as which state's laws apply.) It's quite possible that your health insurance could be limited at first, and grows to cover more things and higher dollar amounts. And before anyone says you can't do this, go look at your dental insurance. Odds are that your coverage increases each year so long as you have two checkups annually and don't let a lapse of insurance occur. Note that as the ACA is __currently__ written, the situation the OP states probably exists.
    - dlp211 10y ago
      And what happens when you're 18 and get cancer? Building up may work for dental because even in the most catastrophic case, the costs have a ceiling, but your overall health doesn't have these kinds of ceilings. Also, every dental plan I have ever had has lifetime maximums, something else that doesn't work with health insurance.
    - mikeash 10y ago
      I've never heard of anyone getting hit with a million-dollar bill for dental work, so I don't think that's quite the existence proof you want it to be.
  - db48x 10y ago
    You're making the assumption that nobody could possibly pay for their health care out of pocket. That's just not true, even with health care as expensive as it is these days.
    - dlp211 10y ago
- toodlebunions 10y ago
  You have that choice right now.
- rrock 10y ago
  I'd like for you, along with everyone else, to pay an increased income tax to cover health care for everyone (the way every other industrialized country does it). And before you reject that notion, try asking someone from one of those other industrialized countries if they'd like to swap their system for ours.
DougN7 10y ago
The fact that we have to buy such expensive insurance is what burns me. Before ACA my family had good options for an individual plan (I'm self employed). Now we must pay $20K/year, and don't even get much benefit until we've spent another $5K out of pocket. The scope is what I don't like.

burkaman 10y ago

You actually don't owe the state anything if you can't afford health insurance. So similar to income tax, you can choose not to work and you won't have to pay the penalty. And of course, it's not by birth, you owe nothing if you're dependent on someone else.

nyxtom 10y ago

Choosing to not be insured is unsustainable for our economy the moment you have an issue and need a doctor.

thomasthomas 10y ago
so i shouldnt have the right to choose?
- grzm 10y ago
  You've now made this same point three times in this thread without expanding your argument. Please make each comment each add substantively to the discussion.
  - thomasthomas 10y ago
    because i recognize the futility in expanding my argument which a philosophical one thats been going on for centuries. no ones going to change their minds. if you'd like my expanded argument you should start with 'the road to serfdom' by hayek but i wont attempt to summarize it for you here on HN.
    - grzm 10y ago
      It sounds like you do have something useful to contribute if you chose to do so. If you feel it's futile to contribute substantively, please refrain from doing so. Otherwise it's just noise and distracts from potentially useful discussion.
- nyxtom 10y ago
  No, because at some point you will inevitable need care. We build care systems in place and pay into them to mitigate and distribute risk. You are effectively free-riding on everyone else's participation.
  - MR4D 10y ago

felipellrocha 10y ago

If, you chose to gamble with your life, and end up not being able to afford medical treatment in the future one of two things ends up happening. You actually notify your doctors before hand that you don't have money, and will elect to not receive any treatment and follow through with your gamble, or someone else will pay for your treatment for you. Most likely every other person who can afford to pay for their treatment via raised prices (which will, in turn, remove more people from the market, more people will gamble, raising prices further in a spiral). Which option do you think is more likely to happen?

rrock 10y ago
Which is, of course, exactly what happens: those with insurance subsidize those without. Why do you think a simple bandage or ibuprofen costs so much on insurance? To cover those that walk into hospital ERs, uninsured. It's a hidden tax, highly inefficient, but quite real.

runamok 10y ago

They definitely did push back against the mandate and that was one of the arguments that went to the supreme court. http://www.nytimes.com/2012/06/29/us/supreme-court-lets-health-law-largely-stand.html http://www.nytimes.com/2012/06/29/us/supreme-court-lets-heal... Furthermore all of us are consumers of health care at one time or another. I admit I am resentful against the many people that take terrible care of themselves but the fact is 40% of americans will get cancer. http://www.upi.com/Health_News/2010/05/06/41-percent-of-Americans-will-get-cancer/75711273192042/ http://www.upi.com/Health_News/2010/05/06/41-percent-of-Amer... Due to laws like this: https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an... and of course for ethical reasons hospitals can't turn you away when you can't pay. I do feel it all needs urgent reform but I do feel the ACA was an attempt to expand competition and fairness while not leaving it completely unfunded like so many government plans seem to.