Moffit's basic point is that individual mandates already exist, since taxpayers are already paying for health insurance in the form of uncompensated care and Medicaid and Medicare. He appears to put a lot of the blame on "people who can protect themselves through health insurance" but "are failing to do so."
I'm not sure I agree with that, since he doesn't clarify who he's referring to (I mean, what qualifies as affordable? What makes you too "low-income"? ... I want some percentages on why people don't buy insurance before I'm sold on this), but he has a point that unpaid medical bills are distributed to the rest of us in the form of higher premiums. He calls it "irresponsible" for people to ask others to pay for their bills. Fair enough.
Moffit writes
That's why my Heritage Foundation colleagues and I support the "personal responsibility principle." It's a simple idea: All adults have a responsibility to buy their own health insurance, pay their own health-care bills, and not shift those costs to others.He supports the purchase of "catastrophic" insurance policies as a minimum form of coverage, which I assume can be purchased at a lower price than every day insurance plans. However, he writes, "People who do not wish to buy health insurance for whatever reason should be free to do so."
So no individual mandate for Moffit. I guess I shouldn't be surprised. His suggestion instead? People who "choose" not to purchase insurance "must demonstrate in some tangible way that they are really going to pay their own hospital bills," such as by putting thousands into an escrow or by providing some sort of financial guarantee that they can indeed pay those medical bills, should they incur them.
And if they don't?
The people who choose this option should no longer be able to claim a personal tax exemption when filling out their IRS and state tax forms every year. Somehow, these people should pay something that could be used to offset, to some degree, a portion of the rising costs of the uncompensated care.I guess my problem with his whole argument is that he is operating under the assumption that people choose not to have insurance. And while I admit I live in a little health care news bubble, which tends only to focus on the cases that make you sympathetic, and have my young adult "invincible" tendencies, I'm just not buying it. I don't have a couple thousand to throw in an escrow, Mr. Moffit (in fact, I'm not really sure I even know what an escrow is), unless somehow my college loans and credit card debt are magically transformed into profit. As it stands, I struggle enough with my day-to-day living expenses. And from everything I read, the people without insurance are the self-employed with previous medical conditions, who maybe are solidly middle-class, but can't afford the hundreds or thousands per month that insurance companies want them to pay, or are people who just can't get insurance because they're too sick. To imply that people don't get health insurance because they don't want it is a little elitist/health-ist for my tastes.
To his credit, Moffit does suggest tax credits or vouchers for those who can't afford catastrophic care policies. But at what levels? Is he talking Medicaid levels? Because seriously, those income requirements are a joke. Just because someone makes 110% of the poverty level doesn't really mean that they are any more able to afford health insurance than those making 99% of the poverty level. (100% of the federal poverty level is an annual income of $10,210 for an individual.)
Alright, I'm changing my mind, I agree with Moffit about 70% of the way -- I should have known better than to almost agree with anything the comes out of the Heritage Foundation. In conclusion: Personal responsibility, good. Finger pointing at the uninsured, bad.
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