Posted on 06/22/2005 4:47:29 PM PDT by inquest
Massachusetts residents who choose not to obtain health insurance would face tax penalties and even the garnishing of their wages under a proposal Governor Mitt Romney unveiled yesterday.
-snip-
Under Romney's proposal, uninsured Massachusetts residents would be asked to enroll in a plan when they seek care.
If they refuse, the state could recoup the medical costs in several ways, Romney said yesterday: The state might cancel the personal tax exemption on their state income taxes, which is worth about $175. It could withhold some or all of their state income tax refund and deposit it in what Romney called a ''personal healthcare spending account." Or, it might take money out of the person's paycheck, as it does now to collect child support.
(Excerpt) Read more at boston.com ...
That sounds a lot like "government funds surplus".
If they refuse, the state could recoup the medical costs in several ways
. . .it would seem it only applies to those who do not pay their bills.
The manner in which this is being managed might be wrong, but from a conservative standpoint, it is very correct to require people to reimburse the state for monies paid out for their medical care.
What is moderate about personal responsibility? Where do you see a problem with Mitt's idea on health care? Are you for Hillary care? Are you for the status quo? Which would be better? Are you for no health care? Are you for higher taxes? Where is Mitt moderate on this issue?
All I would like you to do is answer the last question to me, the rest of the questions may help you develop an understanding of the issue at hand.
Can you drive a car in your state without insurance? Can you mortgage a house without insurance? Should you have access to medical care without insurance or some proof that you are prepared to pay for it? What is wrong with personal responsibility?
It's sophistry to claim that they are totally different. The fianacial harm from a crash could also be something that "society chooses to bear". In fact, it did so in the not-so-distant past.
How is it "un-conservative" to require people to pay for what they use? If it were "un-conservative" it probably wouldn't be supported by Gingrich and the Heritage Foundation.
Maybe that's true in some states, but according to the article, it's not true in Massachusetts:
"Currently, people without health insurance often go to hospitals and receive care they never pay for, because the hospital and the state pick up the tab."
Dear inquest,
Then, do you have a problem with the state of Massachussetts saying, "If you refuse to buy health insurance, and you require health care, we will come after you for payment."?
Apparently, that is all that Gov. Romney is talking about.
I'd go further, knowing that the state will be unable to get much out of most of the folks who are uninsured and require lots of expensive health care.
sitetest
It would seem so from that statement, but then the article goes on to decribe one of the "several ways": "It [the state] could withhold some or all of their state income tax refund and deposit it in what Romney called a 'personal healthcare spending account.'"
That's not "recouping the medical costs". Essentially, the article's contradicting itself here.
I don't think it is. See #70.
It's not something that the victim chooses to bear. That's the (very big) difference.
You're talking about the same Newt Gingrich who recently stated that Hillary Clinton knew better than anyone else about what to do about health care in this country? No thanks, I'll get my "conservatism" elsewhere.
Dear inquest,
The article is confusing, but that may be the fault of the article, rather than the governor's proposal.
Here's the entire paragraph:
"If they refuse, the state could recoup the medical costs in several ways, Romney said yesterday: The state might cancel the personal tax exemption on their state income taxes, which is worth about $175. It could withhold some or all of their state income tax refund and deposit it in what Romney called a 'personal healthcare spending account.' Or, it might take money out of the person's paycheck, as it does now to collect child support."
The paragraph IS almost internally contradictory, bordering on incoherent. I suspect conflation of several more elaborate points due to sloppy editing. I have a former journalist who works for me, and I see this in his writing frequently.
I suspect that what is being said here might go something like: If you don't have insurance, you refuse to get insurance, and you use healthcare for which you can't pay, we'll seize some of your money (income tax returns, garnished wages, etc.) to pay for your health care, and in the process, we will create a health savings account for you, and any money we take from you beyond what you owe for your healthcare, we will deposit in your health savings account.
An alternative reading is that the money will first be put in a health savings account for you, and then be used to pay the healthcare expenses you've already incurred (which may result in tax savings to the consumer).
There are other alternative readings, but they become increasingly self-contradictory.
From this article, it really isn't all that clear what the governor has proposed for folks who refuse the individual mandate.
However, I think it's fair to say that the thrust of the governor's actions is likely to force folks to either maintain health insurance, or force them to pay for at least some portion of the healthcare costs they incur.
If that is what the governor is proposing, do you disagree with it?
If further reporting on this reveals a different agenda (and it might), then that would be a different story.
sitetest
The estimates tend to the high side when policy decisions are on the table but most folk without insurance are wiser shoppers than those who simply hand over a card.
Forcing everyone to participate will only serve to raise the demand for services since the holders of policies will act as though they are deserving of a tangible reward for having parted with their money and the ERs will still be crowded, there will still be tons of unpaid bills (deductibles) and the mortality tables will remain much the same.
Mass residents does not include illegal aliens of course - illegals will not be required to obtain insurance. Illegals will end up getting a free ride while we get taken to the bank - thank the politicians for their infinite wisdom.
Dear Old Professor,
"Forcing everyone to participate will only serve to raise the demand for services since the holders of policies will act as though they are deserving of a tangible reward for having parted with their money and the ERs will still be crowded, there will still be tons of unpaid bills (deductibles) and the mortality tables will remain much the same."
It may be that if all the uninsured were to become insured, and if they were required to pay their own premiums, that their demand for healthcare would exceed the value of the premiums that they paid. If that's the case, then the problem becomes an underwriting problem, and a plan design problem.
However, right now, the problem is that the rest of us are paying for their healthcare, and it appears that in Massachusetts, they are not required to make any of their own contribution to that healthcare at all.
Although I don't know of any studies that bear out the assertion, I also think that it is likely that folks who have insurance to go to the family doctor when they have a serious, but non-emergent, health problem may be more likely to go to the family doctor, rather than the emergency room at the local hospital. Receiving basic healthcare at the emergency room is a rather expensive way to do things. An individual's use of healthcare could increase significantly, without spending additional money for it, if that individual merely sought out healthcare in a more normal fashion.
It's at least worth a try to attempt to get more folks insured, and using healthcare resources without routine resort to hospital emergency rooms.
sitetest
I agree with your premise, if they have traditional health care plans with a $10 copay for all doctor's visits. However, if they choose to purchase a much less expensive "high deductible" health plan, where the patient pays for his/her first $1,000 of health care per year, then I don't think we'd see an increase in demand. Actually, if more people would choose these plans, then we'd actually see a decrease in overall demand...we would move back in the direction of how health care was pre Medicare.
I don't see him as being moderate on this issue, more off the charts.
Health care? It's so screwed up that a simple person like me has no answer. I do know a few things, though.
1. Get rid of health care insurance. As at least one other poster noted, it has helped the price for any medical care go through not only the roof but the stratosphere. Insurance companies, bless their hearts, are not charity orgs. They are profit driven companies, and I am not faulting them for that. But they need their money, and our money becomes their money, and the price of dr visits and eveyrthing else goes up, up, up.
2. Tort reform. Lawyers need to be muzzled, restrained, put in strait jackets, and defanged.
3. Medical savings accounts sound good.
4. Other kinds of medical licenses could work; a lot of Americans already visit "alternative" caregivers such as chiropractors, acupuncturists, massage therapists, and the like. Actually many of these people are very qualified and knowledgeable, and could help peoples' health before it gets irreversibly bad, thus needing more expensive and invasive methods.
5. Even regular medical schools could offer other kinds of degrees - for instance, there has been a proliferation of "nurse practitioners" who are very knowledgeable and can do much that a regular doctor can do, but presumably less schooling, and therefore cheaper to become one.
6. Related to health insurance - if people have to pay, out of pocket, for each visit and each pill, they will not be so profligate with going to the doctor for each cold and flu, and not be so stupidly demandind of pharmaceutical drugs for same. Which generally do no good anyway. There's a huge problem with over prescribing anti-biotics for every cold and flu, which do no good whatsoever, and just screw up peoples' health anyway.
How's those for starters?
And for really poor people, doctors and nurses who are so inclined (there are some, in this area there is a clinic for low income people staffed by retired nurses and doctors who wanted to work there) can work for less money, on a sliding scale, so people can afford it who have little money.
And, in the past, churches and private organizations took up the slack to help the poor. If taxes were lowered (which they should be), private individuals such as you and me could afford to donate more to our favorite charities, and help the poor that way. Much better use of money.
What do you think of those ideas, just off the top of my head?
That implies that the person in question would actually be capable of paying off the bills in the first place. If that's the case, then once they do, the state should have no further business with them at all.
An alternative reading is that the money will first be put in a health savings account for you, and then be used to pay the healthcare expenses you've already incurred (which may result in tax savings to the consumer).
And I find that rather convoluted. If you're making them pay the bill, there's no need to have the money stop over at a separate account; just have them pay the bill. The state can still write it off from their taxable income without setting up any type of account. All it requires is a line on the tax form: "How much did you pay on medical expenses this past year?"
However, I think it's fair to say that the thrust of the governor's actions is likely to force folks to either maintain health insurance, or force them to pay for at least some portion of the healthcare costs they incur. If that is what the governor is proposing, do you disagree with it?
I disagree with making them get insurance, because that's just a form of corporate welfare. The state should not be forcing people to do business with any private entity they don't want to do business with. But it can make life difficult for people who incur expenses (of any kind, not just health care expenses) that they're not able to pay. As far as I know, there are already consequences for doing just that, which people are shielded from when it comes to health care. Just remove that shielding from people who are able to afford insurance.
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