Insurance mandate: Should the healthy pay for irresponsibility?

RationalAltruism · Mar 13, 2010

Many Democrats are arguing that an insurance mandate is necessary so that everyone will be forced to get health insurance. This is for the sake of cost sharing; nowadays, for instance, many consumers are looking to tighten their belts and find savings everywhere they can. One bet many poor healthy people have made is to not get health insurance because they won't need it enough to justify the cost. Insurance companies lose many of their healthy subscribers, so they lose profit; as a result, those who are too sick remain on the plan, but for the company to offset its losses, it has to increase premiums. This is probably what caused the recent 39% premium increase Anthem imposed, in California. A mandate will prevent the possibility of this happening in the future; people will have to get insurance even if it would not be economically rational, and insurance companies get more profit.

I have two main disagreements with this:

Healthy people should not have to pay for sick people directly because sickness is often caused by poor lifestyle behaviors. If some people make poor decisions about their health, others (the healthy who would be forced to get insurance for cost-sharing) should not be forced to pay for it. Call me heartless, but I think if you eat so much that you're 300 pounds and need coronary bypass surgery or something, you should be the one to pay for it. It's basic personal responsibility.
The government has no imperative to force citizens to buy something simply so that an industry can make more profit. Without the mandate, the people in need will disproportionately desire health insurance more - but that's how it is for every single other good and service the market provides. It's not unfair to the companies, they're voluntarily providing a service (hopefully) and others are voluntarily choosing to purchase that service or not.

Firstly, the healthy should not have to pay for those who make bad decisions and make themselves sick or require expensive surgery or drugs. Of course, there are many ailments which are not caused by negligence, but many are. For instance, eating at McDonalds every other day, or taking the elevator up to the 2nd floor, or using a motorized lawn mower you ride on, or not exercising, etc. Recent advances in technology and manufacturing have increased our ability to stay inactive or to buy cheap, unhealthy goods. You can see the effects of thsese things today:

Obesity:

2/3 of all Americans are overweight.
1/3 of all Americans are obese.

American Health Rankings said:
In 2018, the cost of obesity at a national level is projected to be $1,425 per person.
Source

($1425 per person * ~300 million people = $427,500 million, or $427.5 billion)

Diabetes:

MedicineNet said:
If nothing is done, the number of Americans with diabetes will nearly double in the next 25 years and spending on the disease will nearly triple, a new study shows. ... By 2034, as many as 44 million Americans will have diabetes, up from 23 million today, according to the new projections, published in the November issue of the American Diabetes Association journal Diabetes Care.

The cost of caring for diabetes patients is projected to rise from $113 billion to $336 annually, before adjusting for inflation.
Source
Medical Journal Source

Alcoholism:

CDC said:
Percent of adults who were current regular drinkers (at least 12 drinks in the past year): 50

Number of alcoholic liver disease deaths: 13,050

Number of alcohol-induced deaths, excluding accidents and homicides: 22,073

Source

The bottom line is that poor lifestyle choices are a significant cause of much of our extravagant health care spending. These poor choices should not be subsidized by unrelated third-parties (the healthy) - it creates a moral hazard. People are more likely to make bad decisions if they know others would pay for potential consequences.

Secondly, even if the lack of a mandate gives a company greater cost pressures, that's no reason to interfere with the market simply for the sake of providing the company more profit. We don't force corporations to operate at a loss; why should we force some consumers to operate at a loss (be forced to buy insurance)? This would simply be a giveaway to the insurance companies. They're already making billions of dollars in profits; why should the government interfere simply to give them more, hurting healthy citizens in the process?

Of course, there is one caveat applicable to both of these, which is that some sicknesses are not caused by risky behaviors. It would be quite difficult to fairly and consistently separate those responsible, and given that reducing costs is one of the main reasons for health reform, I don't see a solution, other than the following:

There is also the idea that, whether or not one is responsible for one's ailment, the state nevertheless has a duty to help out financially. While this may have philosophical merit, I don't think it's workable here, given that personal freedom is supposed to be one of the main principles of the country, and that cost control is absolutely necessary.

One last argument for the mandate is that some will buy health insurance only when they get sick, decreasing the insurance industry's profits if they decide to carry you. A possible counter is that the firms may be free to deny your insurance application, which would incentivise getting insurance before you need it, for the sake of cost-sharing among the healthy.

What do you think?

Dirk · Mar 14, 2010

I think first it's more important to ensure everyone has access to good quality healthcare, then start thinking about to what extent they should be held responsible for their own lifestyles - if at all. It is, of course, questionable, whether they should be held accountable, since it can be debated whether or not they're truly to blame.

deanhills · Mar 14, 2010

Dirk said:
I think first it's more important to ensure everyone has access to good quality healthcare, then start thinking about to what extent they should be held responsible for their own lifestyles - if at all. It is, of course, questionable, whether they should be held accountable, since it can be debated whether or not they're truly to blame.

Isn't healthcare one of the important lifestyle factors? You can't really separate the two?

RationalAltruism · Mar 14, 2010

Dirk said:
I think first it's more important to ensure everyone has access to good quality healthcare, then start thinking about to what extent they should be held responsible for their own lifestyles - if at all. It is, of course, questionable, whether they should be held accountable, since it can be debated whether or not they're truly to blame.

Yeah, the issue of paying for health care in general is a more fundamental one. I'm just thinking about, given the fact that the public option is most likely dead, if the mandate would be acceptable or not.

True, ultimate responsibility may not lie with the person, but with the government/education system/parents for instilling the knowledge, beliefs, and willpower the person has. However, even if they are not entirely responsible for their actions, there's a slippery slope for many other social problems.

In addition, no matter if they are truly philosophically responsible or not, having them be the primary financiers of their own potential health troubles would be a useful financial incentive.

deanhills · Mar 14, 2010

RationalAltruism said:
Yeah, the issue of paying for health care in general is a more fundamental one. I'm just thinking about, given the fact that the public option is most likely dead, if the mandate would be acceptable or not.

True, ultimate responsibility may not lie with the person, but with the government/education system/parents for instilling the knowledge, beliefs, and willpower the person has. However, even if they are not entirely responsible for their actions, there's a slippery slope for many other social problems.

In addition, no matter if they are truly philosophically responsible or not, having them be the primary financiers of their own potential health troubles would be a useful financial incentive.

I still think that there is a possibility for having medical insurance for all citizens. If they can do it in Massachusetts, they can for the rest of the country. The Bill that is being proposed is clumsy as it is, maybe they should ask Massachusetts for a formula that can be tested on say two other consenting States for its effectiveness. A trial run. And then take it from there. In the end the Medical Insurance will be State run and not Federally run. As it should be.

Refer: http://en.wikipedia.org/wiki/Massachusetts_health_care_reform

myp · Mar 16, 2010

Insurance, even in a private form still involves healthy people paying for sick people. I am opposed to this mandate as well, but I thought I'd just throw it out there. Insurance companies help people pool their risk and their money and with that make payments out to those who are sick, while those who are healthy just pay premiums and get no benefit. Of course the whole idea of insurance is to protect against what might happen, in which case the healthy could justify their payments.

I would much rather have it left to the private sector where people can decide for themselves whether or not they want to pool their risk as opposed to a mandate which requires everyone to do so.

RationalAltruism · Mar 16, 2010

myp said:
Insurance, even in a private form still involves healthy people paying for sick people. I am opposed to this mandate as well, but I thought I'd just throw it out there. Insurance companies help people pool their risk and their money and with that make payments out to those who are sick, while those who are healthy just pay premiums and get no benefit. Of course the whole idea of insurance is to protect against what might happen, in which case the healthy could justify their payments.

It's important to differentiate between risk sharing and cost sharing. Risk sharing is the fundamental concept of insurance; people pool their assets and the few that are unlucky are protected from bankruptcy. However, with a mandate, everyone has to pay premiums towards the pool (share costs), despite having vastly different levels of risk:

The healthiest 50% current pay 3% of the total health care expenditures. However, a mandate will force them to share costs more, paying primarily for the most expensive 10%, despite the fact that the healthy have most likely practiced generally responsible health habits, and the least healthy 10% are likely to have neglected to practice responsible health habits.

In other words, those with very little risk would be forced to share it with those with relatively high risk.

deanhills · Mar 16, 2010

RationalAltruism said:
Many Democrats are arguing that an insurance mandate is necessary so that everyone will be forced to get health insurance. This is for the sake of cost sharing; nowadays, for instance, many consumers are looking to tighten their belts and find savings everywhere they can. One bet many poor healthy people have made is to not get health insurance because they won't need it enough to justify the cost. Insurance companies lose many of their healthy subscribers, so they lose profit; as a result, those who are too sick remain on the plan, but for the company to offset its losses, it has to increase premiums. This is probably what caused the recent 39% premium increase Anthem imposed, in California. A mandate will prevent the possibility of this happening in the future; people will have to get insurance even if it would not be economically rational, and insurance companies get more profit.

I have two main disagreements with this:

Healthy people should not have to pay for sick people directly because sickness is often caused by poor lifestyle behaviors. If some people make poor decisions about their health, others (the healthy who would be forced to get insurance for cost-sharing) should not be forced to pay for it. Call me heartless, but I think if you eat so much that you're 300 pounds and need coronary bypass surgery or something, you should be the one to pay for it. It's basic personal responsibility.

The government has no imperative to force citizens to buy something simply so that an industry can make more profit. Without the mandate, the people in need will disproportionately desire health insurance more - but that's how it is for every single other good and service the market provides. It's not unfair to the companies, they're voluntarily providing a service (hopefully) and others are voluntarily choosing to purchase that service or not.

Firstly, the healthy should not have to pay for those who make bad decisions and make themselves sick or require expensive surgery or drugs. Of course, there are many ailments which are not caused by negligence, but many are. For instance, eating at McDonalds every other day, or taking the elevator up to the 2nd floor, or using a motorized lawn mower you ride on, or not exercising, etc. Recent advances in technology and manufacturing have increased our ability to stay inactive or to buy cheap, unhealthy goods. You can see the effects of thsese things today:

Although I agree with you in general about there being a difference in people taking care of their health, I would rather use a different method by rewarding those of good health through discounts on their health insurance premiums. If they can show a Doctor's certificate that verifies certain factors, such as they would do to establish the fitness of a pilot to fly, they should be rewarded for taking care of themselves.

Obesity to me is a disease. For someone of normal weight, and who has never struggled with serious obesity it is probably difficult to understand how serious it is as well as how for some, at the weight of 300lb, it is very difficult to loose weight. At that enormous weight, special assistance is needed, medical, behaviourly, lifestyle, nutrition. I believe Society needs to take better care of the obese by making more services available to help obese people to help themselves. When one is at 300lb, your metabolism is usually completely wrecked. You can hardly move, even if you wanted to, and even then the embarrassment to go out must be enormous. And when you cannot move, you cannot go out to ask people for help. By stopping to eat, very few really loose weight. They may loose a few pounds, and then the wrecked metabolism will kick in and weight loss level off. I feel for people like that.

I think society has come long ways to let people know that it is a disease, and there are quite a number of organisations specializing in treatments, but not enough. Society should take responsibility for the junk food that is being sold by large corporations that contain harmful ingredients that make people addicted to that food, as well as make them fat. There should be much stricter regulations about those harmful ingredients. Sodas are also bad as they also contain ingredients that are harmful to health, both the diet and no-diet variety. Excess sugar is immediately converted into fat, and all the additives are usually buried in the fat. A way that this could be dealt with is the same as above. To reward those corporations who sell healthy foods maybe with special tax incentives.

RationalAltruism · Mar 17, 2010

deanhills said:
Although I agree with you in general about there being a difference in people taking care of their health, I would rather use a different method by rewarding those of good health through discounts on their health insurance premiums.

The problem is that even with those discounts, health insurance would probably still be quite expensive, even for healthy people. The lack of a mandate isn't a "reward" - it's the status quo, how the market works.

deanhills said:
If they can show a Doctor's certificate that verifies certain factors, such as they would do to establish the fitness of a pilot to fly, they should be rewarded for taking care of themselves.

Another problem is that it would be primarily the private insurance companies managing this, and they have an incentive to gather as much profit as possible; they'll attempt to deny as many discounts as possible; they have a severe conflict of interest.

The other thing is that not all healthy people are the cause of their own well-being; they may simply have been lucky. Heck, some may even have some bad habits (such as smoking) but not have it noticeably affect their health. In addition, many of the most healthy are also quite well-to-do, and do not need a discount.

The mandate's target population I would presume to be the young, poor, and healthy who want to get by without insurance so they can have extra money to pay for food for the family or for the mortgage, while they would only expend a few hundred dollars on regular annual medical checkups. These are the kinds of people who wouldn't want insurance; anyone well-to-do would probably get basic (high-deductible) insurance anyway, just in case they have a sudden expensive medical emergency.

For these poor healthy people, even a "discount" on their premiums (if that plan is even workable) could leave them significantly worse off than before (especially given the unemployment rate).

deanhills said:
I think society has come long ways to let people know that it is a disease, and there are quite a number of organisations specializing in treatments, but not enough. Society should take responsibility for the junk food that is being sold by large corporations that contain harmful ingredients that make people addicted to that food, as well as make them fat. There should be much stricter regulations about those harmful ingredients. Sodas are also bad as they also contain ingredients that are harmful to health, both the diet and no-diet variety. Excess sugar is immediately converted into fat, and all the additives are usually buried in the fat. A way that this could be dealt with is the same as above. To reward those corporations who sell healthy foods maybe with special tax incentives.

I agree completely. In addition, it might be a good idea to stop subsidizing all that corn we do currently. After all, I'm sure that an extra $7 billion or so in subsidies every year turns into a lot of soft drinks.

EDIT: Prevention of obesity in the first place is a much more cost-effective tool than simply providing services to treat it and increasing taxes on unhealthy foods and decreasing harmful subsidies. That is, with increased education and food-health classes, fewer people would develop the propensity to have obesity in the first place, even with access to all of the unhealthy food they do currently.

deanhills · Mar 17, 2010

RationalAltruism said:
EDIT: Prevention of obesity in the first place is a much more cost-effective tool than simply providing services to treat it and increasing taxes on unhealthy foods and decreasing harmful subsidies. That is, with increased education and food-health classes, fewer people would develop the propensity to have obesity in the first place, even with access to all of the unhealthy food they do currently.

Totally agreed. But how do we prevent obesity? As it is not just a simple matter of eating less. It is a whole lifestyle issue. And some families come with real genetic issues. It is like cancer. People who eat healthy, and lead healthy livestyles, still get cancer. Obesity is really a disease. Not just something that happens when you eat more than you should. For me increased education should include the education about obesity being about more than just eating more food and being lazy. Agreed that some of it starts that way, but then when it does, there should be helping hands everywhere. Right now the reaction is one of embarrassment and shame, rather than compassion with ready clinics to treat people in a holistic way.

RationalAltruism said:
The problem is that even with those discounts, health insurance would probably still be quite expensive, even for healthy people. The lack of a mandate isn't a "reward" - it's the status quo, how the market works.

Another problem is that it would be primarily the private insurance companies managing this, and they have an incentive to gather as much profit as possible; they'll attempt to deny as many discounts as possible; they have a severe conflict of interest.

The other thing is that not all healthy people are the cause of their own well-being; they may simply have been lucky. Heck, some may even have some bad habits (such as smoking) but not have it noticeably affect their health. In addition, many of the most healthy are also quite well-to-do, and do not need a discount.

These are all very good points. Agreed. The tax credits would not be good enough. Healthy people should be able to opt out of the Government plan. It should not be compulsory for all. I wonder how they would be able to administrate that however? As employers would be compelled to provide health insurance for everyone. If there are going to be exceptions who prefer to have their own health insurance, or none at all, how would the exceptions be efficiently administrated?

RationalAltruism said:
The mandate's target population I would presume to be the young, poor, and healthy who want to get by without insurance so they can have extra money to pay for food for the family or for the mortgage, while they would only expend a few hundred dollars on regular annual medical checkups. These are the kinds of people who wouldn't want insurance; anyone well-to-do would probably get basic (high-deductible) insurance anyway, just in case they have a sudden expensive medical emergency.

For these poor healthy people, even a "discount" on their premiums (if that plan is even workable) could leave them significantly worse off than before (especially given the unemployment rate).

More good points. Perhaps the Government should rather try and make the system it has right now more efficient, than start something new that may in the end be much worse than it has right now. I.e. upgrade programs such as Medicare, Medicaid, TRICARE, the Children's Health Insurance Program and the Veterans Health Administration. Symbolically, if the existing health programmes are not working well, there is a good chance that the health care reforms as proposed by Obama may be much worse, especially from a cost point of view.

SpayAndNeuterLibs · Mar 28, 2010

Dirk said:
I think first it's more important to ensure everyone has access to good quality healthcare, then start thinking about to what extent they should be held responsible for their own lifestyles - if at all. It is, of course, questionable, whether they should be held accountable, since it can be debated whether or not they're truly to blame.

Everyone has access, as long as they can pay for it. Emergency care though is a different story. After all there is cost involved in the care of a person. How should the cost be covered, who should pay for it, and why? That's the true question.

Dirk · Mar 28, 2010

SpayAndNeuterLibs said:
as long as they can pay for it.

That's the thing, it's always about money. Everybody should be able to get the treatment they need.

RationalAltruism · Mar 28, 2010

Dirk said:
That's the thing, it's always about money. Everybody should be able to get the treatment they need.

Something else to consider is that "need" is subjective. One might argue that a child "needs" all those vaccinations and that the car crash victim "needs" all that medical treatment, but would you say that everyone suffering from cancer necessarily should get chemotherapy, or that someone in intensive care in the hospital "needs" that extra $5000+ or so necessary to prolong their life a few more hours? (Look up health care expenses used at the end of life, it's quite significant)

The problem is that of "controlling costs" is one of our first priorities regarding health care legislation, saying that everyone should get what they "need" may be antithetical to that goal. I'm not saying I support death panels or anything like that, but if we care about controlling costs, what "need" means is an issue to consider.

myp · Mar 28, 2010

Dirk said:
That's the thing, it's always about money. Everybody should be able to get the treatment they need.

So you are essentially suggesting that health care should be made a right. The problem with that is that in order to make health care a right, you are effectively taking away the rights of others- those who you must steal from to pay for treatment or coerce into doing the treatment.

The alternative is to not make health care a right, but instead to focus on reducing costs and increasing choices. If it was more affordable and perhaps if people had more money in their pocket, not only would more people be able to afford health care, but there would also be more people offering free health care as philanthropy. In this situation, there is no restricting of freedoms or violation of rights.

RationalAltruism · Mar 28, 2010

myp said:
So you are essentially suggesting that health care should be made a right. The problem with that is that in order to make health care a right, you are effectively taking away the rights of others- those who you must steal from to pay for treatment or coerce into doing the treatment.

Another problem to consider is, if health care is a right, is it a fundamental human right as I hear many liberals arguing, or is it a uniquely American right?

If it is a "fundamental human right" then there are many, many other places where health care reform (or attempted changes to the system, or welfare, or something) would have a much greater effect on the people; by that logic, improving those places (Africa, etc) deserve a much higher priority than fixing our own system. In other words, from that train of thought, we are not morally bound to provide for 300 million people; we are morally bound to provide for 7 billion people.

But you'd probably find many people who would oppose increased international aid rather than domestic health care, so perhaps there's a problem with stating that health care is a fundamental human right.

SpayAndNeuterLibs · Mar 29, 2010

RationalAltruism said:
I have two main disagreements with this:

Healthy people should not have to pay for sick people directly because sickness is often caused by poor lifestyle behaviors. If some people make poor decisions about their health, others (the healthy who would be forced to get insurance for cost-sharing) should not be forced to pay for it. Call me heartless, but I think if you eat so much that you're 300 pounds and need coronary bypass surgery or something, you should be the one to pay for it. It's basic personal responsibility.

The government has no imperative to force citizens to buy something simply so that an industry can make more profit. Without the mandate, the people in need will disproportionately desire health insurance more - but that's how it is for every single other good and service the market provides. It's not unfair to the companies, they're voluntarily providing a service (hopefully) and others are voluntarily choosing to purchase that service or not.

I agree, this kind of thinking falls along the lines self-reliance, and accountability. I'm a bit overweight, but I have no one to blame except myself. McDonald's didn't do it to me. I did it to myself through my poor eating and exercise habits. For the past few months I have been doing something about it. If my health care costs more because of me being overweight, then so be it. I am compelled by my sense of self-reliance, and accountability to pay more if need be.

Dirk · Mar 29, 2010

RationalAltruism said:
Something else to consider is that "need" is subjective.

In certain cases.

One might argue that a child "needs" all those vaccinations

Well, presumably, they won't need all of them, but they would require all of them.

and that the car crash victim "needs" all that medical treatment,

Yes.

but would you say that everyone suffering from cancer necessarily should get chemotherapy,

Yes, provided they want it.

or that someone in intensive care in the hospital "needs" that extra $5000+ or so necessary to prolong their life a few more hours? (Look up health care expenses used at the end of life, it's quite significant)

Do they want to live that last few hours? Would you rather be kept on a machine, drugged up and in agony until you die? I wouldn't. It shall be "doctor, more morphine" for me. But there are circumstances where they may wish to hold on until they've seen a loved one, or something. So i think these things should be considered.

The problem is that of "controlling costs" is one of our first priorities regarding health care legislation,

Screw the legislation. It's stupid anyway. It does a few long-overdue additions and does very little of value. I just think everyone should be able to be healthy.

saying that everyone should get what they "need" may be antithetical to that goal.

Money vs human life. I pick the latter.

I'm not saying I support death panels or anything like that, but if we care about controlling costs, what "need" means is an issue to consider.

First, i care very much about the cost. I care about the cost in human life. Whatever we save in currency must NOT be paid in blood.

myp said:
So you are essentially suggesting that health care should be made a right. The problem with that is that in order to make health care a right, you are effectively taking away the rights of others- those who you must steal from to pay for treatment or coerce into doing the treatment.

The alternative is to not make health care a right, but instead to focus on reducing costs and increasing choices. If it was more affordable and perhaps if people had more money in their pocket, not only would more people be able to afford health care, but there would also be more people offering free health care as philanthropy. In this situation, there is no restricting of freedoms or violation of rights.

I don't really know about rights. I just want everyone to be happy, healthy, safe and free. If people want to consider it a right, then i can think of little nobler. But if you mean rights in legislation, i care nothing of it.

myp · Mar 29, 2010

Dirk said:
I don't really know about rights. I just want everyone to be happy, healthy, safe and free. If people want to consider it a right, then i can think of little nobler. But if you mean rights in legislation, i care nothing of it.

I am not sure what you mean. From your previous statements I got the feeling that you feel that everyone should have health care and that society should actively work to provide it. Am I right in that assumption? If so, do you feel that coercion is an acceptable means of providing such universal health care? If not, how would you suggest we do it (the market as I suggest?)

Note the difference between the idea that everyone should be provided healthcare (there is a right to it) and the idea that it'd be great if everyone could.

Dirk · Mar 29, 2010

myp said:
I am not sure what you mean. From your previous statements I got the feeling that you feel that everyone should have health care and that society should actively work to provide it. Am I right in that assumption?

Yes.

If so, do you feel that coercion is an acceptable means of providing such universal health care?

Acceptable? If it really comes down to it. Necessary? I don't think so - though i may be wrong.

If not, how would you suggest we do it (the market as I suggest?)

I'm still drawn to my LHS idea.

I'm not entirely convinced money should even exist - i'm still working out what i think with that. And i'm still working on logistics for alternative systems. Especially with something as important as human life, i'm very wary of this "pay for everything" mentality.

Note the difference between the idea that everyone should be provided healthcare (there is a right to it) and the idea that it'd be great if everyone could.

In that sense, i suppose i think there should be a right to it. Not necessarily written down as law, but i think everyone should be entitled to live a healthy life and achieve their potential without restriction.

myp · Mar 29, 2010

Dirk said:
I'm still drawn to my LHS idea.

LHS?

Dirk said:
I'm not entirely convinced money should even exist - i'm still working out what i think with that. And i'm still working on logistics for alternative systems. Especially with something as important as human life, i'm very wary of this "pay for everything" mentality.

Money is just a way to make the barter system easier. If you don't like the concept of paying, then you wouldn't be for the barter system either and without that I am not sure how the world would run. Frankly, I don't think it is possible. Everyone has self interest, this is not a utopia. If you figure it out let me know

Dirk said:
In that sense, i suppose i think there should be a right to it. Not necessarily written down as law, but i think everyone should be entitled to live a healthy life and achieve their potential without restriction.

Having the ability to live a healthy life is completely different than having healthcare access. A vast majority of Americans, including a vast majority of conservatives, surely believe in the right to life as described by our founding fathers and Locke. Healthcare is not the ability to live though, it is the ability to get care from trained professionals when something happens or if you have a sickness. The right to life is there by default and can only be taken away by others, the right to healthcare is not there by default and can only be given by others.

I don't think any sane person is against a situation in which everyone has access to health care. The rift comes in when some look to the government to coerce doctors, taxpayers, and insurance companies to look after others because that in turn reduces the freedoms of said doctors, taxpayers, and insurance companies.

Insurance mandate: Should the healthy pay for irresponsibility?

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