Forcing people to do anything seems to be almost anti-American, since this country was founded on the idea that we want to make our own choices. However, health insurance is so important and those who don’t have it are such a strain on society as a whole, one has to wonder if this is a case like seatbelts where the government should step in to protect people from themselves.
“There are over 45 million uninsured people in the United States”
The number of uninsured is loosely tied to the unemployment rate (since people often get health insurance through their employer) but the number without health insurance is often harder to drop. Sometimes unemployment will fall with seasonal hires but those jobs often do not carry health insurance benefits, so unemployment will drop, but the number of uninsured will not.
It doesn’t take a rocket scientist to figure out that it’s better to have health insurance than not to. Even routine medical bills are a huge financial drain and one major medical problem can easily bankrupt a family with no insurance. It’s not as if people who can afford it don’t want insurance, it is purely a matter of cost.
The big problem with forcing people to buy health insurance is that in most cases you would be forcing people to spend money they do not have. Can you tell a family that they can’t buy food or clothing because they are legally required to buy health insurance first? Of the uninsured in America, a number of them are illegal immigrants whom it might be hard to force into buying health insurance.
The way the government would attempt to avoid this problem would be by mandating insurance for those who can afford it. Again, this is probably a waste of time, since most people who can afford health insurance already have it. It is also a dangerous proposition to give anyone the power to determine who can afford insurance and who cannot. It could be somewhat of an arbitrary decision.
How would a mandatory health insurance law be enforced?
It appears that when and if health insurance becomes mandatory for those who can afford it, it would fall on the IRS to enforce it. It makes sense to a certain degree, since the IRS is already privy to all the personal financial information of everyone in the United States, anyway. The system they are looking at now is a system of matching documents, wherein you would send a proof of insurance document to the IRS that they would then match to a similar document from your health insurance provider.
There is a lot of doubt about how this would work. There is concern that the IRS does not have the resources to take on this kind of responsibility. Some estimates say that they would need to add 16,500 jobs to handle the workload, and with the federal government in dire financial straits, that doesn’t seem likely. Even if they get the extra help, it is feared that the extra responsibility will lower the efficiency of an agency that is generally considered inefficient to begin with.
Another problem with the IRS enforcing mandatory health insurance is that their computers and databases are in dire need of an upgrade to handle the massive amounts of data they already process. Adding more data will surely require a massive update; otherwise, a system crash seems likely.
In terms of actual enforcement, at the moment the IRS would not be allowed apply their normal tactics of imposing liens and levies, seizing property or putting people in jail if they violate the rules to those who fail to get mandated health insurance. Without these tools, all they could really do is withhold tax refunds from those who do not get insurance. It is generally believed that this would not be enough to make people follow a mandatory insurance law.
When will mandatory health insurance go into effect?
Mandatory health insurance was part of President Obama’s health care reform package of 2010. Assuming the law is not repealed, modified, or otherwise tinkered with, it should go into effect in 2014. That is a bold assumption, since Republicans continue to target the bill as an unacceptable expansion of federal government that must be repealed.
Several states filed lawsuits challenging whether mandatory health insurance was constitutional and a few have won their early court decisions. The argument will clearly be ongoing for quite some time to come.
Has the United States ever had mandatory health insurance before?
In 1798, the United States, then under the direction of President John Adams, passed a bill mandating insurance for private workers on maritime vessels. While this was a very limited group of employees to which the law was applied, proponents of mandatory health insurance feel that it is proof that the founding fathers agreed with the idea, in principle.
It is not a new idea in modern times, either. In 1974, President Gerald Ford made the statement that national health insurance was inevitable. In 1977, President Jimmy Carter pushed unsuccessfully for mandatory health insurance, as well.
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