Armey: Individual Mandate Would Be a Healthcare Industry Boondoggle

Re: "In one presidential debate, he said, 'Senator Clinton believes the only way to achieve universal healthcare is to force everybody to purchase it. And my belief is, the reason that people don't have it is not because they don't want it but because they can't afford it.'"

The idea behind individual mandates is that it spreads the risk around (since now ALL of the healthiest, who might otherwise forego coverage or just get a lower premium "catastrophic" plan, such as a high-deductible health plan), are also paying into the system), and it also avoids the free-rider problem (those who can afford insurance, but who forego it and just utilize the ER if ever necessary). There's a point to be made about the free-rider issue, but currently, insurers are getting away with...well...never mind. They operate like a giant premium black hole in that money for coverage gets sucked in, and who knows if it'll ever get paid out in a timely manner when/if there's a claim filed.

Insurers can literally deny a claim for an number of reasons, including pending the claim for something just nitpicky and not entirely necessary. Or, as anyone who's ever worked in claims knows, the claims are lost somewhere in a vast system until someone, who's job it is to push the claim forward, gets on the phone with a supervisor to get it processed and paid already.

Some claims even end up in court, where lawyers for the insurer and the actual provider (the hospital) hash out contractual issues.

If there's an individual mandate required at some point, can Americans "pend" their premium payments to the insurers for a ridiculous amount of time?

Doubt it. That would never be acceptable, would it?

Angie Koutrotsios of IL 6:21PM October 12, 2009