Not every form of cost-shifting is morally equal. If the two of us are in the same insurance risk pool, and you happen to get sick, I may have to pay higher premiums. More than likely you getting sick wasn't your fault (although it conceivably might have been). However, if I am in a risk pool and you are uninsured, then you get sick and receive free care that I have to pay for, then I am being penalized because you made a willful decision to not be covered.
Your zero sum argument is off point. What is zero sum is the total cost of treating everyone, insured or uninsured. What is not zero sum is the average cost of healthcare premiums for those who are actually insured. Those premiums are padded because people without insurance receive FREE (i.e. un-reimbursed) care. Basically, the people not insured are leaching off those who are.
- wolf
Not at all. In any instance we're both paying for everyone. With us both covered we're both paying premiums which are based on an amount set by a group that chooses the cost based on available capital...meaning the costs will go up the more people that get coverage purely because there's that much money being held by insurers for reaping by them so they can get away with it. We both also pay taxes. Nothing says the amounts are equal, because we may not earn the same, may live in different cost of living areas, etc. But in theory, we're already paying into a pool for everyone, not paying for ourselves.
If you're paying premiums and I'm not, your premiums don't go up based on my non-payment, and in fact go down because the available capital pool is less (ie drug manufacturers can ONLY charge what it's possible to be paid, or they go out of business) AND the overhead and required services are less. Either I have to pay my costs myself (impossible because costs are based on a collective capital pool and not individual ones), or they get shifted to financial institutions (if I take loans) or a combination of the providers and the government. That means a slight increase in frontline costs, a slight increase in financial cots, a slight increase in taxes, but lower or stagnant insurance rates. I suffer the same increases as you do, but get none of the benefits.
If neither of us has insurance then we both have more money to begin with. Costs go down significantly because capital is reduced to individual levels. If the government provides care then taxes go up, if we're responsible then our costs go up. If care is out of reach then everyone's costs go up for law enforcement property insurance, etc.
The point is, you're not really paying much more for people who are uninsured, and wouldn't be paying ANY more if there were no insurance pools to throw the system out of equilibrium. Not only that, you're already paying for other people because your insurance pays for everyone else who has it, not just you. There is NO appreciable change in who or what you pay based on insurance coverage so long as insurance exists.
The evil inherent in the system is the EXISTENCE of insurance, not the number of uninsured.