Insurance Mandates

Over at The Volokh Conspiracy, Jonathan Adler brings us a story about a retired couple in Mass who are quite happy with their insurance, but they’ve been told it is unacceptable under Mass rules and they’ve been fined. Go read the post and the comments.

This is comment that I left there today at 8:27 pm

Reading the comments it seems that many people equate using the emergency room with being un/under-insured.

On Monday night I had to take my soon to be 9-year-old son to the emergency room/acute care center. He had been running in the hall at school that evening (we were there for Cub Scouts) and he ran into a door. He smashed his left middle finger (distal phalanx), and when pulling his finger out from between the door edge and the wall, cut the pad of his finger pretty deeply. He required an x-ray of his finger to ensure he hadn’t broken it and four stitches to close the wound.

We have insurance and had to go to acute care since it was obvious that it couldn’t wait until the next day when I may have been able to get an appointment with his pediatrician.

There may be a lot of people that use the E/R as a primary care facility, but that is because of the Emergency Medical Treatment and Labor Act (EMTALA). There also seems to be a misunderstanding of what treatment is required for those that are uninsured. EMTALA requires only that the patient be stabilized.

When I was a kid, my father had catastrophic insurance through the university he worked for. Regular old doctor visits and vaccines were paid for at the visit or in a couple of payments. Insurance kicked in when my sister fell on a two by four and got a puncture wound in her thigh after running through the yard next door where they were building a house and my Dad had to take my sister to the hospital.

When my husband had a tonsillectomy as a child, his parents made payments to the hospital until the bill was paid off.

Back then we knew what we were paying for our health care. Now we pay $300 a month and a $3,000 deductible for a PPO and we don’t reach our annual deductible in regular medical costs, even with a child with chronic illnesses. We still pay for our insurance in case of a catastrophic illness or injury.

My monthly premium is lower because of the relatively high deductible. It seems that Mass wouldn’t allow me that choice. How much of an increase would there be in my premiums for a lower deductible? How much of a tax fine? Up above some people seem to be saying that the tax fine that the Williams must pay amounts to “only” $80 a month. But that’s if the Commonwealth of Mass will take monthly payments. I’d not be surprised if the tax fine was due, in full, last week or face interest charges…

Being forced to pay for coverage that I don’t want or need is another story. That’s like going to the store for milk and eggs and being told you must also purchase and pay for oatmeal, salmon fillets, and fresh asparagus and beets. Oh, and by the way, that whole milk you wanted to buy? So sorry, it’s skim for you.

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