Yesterday, I had a discussion with my neighbor about Obamacare. He is conservative and opposed to it on the grounds that it restricts his personal freedom not to have insurance. He is about my age (late 70's).  I pointed out that he is on Medicare with a good secondary insurance from his former employer and is therefore unaffected by ACA, his reply was that he would be if he didn't have insurance and that was enough to make him mad.

The argument that the uninsured use emergency rooms for which he pays indirectly through increased hospital costs did not make any difference to him since he never sees those costs explicitly. The man is a retired software engineer and might be expected to understand things better, but his rightwing mindset prevents it. He said he preferred the country he grew up in where you still had choices. In that country—before Medicare—one third of people our age lived below the poverty line.

This illustrates the difficulty in getting people to understand public issues. Once the issues have been framed in an emotional setting, reason departs.

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Did you ask him why he is on Medicare?

No, I don't want to antagonize him. He has been a good neighbor and done a lot of work for me on my house at quite reasonable prices.

I already explained to you and other people here why forced health insurance is so objectionable. 

Health insurers try to regulate medical care.  But medical care isn't cut and dried, because medicine isn't.  If one has difficult and little-understood medical problems, it's oppressive and unfair to be forced to pay for health insurance that will try to dictate to you what to do about them. 

I see a good allergist in NYC.  He's out of my area, likely a health insurer wouldn't pay for that or have as good coverage.  And, he's prescribed an extremely expensive drug for me, for an off-label unconventional use.  The drug is likely helping me, but because of the off-label use it's likely not to be covered. 

Even if I got an insurance co. to cover this, it would still be drudge-work for me to go through the process of getting it approved.  At a time when I need to concentrate on my health problems, not on drudge-work. 

I had terrible problems with the group health insurance at one of my jobs.  They had a schedule of "reasonable and customary" charges that was drastically lower than the actual costs of medical care.  I fought for months to get them to cover one bill for an imaging service, and they still denied it.  Finally I complained to the insurance board of the AMA in that state, and they agreed with me.  This insurance co. routinely underpaid many of my medical bills. 

Forcing people to deal with health insurance companies, gives them even more power to rip people off. 

Framing it as unreasonable for people to object to this, is unfair. 

Is it better then that hospital emergency rooms have to treat the uninsured—and the law requires them to do so—and pass the cost along to those of us who are insured? Is it better for the uninsured to go untreated for chronic diseases until a crisis is reached that requires expensive intervention which the rest of us must subsidize?

It is always going to be the case that insurance companies try to enhance profits by refusing to cover certain drugs, treatments, doctors, etc. We have all had problems of this sort. The best solution would be single payer government coverage for everyone, but current politics won't allow that. It would not even allow a public option in ACA.

What was unreasonable in my neighbor's objection is that he objects to something that has no effect on him directly and which in its absence would continue to cost him indirectly.

I don't know what the best answer is, but there are valid objections to forcing everyone to buy health insurance. 

If you're someone like me, it doesn't help if someone else out there is benefited by compulsory insurance.  Injecting an insurance company between doctor and patient, giving an insurance company power over medical treatment, sucks. 

Our health care is not a minor matter in our lives - and taking away choices in health care, is oppressive. 

It wouldn't be so bad if they were forcing people to have catastrophic health insurance.  But no, my overweening government has decided that everyone over a certain age (including me) must have health insurance for everyday medical bills!  It's a massive imposition by the government on our lives. 

You are not 'forced' to get the insurance.  You are more than welcome to pay the fine.  The 'insurance' portion of this act is not the major thrust of the legislation, however.  We need to remember that the title 'Affordable Care Act' in given because the new policies are designed to reign in the cost of medical care.  If that means that people need to be 'forced' to get insurance (which they aren't by the way), then I am all for it.  I understand that some people are not going to like it, but in a country our size, you cannot please all of the people all of the time.  Sometimes we must sacrifice a bit for the common good.  At present, there is very little hope of someone getting any type of quality medical care in America unless they either have good insurance or they are independently.  The wealthy may very likely just choose to pay the fine - for the others, the ACA is designed to benefit them.

Bottom line - if you don't want insurance - pay the fine.

The fine for not getting insurance is also unfair. 

It's not adequate to say, essentially, "tough luck if that's how you feel". 

you cannot please all of the people all of the time.

I explained how the ACA steps on me and other people with medical problems that are difficult to deal with.

What you're saying is essentially "too bad".  But it's not OK even if on average, it benefits people.  Those of us who are hurt by it ALSO exist.  The rule of the majority if it doesn't respect individuals is tyranny. 

I'm already suffering financially because of my medical problems.  I don't need MORE burdens. 

Luara, we get fined for driving without a license, not having auto insurance and any number of other things so how is medical insurance different?  Are the two fines I just mentioned 'tyranny'.  I'm confused why some people believe some things are just a fact of life and health care isn't.

Insurance companies already have power over what they will pay for, but not over how you spend your own money beyond that.  If you can afford extra tests or traditional "cures," you are free to pay for them.  Do you just not want health insurance?

As I said, it's unfair to force people who aren't benefited by the insurance to pay for it, AS WELL as paying for their own medical care!  And if you don't get the insurance, it's unfair to pay for one's own medical care AND the fine. 

What you should be replying is that " a universal medicare expansion/ public option" would be preferable, instead of drudging up poorly thought talking points that don't actually address the problems that you site.  Your complaints here are about as valid as complaining about having to buy car insurance; the only difference being that people have the option to purchase a car or not, and no choice whether or not to get sick.

 I feel some sympathy for alt-med believers in all this ...  If someone chooses to spend their healthcare money on Chinese herbal medicine or acupuncture, that's their business.  What compulsory insurance takes away from people is the right to make their own choices about how their healthcare money is spent.  They can spend money both on the compulsory insurance and on their own choice, but if they don't have money to spare, that's a problem.  Compulsory insurance tends to enforce conformity. 

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