I know that the system works so that the healthy subsidize the sick–and if you don’t have everyone in the system, the costs go higher. But at this point, the industry costs are driven by alot of other factors beyond the “costs” of the sick–the “supply/demand” theory as it relates to whether costs rise or not doesn’t always hold water. Corporations will struggle to keep costs high, because they make a better profit no matter how many people are using the service.

In the health care field, we don’t force the drug companies to negotiate costs, and we have a lot of costly technologies that don’t necessarily do a better job of screening or treating certain conditions. They’re just the new and latest thing and people pay high costs for them.

So the reality is, unless costs are driven way down (and the only way to do that is to have a single payer system if you ask me), neither of their plans will do what they promise. So weighing that against the potential punitive measures that Massachusetts is now using, I still think his plan is the better choice.

But, I am persuaded by some fairly simple arguments – maybe I’m misled, but, allowing people to opt out of health insurance, as Obama is proposing, means that the very poor, and the very healthy, won’t be insured. He talks about driving costs down, and he talks about the possibility of subsidies, but it seems to me that it will still be beyond the reach of some folks — meaning, they will continue to show up at the ER when a simple cough has become pneumonia, or a cut has become gangrenous.

And the very healthy — the young, the active, the fit — may choose not to pay for health insurance. This has the effect of driving premiums higher! By not spreading the risk across the entire population, the pool of insured people ends up costing more per capita, because healthy folks who would “cost” the system little aren’t paying into it.

Finally… you talk about the burden of a mandatory 10% of wages going towards health care costs. Last time I checked, I personally have 7.65% of my wages garnished as a mandatory contribution to Social Security/Medicare… and my employer has to pay ANOTHER 7.65% on top of that!

I agree that punishing people who don’t have insurance is a lame idea. But, if you don’t believe in mandates, does that mean… we make Social Security and Medicare contributions optional, too? If not, how is that different?