SCOTUS: The Government Case was Factually Wrong

The principal factual claims made by the individual mandate’s supporters are that the failure to purchase conventional health insurance causes harm to the uninsured person (in the form of worsened health) and to others (in the form of a shifting of the burden of the costs of care)…

Peer-reviewed studies from the National Health Insurance Experiment and other data dating back to the 1980s have concluded that there is little or no causal relationship between health insurance and a person’s health outcomes…

[A] comprehensive, peer-reviewed study…in Health Affairs in 2008…concluded that “Private insurance premiums are at most 1.7 percent higher because of the shifting of the costs of the uninsured to private insurance.”

Source: John F. Cogan, R. Glenn Hubbard and Daniel P. Kessler in the WSJ.

Comments (7)

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  1. Alex says:

    That’s a lot lower than what we’re led to believe.

  2. Jane Lindell Hughes says:

    Another interesting fact is that only 2% of our healthcare expendatures are from emergency room care, and much of those costs are paid for either by the patient, or by signing the eligable patient up for Medicaid. However, as a practicing physician and past chief of service for a large hospital system, it is the physician who does not get paid. Having said that, although not ideal, the emergency room is a safety net that is in place. We have a compassionate, efficient healthcare system that needs fixing, not destruction. We have heard from the lawyers, now the final verdict will come from the people in November

  3. Brian says:

    I thought so too, Alex.

  4. Devon Herrick says:

    The purpose of the individual mandate isn’t to enforce individual responsibility — in an attempt to prevent people free-riding on their more generous brethren.

    Rather, the purpose of the individual mandate to force people to purchase comprehensive policies that create huge cross-subsidies.

    Public health advocates feel everyone should have a comprehensive health plan. Advocates also believe older, sicker enrollees should pay little more than young, healthy enrollees pay for comprehensive coverage.

  5. Imrana Iqbal says:


    Could you please help me understand this part of your post: “the purpose of the individual mandate is to force people to purchase comprehensive policies that create huge cross-subsidies”? I am not fully sure (1) who the beneficiaries of subsidies are, other than the obvious ones; (2) who else might be reaping benefits of these subsidies; and(3) what other benefits might there be for the latter groups.

  6. Bob Hertz says:

    Let me take a shot at the real goal of the mandate. Devon is basically right. I have an actuarial background so I am going to go at it from that angle.

    If no one is forced to buy health insurance, and no big employer or union pays the premium, then each consumer will make their own decision.

    People who are young and healthy will generally not buy coverage. They are not sick, and if a male they rarely see doctors or the inside of a hospital. If they are in a car crash, they believe that their auto insurance will pay most of the medical bills anyways,

    So the only people who buy individual health insurance are those who expect to use it. That does NOT occur with life insurance or fire insurance.

    This causes health insurance rates to go up and up as the pool of buyers gets older. The insurance companies cannot stop this no matter how many discounts they get from providers. The ‘actuarial death spiral’ cannot be reversed.

    The goal of the mandate is to get young and healthy people to buy health insurance. It was assumed by the bill’s authors that this would lower all premiums. The younger people would get subsidies so that the mandate would be somewhat less burdensome.

    There are some problems with this of course.

    The most obvious is the federal government cannot act like a big employer or big union for 25 million young non-insurance buyers. The mandates are probably unenforceable.

    Also, in the American health insurance system outside of Medicare there are no cross subsidies between insurers. Blue Cross might get 2 million young people and be in a position to lower premiums. But Aetna might get 100,000 very sick people as new subscribers and be forced to raise rates even if they do get one million new young people.

    The countries which do have mandates and subsidies have MUCH more extensive regulation of health insurers than we do.

    My own view is that the mandate is a crude and expensive tool to try and accomplish the smoothing of premiums that Devon referred to.

    I think Dr Goodman himself has stated that if we want to help Americans over 50 to buy health insurance, we need to give them money. That is cheaper and certainly less disruptive than massive mandates.

    Bob Hertz, The Health Care Crusade

  7. Natasyah says:

    Most states do not force you to cooshe where to take your vehicle for repairs If you use the ones your insurance companies recommend they are usually guaranteed work at 100%. If you cooshe another shop ANY!!!! errors or problems will be your responsibility. Most companies also require they insurance adjusters to look at your vehicle PRIOR to any work being performed so they know what is done before any repairs and that is normal and standard procedure. This is in your best interest as well. so it is preferred you let your company and their company look at the vehicle..estimates are just that an estimate one company may have better parts equipment software and can find cheaper local parts another may have older software and their parts have to be shipped which cost nmore and change the values of the two estimates, so estimates are usually never the same .ONCE work is performed their may also be hidden damages..this can be a cracked bumper absorner that one couldn’t see visibly so the estimate may increase..THIS IS OK if it is determined to be accident related..FYI***THERE IS A HUGE RISK IN USING SHOPS YOU CHOOSE UNLESS YOU PERSONALLY KNOW THEIR WORK *Insurance companies pay people to research and monitor body shops who they place on their lists, in most states it is illegal to get any amount of the shops profits..they are partnerred with trust and confidence and recommendations..if a shop has angry customers reviews, service and work they are quickly and easily removed because other shops WANT to be in connection with free recomendation and customers** If you go to a shop who owes back taxes it is your responsibility to ask, because the govmnt will take their back taxes due amount from any work performed by that shop If the company that you cooshe disagree’s with the bill they can hold your vehicle until their pymnt is made and won’t care if you are in the middle..If you cooshe your own shop and they pait your maroon car red is some areas it is your responsibility to get it corrected. It is not worth the risk. I ALWAYS use their shop because they have to fix the damages and return you to a rental if it is something their shop did wrong If you use your cooshen shop good luck..sorry so long