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Comment by Zak | Hacker News Reader

If you want to drive, but this would require health insurance simply for being alive, the alternative to which most of us do not consider an acceptable option.

It's also noteworthy that in most states, you can demonstrate an ability to pay for a certain amount of damage in lieu of car insurance.

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If you don't consider being dead an acceptable option, then health insurance sounds just right for you!

Seriously, this debate only makes sense in a context where you consider health insurance to be an "optional extra". It's not. Health insurance is as basic as roads and garbage collection, fire departments and a police force. Out of the whole developed world, it's only in America that something as fundamental as health insurance is considered an optional extra.

There are people that compost and bring what little trash they have to the dump themselves. There are people that ride bikes instead of driving cars. There are people that are their own fire department. Why is it so had to imagine that health insurance might be optional foe some people.

Ok. Doctors don't have to get health insurance.

The rest of us, who can't treat ourselves without external assistance (and also those amongst the doctor who expect that they might at some point get ill enough to require assistance from another human being), the rest of us need health insurance.

Pardon the snideness here, but:

As it turns out, doctors are actually human beings, who are able to form relationships and make arrangements with other human beings, whether or not this takes place within the scope of formal public policy or under the aegis of bureaucratic institutions.

People who are not doctors could treat themselves too, if only it were legal.

Health insurance is optional. My parents never had health insurance and were always able to pay for medical expenses, even with six kids. I also don't have health insurance and so far I've also had no problems paying for medical care. I don't know where the idea that health insurance is a necessity comes from, but it's not based on fact.

Had you been less lucky and encountered medical bills that you and your family couldn't afford, everyone else would have to pay higher prices to make up for your failure to pay. If you want to live in a society where no one will be left to die because they can't pay, then you're going to have to chip in to make that happen. That requires insurance for large medical expenses so no one else has to pick up the tab for you.

I know some people who have crossed the road without looking many times, and they're still ok.

I guess looking before you cross the road is also "optional".

It is and there is no tax on people who don't have road crossing insurance. It's a risk that you can choose to take. If you choose to not have medical insurance and you can't pay for medical care then you might die, but it should be up to you choose if the risk is acceptable or not.

That's not the argument you previously made. You said "it's fine not to have health insurance because I didn't have health insurance and I'm still ok". That's a severe failure of logic. Anecdotal reasoning when looking at something like health insurance is pretty silly.

Unless you're the kind of person whose plan to get rich is to play the lottery, you need health insurance. At some point, in your life, it is quite likely that you will get very sick, or have a serious accident, or have some sort of mishap that suddenly smacks you with a multi-tens-of-thousands-of-dollars-or-more medical bill. At that point, if you don't either a) have health insurance or b) have lots of money, you're basically fucked.

If you pay the insurance all your life and you never actually get to use it, you should count yourself lucky. Health insurance if the kind of thing you pay every month and fervently hope that you never actually need. But if you do need it, having (good, not the american "we'll drop you if you get too expensive" type) health insurance is quite literally a life-saver.

Finally, if you declare bankruptcy because you can't afford your medical bills (and huge medical bills can happen to anyone), society is paying for your treatment anyway, indirectly. Therefore, it is reasonable to mandate that everyone must have health insurance.

_Medical care_ may be in the same category as roads, garbage collection, police department etc. (although one could argue otherwise: the latter are all examples of public infrastructure, but medical care is in most cases a personal service).

However, health insurance is in no way in the same category as any of the above - insurance is a financial tool, used as a means to achieve a desired end in a high-risk situation. Saying that insurance is absolutely essential is like saying that we can't live without zero-coupon municipal bonds. Sure we can, no matter how important the things they're intended to pay for are.

Where I spent most of my childhood, there were no roads for a few miles, no garbage collection, no fire department, and while the area was nominally in the jurisdiction of the Alaska State Troopers, it would have taken at least an hour for an officer to respond. Of course, a total lack of infrastructure would be less than comfortable in a modern city, it's entirely possible to live comfortably without such conveniences.

As for health insurance, the claim that it is necessary is absurd. One could make a much more reasonable claim than health care is necessary, but the question of the specific mechanism by which it is paid for is orthogonal to whether it should be considered a necessity in a modern society.

If you want to drive, but this would require health insurance simply for being alive, the alternative to which most of us do not consider an acceptable option.

There are a lot of areas in the US (most I'd venture to say...) where driving is essentially a necessity once someone has a full time job. Its not like we have a great public transport system. So while you can technically opt out of driving, its not really realistic to do so in most places.

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