I explained that in order for Medicare to cover more things, everyone would be forced to pay a lot more money in Medicare taxes for things that they might not need, and that wouldn't be fair. She seemed to understand that. But I had no answer for her problem of being "squeezed in the middle," where she was not poor enough for a subsidized plan but not rich enough to be able to comfortably afford a private plan.
Generally, I am all for individual freedom. But health insurance doesn't work that way; it is often prohibitively expensive for individuals, and only affordable in group plans that can be provided either by medium-to-large corporations or by government. I am certainly wary of being dependent on government for health insurance. But is it any better to be dependent on large corporations? It seems to me that our current system penalizes anyone who does not work in a medium-to-large company by making it very difficult and expensive for them to get health insurance. It also seems to penalize the corporations themselves, since they compete in a global market with companies who do not need to provide health benefits for their workers.
ObamaCare is clearly not the solution, either. The individual mandate violates any reasonable interpretation of the U.S. Constitution; Congress can "regulate interstate commerce," but it cannot force people to engage in commerce. Also, ObamaCare only increases the costs to business with its new taxes and penalties for businesses that cannot afford to provide health insurance. But could we have a public option that would end the dependence on big companies without requiring massive tax increases? Two essential criteria would have to be met:
- The health care programs would have to be implemented at the state level, not the federal level. A federal health care program containing an individual mandate would almost certainly violate the U.S. Constitution as mentioned above. Huge federal bureaucracies are always extremely wasteful and inefficient. The existence of different health care programs would allow citizens to vote with their feet if one state's health care program became bloated and expensive (sort of like businesses are choosing to leave California). And finally, some states could decide not to have a public option at all.
- The programs would need to provide several accordingly priced levels of coverage, including one low-priced, basic plan (no chiropractic, no sex change operations, no substance abuse treatment, etc).