Uninsured Outlaws: Why I Hate the New Massachusetts Health Insurance Law

I’ve never written about health insurance before, but a new law here in Massachusetts mandating that all residents carry health insurance has got my biscuits burning.

I’ve never written about health insurance before, but a new law here in Massachusetts mandating that all residents carry health insurance has got my biscuits burning.

My home state (Commonwealth, actually) of Massachusetts knows how to stay in the national spotlight. We have a penchant for breeding (typically unsuccessful) presidential candidates and for getting the conservative majority in a dither with our left-learning laws including the right to gay marriage and, most recently, compulsory health insurance.

Nine days out of ten, I’m proud to call Massachusetts home. This includes the times I drive out-of-state. I love to watch people’s faces as I accelerate around two minivans and a Buick to make a yellow light. (I prefer the term “competitive driving” to “aggressive driving”, by the way).

But today is one of those days when I am contemplating packing up for Texas. I hear they need some guys to build a big fence down there.

Why? The Commonwealth’s new health insurance law is telling people like me how to spend my hard-earned money.

In a nutshell, the health insurance law mandates that all employers provide employees with the option to buy health insurance and provides subsidized insurance for the unemployed and self-employed. Failure to comply results in 2007 results in the loss of a bit more than $200 in a state income tax deduction. Failure to carry health insurance in 2008 will be met with stiffer penalties of hundreds of dollars a month.

I haven’t seen Michael Moore’s “Sicko” yet, but I’m well aware of the skyrocketing costs of healthcare and that the problem is blamed on the uninsured. And, for the most part, it’s billed to the uninsured, too, who may pay more than twice an insurance company’s negotiated rate for the same treatment.

So why do I think mandating residents carry health insurance a bad thing?

It strips me of a liberty that is not only vital to my livelihood, but to the national economy: the freedom to choose how I spend my money.

I am not saying it’s smart not to carry health insurance. In fact it’s a very dangerous choice. But that should be my choice.

In fact, according to a Boston Globe article earlier this week, a lot of young people are taking that risky choice, many forgoing health insurance in spite of the law (or ignorance of it).

Don’t be quick to call a young adult stupid or short-sighted for not buying health insurance. Consider the cost, usually at least $300 a month.

And for what? Assuming no traumatic accidents, a healthy young adult might go to the doctor once every two years.

Sure, a car accident or sudden diagnosis could cost $100,000 overnight. But people our age have the old “it won’t happen to me” attitude.

And, as the Globe article notes, without young, healthy people paying into the system, the costs for everybody else are just going to go up.

If Massachusetts wants to reduce health care costs and eliminate the uninsured, there’s only one answer: universal healthcare.

Yes, I’m yelling about my freedom of choice one minute and promoting a socialist idea the next. But universal health care does not have to eliminate any choice, nor does it force anything upon me.

If I’m going to pay for health insurance (including the cost of treating the uninsured) one way or the other. Why not just tax me?

Of course if I want to pay for premium health care services that will always be my choice.

This is, after all, America, and no policy will eliminate the ability of those with means to purchase the highest quality services, including healthcare.

Conversely, our government should not be requiring the least well-off people to pay for something they probably can’t afford.

Yes, everybody should have health insurance. But if the government wants the un-, self-, or underemployed to have health insurance, please, just give it to them.

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About David Weliver

David Weliver is the founding editor of Money Under 30. He's a cited authority on personal finance and the unique money issues we face during our first two decades as adults. He lives in Maine with his wife and two children.


  1. As someone currently working in the health care system in a major, blue collar US city, I respectfully disagree.

    Issue 1) I think the fundamental problem is that unlike most other things that the free market does just fine with, our society has made a clear and conscious choice that on this front, we’re not going to let people suffer the true consequences of their actions. You can argue whether that’s a good idea or not – I think it is, since I can’t imagine a society that decides that well, actually, we’re ok with people dying in the streets when they can’t afford care, after all could be a very good one – but either way, it’s a choice our society has made. And given that it’s been made, this issue becomes one that no longer falls into the “I can decide whether to buy a TV set or not, gosh darn it” type category.

    Issue #2) It’s not the uninsured that pay for most of care-to-the-uninsured. In fact, it’s the insured that cover it. Yes, you are right that if you are uninsured, your official charges will be higher than if you are insured. But do you have any idea what a low fraction of those charges are ever paid? The vast majority of care to the uninsured is provided as charity care by major hospitals, most often by emergency rooms. This means that something that could have been handled in an office for $50 is costing hundreds-to-thousands in facilities costs. It also means that ER’s cost their hospitals far more than they make – one of the major reasons that many hospitals are closing their ER’s; hospitals that aren’t are generally subsidizing them heavily with, you guessed it, the extra they make off your insurance costs (I don’t hold this against them – I don’t see what else they can do). And in the meantime, I don’t know if you’ve gone to an urban ER lately, but they are so crowded that if you’re not bleeding out you can spend 6-12 hours waiting; where I work so people have realized the only way to see someone fast is to lie and pretend to have symptoms of a heart attack that when my neighbor really did have heart attack symptoms and was rushed to the ER in an ambulance, he was then dumped in a chair to wait for FOUR HOURS before being seen.

    You may be noticing that to some extent I am blurring two groups of the uninsured – low income groups with chronic health issues, and healthy young people who just feel invulnerable. From your post, I get the feeling that you assume that the latter category, when something does go wrong (as it did for a friend of mine who had a 3 month gap in her insurance – and in the last two weeks was hit by a car riding her bike and racked up over $100,000 in costs in just over a week), the person ends up paying for it. Almost always, however, that’s not the case. The person may end up saddled with enough debt to last them years of financial hardship – but hospitals know that if they try to bill a 23 year old english lit graduate student $100,000 one fine morning that even if that student struggles for years, they will almost certainly eventually declare bankruptcy – and the hospital will be left with having spent probably as much in collection costs as they recovered in payments. Instead, almost every hospital will end up shouldering most of the cost themselves (again, out of your insurance payments). The other source of all of this free care: the system whereby there are nationally agreed upon wage standards that make sure that residents who have had 4 years of college, 4 years of (usually very expensive) medical school, and often up to 3 or 4 years of residency already are required – if they want to legally train in their field – to work 60-80+ hours a week for $40-50k a year (an hourly salary of less than a fast food worker in many states) during the same years they’re trying to have kids and buy a first house.

    I’m sorry this is such a long post – it’s just that this is something I feel very strongly about. When I began working in this field 6 years ago, this wasn’t my viewpoint at all. But, confronted with the reality on the ground, I have become convinced that I was wrong – and that either laws like the Massachusetts law or some sort of single payer system are inevitable.