I'm no fan of universal health coverage ideas. I think that they simply attempt to "make someone else pay" for you and your family's health insurance and health care needs. I know that health care and insurance can be expensive, but they're one of the facts of life.

If you're going to have a family, you owe it to them to be responsible and make sure their health care needs are covered. That means bearing your own burden for the costs, just like consumers ought to be bearing their own costs for feeding their families, putting a roof over their heads, clothing them, fixing the car, putting gas in the car, and all of life's other necessities.

So the concept of universal health care seems to encourage irresponsibility, and Hawaii offers a very quick look into how that's so. The idea is simple: If someone else is going to pay your way for you, why be responsible and pay your own way? After just seven months in existence, Hawaii is dropping it universal health coverage for children because most of the enrolled children didn't need the coverage in the first place.

Consumers played the system. Of the 2,000 children enrolled, most already had insurance coverage, but their parents dropped that coverage so they could get the "free" state plan. (I put free in quotes because it's not free. Someone has to pay for it!) Hawaii's plan was designed to ensure that children without health insurance coverage (read: needy kids) would have it.

I can't say I'm surprised at this, since it fits into my theory that consumers aren't going to be responsible for themselves when someone else is there to foot the bill. I know that our health care system isn't perfect and it's expensive. But I also know that consumers need incentives to be responsible. Consumer-driven plans like health savings account are a step in the right direction because they encourage consumers to spend health care dollars wisely, and offer a tax deduction in return.

About a year ago, there was a big push by some Wisconsin lawmakers to create universal health care in our state. What would that have done for me, a responsible consumer who purchases her own health insurance and wisely uses a high deductible plan to control costs? It would have significantly decreased the quality of my coverage (read: worse benefits) and would have more almost quadrupled my cost. I don't mind the concept of finding a way to pay for coverage for those truly in need of a last resort. But to punish me in that way, for essentially daring to be a responsible consumer for the last 10 years is completely unfair.

I don't really know the answer to providing health coverage for the truly needy. I do know that we need to create a system which rewards responsibility. We shouldn't have a system in which allows someone to say "I can't afford coverage for my family," when what they really mean is "I don't want to pay for health care. Let someone else pay it for my family."

Tracy L. Coenen, CPA, MBA, CFE performs fraud examinations and financial investigations for her company Sequence Inc. Forensic Accounting, and is the author of Essentials of Corporate Fraud.

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