One of the most oft-heard arguments against the ACA’s individual mandate is “How can the government compel me to buy something I don’t want and don’t need?”

Well, Skippy, government has been compelling you to do things for a long time.  The Feds make you pay income taxes or risk fines and jail time.  Most states compel you to wear seatbelts, because people who wear seat belts are less likely to die or be seriously injured in auto accidents.  If you don’t wear one and get caught, you get fined, even if YOU aren’t the driver.

If you have a house and a mortgage, the bank makes you buy homeowner’s insurance so they are not stuck with an empty lot if the house burns down and you default.  If you have a car, the state makes you buy auto insurance before you can get license tags and the bank will make you get insurance if you’ve financed the car.

“But what if I don’t own a house or a car?”  If you rent and don’t have renter’s insurance, you’re just a dumbass.  If you don’t have a car or a house, you don’t need auto or homeowner’s insurance, and you’re a dumbass for asking that question.

Here’s the reality.  People who get sick without health insurance don’t just disappear.  They eventually seek care, usually when they are a lot sicker.  The cost for that care was about $176 billion in 2013, and we’re all on the hook for about two-thirds of that.

You don’t think you should pay for someone else’s care because you are healthy? How do you think traditional insurance works in the first place?  Many people pay premiums for auto and homeowner’s insurance; those who get into an accident or suffer damage to their home get the benefit.  Most employees are healthy but the premiums the employees pay cover those unfortunate enough to become ill.  Otherwise, only sick people would buy insurance and the cost would be astronomical.

You own a body?  You need to insure it, so I don’t have to pay for YOUR health care when YOU get sick and don’t have insurance.  It’s only fair.

I really don’t understand the animosity conservatives have against the uninsured now being eligible for subsidized insurance through the Affordable Care Act. Their hatred seems to be based on a few misconceptions.

1. The uninsured are lazy and don’t work
2. If they are working, they should have gotten a job with benefits
3. I don’t want to pay for someone else’s health care

The Institute of Medicine of the National Academies published several monographs on the uninsured between 2001 and 2004. The Kaiser Family Foundation (KFF) publishes the Employer Health Benefit Survey every year or two.  Their findings are sobering.

Eighty-two percent of the uninsured either work or live in a household with someone who works.  Part-time workers generally aren’t eligible for benefits. Neither are independent contractors like me.  People in minimum-wage jobs often don’t get insurance, either because their employers don’t offer it or the workers can’t afford the premiums.  Wal-Mart appears to have the largest number of employees on Medicaid and food stamps.

63% of workers don’t have insurance because their employers don’t offer it; another 16% are ineligible as new hires.  Remember Andy Harris, the anti-Obamacare Republican Congressman from Maryland who, in 2010, complained that he’d have to wait 28 days for his taxpayer-funded health insurance?

Only 57% of all employers offer benefits.  Larger companies are more likely to provide insurance. Only 45% of companies with 3-9 workers offer benefits compared to 93% of companies with 50 employees or more.

Prior to the ACA, some people couldn’t get insurance at any price.  Insurers don’t want to underwrite people with expensive pre-existing conditions, like depression, diabetes, heart disease, AIDS and old age. The last one is why we have Medicare.

Having insurance doesn’t guarantee you will keep it. Your insurance will disappear if you lose your job or the spouse providing your insurance dies or divorces you. You can continue the insurance under COBRA, but you’ll pay the full premium cost plus a 2% administrative fee.  We paid about $950/month when my wife lost her job. So, you can become uninsured in a heartbeat, despite working.

Having health insurance won’t necessarily protect you from financial ruin. More than 60% of bankruptcies in 2007 were due to medical debt and more than three-quarters of those people had health insurance.

Being able to afford health insurance is relative. The average costs of single and family policies in 2013 were $5,884 and $16,351. That comes to $490/month for an individual and $1363—more than my mortgage payment—for a family. And those are just averages.

Someone else IS paying for YOUR insurance. Employers heavily subsidize health insurance premiums (which they write off as a business expense). Employees pay an average of 18% of an individual plan premium and 29% of family plan premiums, often with pre-tax dollars, and they aren’t taxed on those benefits. That means they get around a 75% subsidy. The uninsured have had to pay sticker price for policies on the individual market, if they could even get insurance, with after-tax dollars.

So if you’ve had great health insurance, stop being so smug. Be grateful for what you have, because it could have disappeared in a heartbeat.