Ryan: Obamacare in a 'death spiral' because healthy people are forced to pay for sicker people
Source: Washington Post

This is a video with House Speaker explaining how Obamacare is in a "death spiral" because healthy people are being forced to pay for the health care of sick people.  It sounds grim except for one problem, that is the definition of insurance.

Insurance is about risk, the probability of an event occurring.  In the case of health care, it is the probability of a significant health event.  Think about yourself.  How likely is it you will have a heart attack?  Young? Maybe the likelihood is small.  Older?  The likelihood is greater.  But the likelihood is not zero for either group.  A young person can have a heart attack.  Many do.  If both sign up for insurance, the risk is spread and the cost is lower for all.

The cost of the event is high.  Heart surgery, therapy, medication; all of these costs are significant.  Spreading the risk means a relatively small potential cost for everyone.  Consider company provided health care insurance.  The premiums are lower because the insured are not determined by their health condition but by their employment with the company.  So the healthy workers essentially pay for the sick workers, but since no one knows who will be sick or healthy, all are covered.  Is Paul Ryan saying company provided health care insurance is in a death spiral?  No.

With health care, the risk may be low but the cost is high.  Spreading the risk lowers the potential cost for everyone which is why insurance is valuable.  The mandate that everyone sign up means that everyone is covered so the potential cost of a health event is lower.  It's like car insurance.  You may never need it, but when you do, your covered.

Paul Ryan is making a political argument.  He is trying to pit one group against another.  The Congressional Budget Office projected that the new Republican health care plan will mean about 24 million people will lose their health insurance.  They will not be able to afford normal medical treatment, so they will wait until it is a crisis and go to the emergency room for care.  That is much more expensive and will be paid for by those who do have health care insurance, raising their costs.  Not smart!