Reports have emerged recently of the failure of the Affordable Care Act (i.e., Obamacare) to gain a large turnout of people enrolling in health care exchanges during the first two weeks they've been open. It certainly wasn't unexpected, and this anecdotal stat (below) may have some explanatory power. What it implies is simply that people without insurance might have lacked insurance not because it wasn't available, but instead because they are irresponsible. This failure to obtain coverage through the exchange is a puzzle, assuming that people without insurance actually desired it. But it might simply signal irresponsible behavior on the part of many who are currently uninsured, which explains both why they lacked coverage to begin with and why so few are signing up now. "Why sign up now? I'll do it later and worry about the consequences then."
In this excellent piece about marriage and parents having children out of wedlock, researchers asked adolescent women whether or not they agreed with the following statement:
"Having birth control on hand takes too much planning."
The results tell a story of irresponsible behavior highly concentrated among people with less education. (Notice that the results are by the educational attainment of the mother of the adolescent being asked the question). The problem of out-of-wedlock births is only exacerbated by current health care policy.
Such policies are not compassionate if the consequence is that more children than otherwise would have been are born into families living in poverty where responsibility is neither taught nor exhibited, stress is pervasive, and the children are therefore likely to have little chance of success in life. They repeat the same behavior, creating a culture of poverty that exists in large parts of America today. If this is the case, having access to health care insurance coverage doesn't solve the underlying problem. In fact, it likely creates the incentive to act even more recklessly and irresponsibly.