MyDD :: Mandatory insurance

Mandatory insurance

by InigoMontoya, Sat Feb 02, 2008 at 09:47:05 PM EST

I really don't get why some people get their knickers in a twist about "mandatory" insurance. At least here in California, we have mandatory auto insurance. You want to register your car, you have to show proof of insurance. No big deal and by doing so, it lowers the costs for everyone.

By making the insurance pool as large as possible, costs should be reduced.

And that brings up my other gripe about attacks on "Hillarycare": that's it's "government" insurance. Actually, all the insurance is still through private carriers. For me, a selling point is that the plan currently available to Members of Congress would become available to everyone...boy, would I want to look at the cost-benefit analysis of that. Attacks on "madatory insurance" or "government health plan" are red herrings.

Tags: Hillary, Obama, 2008, primaries, health care, insurance (all tags)

Permalink :: 27 Comments :: Post a Comment

Re: Mandatory insurance (none / 0)

It's certainly not a government health plan. That would be a good thing.

What if you simply can't afford it?

by illlaw1 on Sat Feb 02, 2008 at 09:48:28 PM EST

Re: Mandatory insurance (2.00 / 1)

There is a government plan: a host of options under the government plan, but you will have the choice of private insurance if you want. Please educate yourself before you say these things.

As for "can't afford it," that's the reason we have to get everyone covered. No one will be priced out of the system with a compromise that says to insurance, all of the risk will be contained and homogenized in the system making it less burdensome for you but that means you can no longer cherry-pick customers or price them out. It's a win-win. But a mandate is key to making it work: all of the burden can't be shifted onto just one party. Government, individuals, and the private sector will all have to contribute.

While I could sit in church and pray all I want, I wouldn't be fulfilling God's will unless I went out and did the Lord's work ~ Barack Obama

by bowiegeek on Sat Feb 02, 2008 at 10:32:26 PM EST
[ Parent ]

Re: Mandatory insurance (none / 0)

Yes but it's not a single-payer tax funded plan.

No one will be priced out? Meaning that it'll be free even if I make 70K a year but am paying all of that back out for bills before I'm forced by the government to pay for health insurance?

If it's not single-payer then it's not worth arguing over.

by illlaw1 on Sat Feb 02, 2008 at 10:48:00 PM EST
[ Parent ]

Re: Mandatory insurance (2.00 / 1)

First of all, nothing is free. Single-payer is not free. No method of organizing Universal Health Care is free. Having a government in the first place is not free, certainly government-only health coverage isn't free. So the "but it isn't free" objection is really misplaced. If you want political realism, then I guess we won't be having a conversation. Hillary's last effort was far more top-heavy and government-ized than it is now. It went down in flames because it raised all of the deepest fears people had about the government taking too much liberty over the trajectory of our lifespans and decisions about our health. If you want a plan that's affordable and caps deductibles to a percentage of your income, not just giving you a nominal amount of cash to deal with health insurance on your own, I think you should give Hillary a chance.

While I could sit in church and pray all I want, I wouldn't be fulfilling God's will unless I went out and did the Lord's work ~ Barack Obama

by bowiegeek on Sat Feb 02, 2008 at 11:15:48 PM EST
[ Parent ]

Re: Mandatory insurance (none / 0)

You don't think enough of our tax dollars are taken to pay for a single-payer system?

I think they don't need anymore of our money.

It's so odd how many other countries can manage it but we can't despite how much money the government rakes in.

by illlaw1 on Sat Feb 02, 2008 at 11:18:41 PM EST
[ Parent ]

Re: Mandatory insurance (none / 0)

As I said, if you don't want to talk about political realism in America with respect to healthcare then so be it. If top-down government purchasing alliances got shot down in 1993/94, single payer will not pass Congress.

While I could sit in church and pray all I want, I wouldn't be fulfilling God's will unless I went out and did the Lord's work ~ Barack Obama

by bowiegeek on Sat Feb 02, 2008 at 11:23:57 PM EST
[ Parent ]

Re: Mandatory insurance (none / 0)

I get your point and I would not suggest it is implausible, but I am not sure I agree.

Citing his 1991 JAMA study*, author Himmelstein recounts a conversation with Clinton in which she asked how single-payer could be sold. I agree with him that the way was to "demonize" HMOs and insurance companies and use the presidency to mobilize the 70% of Americans who then supported the basic elements of the single-payer system. She chose another path.

The Clinton team opted for a corporate-oriented plan developed in secret relying primarily on corporate shills, freezing out most single-payer advocates, and aiming to achieve cost savings by empowering HMOs. The option people were presented was far worse than single payer: cost savings would come not out of insurance overhead but by restricting doctor choice and coverage while turning health care over to the corporate behemoths. Perhaps that plan deserved to lose.

It is not at all clear to me that a candidate or President is prevented from pushing single-payer. They just have to want it, be willing to fight for, and do everything in their power to mobilize the substantial latent public support.

Clinton's plan this time is much better than last time and much better than the status quo. I also do not think that if it is true than single-payer is unreachable (and, again, I think it can be realized) that we should do nothing.

*"Liberal Benefits, Conservative Spending," Grumbach, Bodenheimer, Himmelstein, and Woolhandler, JAMA, May 15, 1991

"We live entangled in webs of endless deceit, often self-deceit, but with a little honest effort, it is possible to extricate ourselves from them". -- NC

by Trond Jacobsen on Sun Feb 03, 2008 at 12:56:44 PM EST
[ Parent ]

I'm tired of extreme examples (none / 0)

to crticize something.

"What if someone can't afford it"?

or with voter id cards,
"What if someone can't pay for the documents"

---
There are not THAT many people who can't afford things.

The poorest people in our country have cable, eat out regularly, and so on.

I'm saying, start with a universal goal. Involve the marketplace as much as possible. Subsidize those who can't afford it. Make everyone else who can which is the vast majority be responsible.

Give them plenty of choices but they have to choose one.

Maryland is the same way with auto insurance, I imagine almost everywhere is except new hampshire(?).

If you have a car and it is not insured for even 1 day you have to pay a big fine. I found this out when I sold my car, canceled my insurance before I turned in the registration.

Overall its' a good system because when you are really in need you have insurance. All the other time you complain. That's American and its' great.

by yellowdem1129 on Sat Feb 02, 2008 at 10:05:33 PM EST

Re: I'm tired of extreme examples (none / 0)

"The poorest people in our country have cable, eat out regularly, and so on."

Wow. You don't know many poor people eh?

by illlaw1 on Sat Feb 02, 2008 at 10:48:29 PM EST
[ Parent ]

Re: I'm tired of extreme examples (none / 0)

illlaw1 is right.

http://www.ers.usda.gov/Briefing/FoodSec urity/

In 2006, 89 percent of U.S. households were food secure throughout the entire year. The remaining households (10.9 percent) were food insecure at least some time during that year, essentially unchanged from 11.0 percent in 2005.

The prevalence of very low food security was 4.0 percent of households, also essentially unchanged from 2005 (3.9 percent). In households with very low food security, eating patterns of one or more household members were disrupted and their food intake was reduced at times during the year because the household lacked money and other resources for food. See more on recent conditions and trends.

4% of households in the US do not even eat regularly, much less eat out regularly. We have a lot of work to do, as a nation.

Your attempt to change the subject to "the issues" is irrelevant.

by itsthemedia on Sat Feb 02, 2008 at 11:24:42 PM EST
[ Parent ]

Re: Mandatory insurance (2.00 / 1)

What is Clinton's plan to enforce the mandate?

by Piuma on Sat Feb 02, 2008 at 10:09:12 PM EST

Re: Mandatory insurance (none / 0)

The diarist doesn't know, she ducked the question at the most recent debate.

by Shaun Appleby on Sat Feb 02, 2008 at 10:12:10 PM EST
[ Parent ]

Re: Mandatory insurance (none / 0)

That will be worked out. As a result of the last debate we now know how Obama plans to retroactively mandate insurance: just hit a sick person with fees larger than they'd pay now when they go to the emergency room for "back premiums." It's a tremendously wasteful burden compared with simply covering everyone from the start.

While I could sit in church and pray all I want, I wouldn't be fulfilling God's will unless I went out and did the Lord's work ~ Barack Obama

by bowiegeek on Sat Feb 02, 2008 at 10:35:50 PM EST
[ Parent ]

Re: Mandatory insurance (none / 0)

Hard to say. I actually imagine voluntary compliance will be quite high--a lot of people are simply the law-abiding type.

What's Obama's plan for dealing with free riders and adverse selection? I imagine he has a few ideas, but doesn't want to be explicit, because as with Clinton, it's a political loser to be specific.

by OrangeFur on Sat Feb 02, 2008 at 11:15:24 PM EST
[ Parent ]

Re: Mandatory insurance (none / 0)

If you listen carefully here (timecode 3:54), you'll see that his proposal is the most heavy-handed of all the possible ways to combat free riders. He wants to retroactively impose a mandate on sick people when they go to the emergency rooms uninsured hitting them with a fee that arguable eclipses what uninsured people have to contend with now.

While I could sit in church and pray all I want, I wouldn't be fulfilling God's will unless I went out and did the Lord's work ~ Barack Obama

by bowiegeek on Sat Feb 02, 2008 at 11:20:19 PM EST
[ Parent ]

Re: Mandatory insurance (none / 0)

Which would mean his plan is more "Universal" than hers is. But, actually, he didn't say that's what he wants to do, he suggested it as a possibility.

by Mystylplx on Sun Feb 03, 2008 at 02:00:50 PM EST
[ Parent ]

Re: Mandatory insurance (none / 0)

That's funny to me. So Barack Obama the individualist who sends out mailers raising the specter of Hillary Clinton wanting to take over your life wants to punish people when they get sick for not choosing to buy health insurance. Let's take a moment and savor that, shall we?

While I could sit in church and pray all I want, I wouldn't be fulfilling God's will unless I went out and did the Lord's work ~ Barack Obama

by bowiegeek on Sun Feb 03, 2008 at 02:11:35 PM EST
[ Parent ]

Re: Mandatory insurance (none / 0)

Let's take a moment and savor the fact that none of the plans are Universal and only Barack Obama is honest enough to say so.

by Mystylplx on Mon Feb 04, 2008 at 12:23:00 PM EST
[ Parent ]

Re: Mandatory insurance (none / 0)

Obama chose honest after some cajoling that his plan wouldn't cover anyone, despite his lie during a debate that it would. Hillary sets the goal of covering everyone with teeth to back it up. If honesty means aiming low, then Obama sure is honest.

While I could sit in church and pray all I want, I wouldn't be fulfilling God's will unless I went out and did the Lord's work ~ Barack Obama

by bowiegeek on Mon Feb 04, 2008 at 08:10:08 PM EST
[ Parent ]

Re: Mandatory insurance (none / 0)

It is about principle. Mandatory health care is about how you think about social services and how one sees the government and its function.

Obama uses/believes what republicans think about health care and social services. I respect his opinion but I would not vote for the one who does not agree with the principle of Democratic Party.

by praxis1 on Sat Feb 02, 2008 at 10:26:29 PM EST

Re: Mandatory insurance (2.00 / 1)

Let's look at the long view. Most progressives would agree that the real best system would be some form of single-payer health care. Obama is on record as saying that he would go with single payer if he was starting from scratch, but he does not think that politically we can get there directly from where we are. Obviously, the other major Democrats agree - the only single payer plan proposed this cycle was Kucinich's "Medicare for All", which was eminently practical from a policy standpoint, but went nowhere politically.

So what is the likely long term evolution of the two surviving proposals?

Obama's plan is not universal, and he defends that with a distionctly libertarian argument - people should not be forced to buy insurance if they don't want to buy it. It sounds great, freedom loving in an Ayn Rand-ish sort of way, but the consequence is a continued upward spiral of private health insurance premiums as healthy people take themselves out of the system. The cost of subsidizing insurance for the working classes will rise in tandem, and at some point the cost of the whole system will rise to the point where Republicans can point to it as wasteful and unaffordable. If we go with the Obama plan now, we will be defending it forever, just to keep from backsliding.

In the Clinton plan (I'm not calling her a copycat, but it is nearly identical to the Edwards plan), everyone must have insurance, but there is an option to buy into a government run plan if non of the private insurance plans are right for you. There are subsidies for lower income people. This sets up a competition between the for-profit private plans and the non-profit public plan. If the public plan is run with anything near the efficiency that Medicare is run, the for profit plans will not be able to compete long term. Before too long, businesses will clamor to use the public system for their employee health plans, because of lower costs and better coverage. We will be on a glide path to a single payer system.

Your attempt to change the subject to "the issues" is irrelevant.

by itsthemedia on Sat Feb 02, 2008 at 10:35:49 PM EST

Re: Mandatory insurance (none / 0)

How many voters do you think will be turned off to the Dem party by being forced by the feds to buy health insurance?

by illlaw1 on Sat Feb 02, 2008 at 10:49:51 PM EST
[ Parent ]

Re: Mandatory insurance (none / 0)

That is an imponderable. Auto insurance is required in my state, and I can not recall ever hearing anyone complain about it. Doubtless, there are some. There are also some people who complain that we have an income tax, but we still make them pay.

Your attempt to change the subject to "the issues" is irrelevant.

by itsthemedia on Sat Feb 02, 2008 at 11:32:43 PM EST
[ Parent ]

Re: Mandatory insurance (2.00 / 1)

As mentioned above, there is a public plan offered in Clinton's proposal. It will be based on Medicare.

Every time I see someone criticize her proposal because it will force people to buy from rapacious private insurers, it drives me nuts. It is simply and flatly false.

by OrangeFur on Sat Feb 02, 2008 at 11:17:45 PM EST

Re: Mandatory insurance (none / 0)

But it does force you to pay rather than using existing tax dollars correct?

by illlaw1 on Sat Feb 02, 2008 at 11:19:35 PM EST
[ Parent ]

Re: Mandatory insurance (none / 0)

That's correct. If you're advocating that it be paid for out of taxes, as happens with Medicare, then I would agree with you. I suppose it's possible to set the system up so that you can enroll via taxes, as is done with Social Security.

by OrangeFur on Sat Feb 02, 2008 at 11:40:20 PM EST
[ Parent ]

Social Security (none / 0)

is a mandated program. It is not optional. Everyone contributes, everyone benefits, and that is why it works. Social Security is more than just retirement - it is also disability and survivors' insurance.

I see nothing wrong with mandating health insurance the same way. And considering the efficiency of the Medicare program (3% admin costs) vs. private insurance (30% admin costs), it won't take long for the private insurance companies to crumble under the pressure.

But before we get there, the insurance companies will put up one hell of a battle. After all, those company execs have thier big salaries and bonuses at stake.

by Bear83 on Sat Feb 02, 2008 at 11:33:29 PM EST

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