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Just how are healthcare plans that are mandated going to be enforced?

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zulchzulu Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 10:51 AM
Original message
Just how are healthcare plans that are mandated going to be enforced?
I ask this to the Clinton and Edwards folks who have candidates that think that health care plans are to be mandated in order to cover everyone.

I have no idea what the Clinton plan is in regard to enforcing health care coverage as a mandate on Americans. Do people get fined if they don't join a pre-suggested menu of plans?

As for the Edwards plan, I have heard that people are automatically signed up to a "default plan" when they file for taxes and then have to pay for that plan. Perhaps that's not what the plan is.

If possible, a boiled down explanation would be great from those that know the details and want to share.

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ThomCat Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 10:54 AM
Response to Original message
1. Exactly! We will be required to spend money
(that we may not have) to buy insurance, but there will be no sure way to make sure that the insurance actually helps us.

A lot of people will have high deductables and co-pays, and a lot of claims will ge rejected just because the insurance companies can get away with it. So we'll have even more people mandated by law to give money to insurance companies, who won't be mandated by law to actually provide a usable service.
x(

We need universal healthcare, not univerally mandated insurance.
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zulchzulu Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 11:05 AM
Response to Reply #1
3. Mandated health insurance policies help out the health insurance companies the most
Edited on Fri Nov-30-07 11:05 AM by zulchzulu
It doesn't solve any of the problems of affordability...it just guarantees that the health insurance companies get their fees from EVERYONE by force and they can do the usual tricks to not actually carry through.

I'd like to see an example where healthcare insurance companies would be mandated to cover pre-existing conditions as much as the American public would be under the same mandate to get healthcare coverage.

Who writes the policies that have the small print that taketh the big print away? One guess...
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ThomCat Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 11:09 AM
Response to Reply #3
4. Exactly!
My insurance right now includes lifetime caps on spending and on phsyical therapy visits. I'm likely to hit those caps. What happens then? Will I be required to pay for insurance I'm not allowed to use? Will I have access to a different plan that doesn't include caps? Will I be eligable for it, and be able to afford it?
x(
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zulchzulu Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 11:15 AM
Response to Reply #4
5. If you can't find the mandated insurance to cover your needs...
...then you just pay a fine. OK! Next!



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cuke Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 04:27 PM
Response to Reply #4
24. Then you buy into the Fed program
Edited on Fri Nov-30-07 04:29 PM by cuke
which has no cap.

And as far as helping the insurance industry, both the Edwards and Clinton plans force the insurance industry to cover the people it doesn't want to cover. You will no longer be denied coverage because of you prior conditions, nor can you be hit with an unaffordale premium
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Sparkly Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-01-07 09:05 AM
Response to Reply #3
47. A few things...
As I understand it, the proposed plans DO require equal coverage for people who have pre-existing conditions.

I frankly do not understand why we should still have for-profit insurance companies involved, either. I would really like to hear Clinton, Edwards, and Obama explain why they believe their proposals are better than Kucinich's.

The problem with Obama's proposal is the combination of equal coverage and no mandates. Why sign up and pay in when you're healthy, under that system? Just wait until you face a crisis and then sign up. Meanwhile, the result is that it's much more expensive for those who are signed up. It makes sense for universal coverage to apply to ALL, and have ALL pay in. That's what makes it work, seems to me.

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Hieronymus Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 09:30 PM
Response to Reply #1
40. With Hillary's we will be required to spend money with private health
insurance companies. With Edwards' plan we'll have the choice of a much cheaper and efficient single payer system or private.

4% of Edwards' contributions come from business.
56% of Hillary's contributions come from business.
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Sparkly Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-01-07 09:34 AM
Response to Reply #40
49. That's not true.
Clinton also proposes a choice between private and public plans. I believe Obama does, as well.
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aquart Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 10:59 AM
Response to Original message
2. It's idiotic.
Somebody needs to knock their heads together to make a pleasing sound.

And these are the candidates I like. Go figure.
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Mountainman Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 11:18 AM
Response to Original message
6. If we would pay the money in taxes and have a single payer system it would be much better.
Edited on Fri Nov-30-07 11:19 AM by Mountainman
I would be for a two teared system. One just as it is for those who can afford it and a single payer system for those who can't. A designated portion of the payroll tax deductions of these people would go directly to the single payer system. In other words their taxes would be earmarked and go into a fund that pays for the medical care. That way the rich can't say they are funding someone else's health care.

The unemployed would share in this care also but if able to work they should be made to work if a job is available to pay for the coverage.
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zulchzulu Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 11:24 AM
Response to Reply #6
8. I saw somewhere the term "Medicare For All"
Medicare and Medicaid are basically forms of single-payer health care. I wish we could just jump to that instead of incremental "universal" healthcare gamesmanship...

"Medicare For All" should be what we should be addressing...and it wouldn't be mandated with the threat of a fine.

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redqueen Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 11:26 AM
Response to Reply #8
10. That would be HR 676
The Expanded and Improved Medicare for All Act / National Health Insurance Act

I think it has around 80 co-sponsors. No companion bill in the Senate (shock!)
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ramapo Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 11:27 AM
Response to Reply #6
11. Not just affordability
It is access to decent coverage. Rules in NJ are relatively enlightened. Coverage cannot be denied based on pre-existing conditions (although it can be delayed if you haven't been covered) and there are mandated plans for those not covered through their employer. However these are very expensive and coverage isn't great.

But if your employer offers a plan and you can't afford it or it is crap or whatever, then you have no choice. Take it or too bad. If you change jobs, maybe you'll get coverage that is better or worse. Who knows. Start your own business? Now you're really screwed. Can you afford $20K or more a year for crappy insurance.

Doctors hate my insurance. The company doesn't pay. Doctors drop the plan so we can't use their services without going out-of-network and taking whatever the insurance company feels like paying.

We need single payer. We need something affordable that is available to everyone, employed, self-employed or unemployed. I have little hope that I'll see it in my lifetime.
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Mountainman Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 04:08 PM
Response to Reply #11
22. Doctor's hate your plan because it pays them less than Medicare.
I use to be the controller of a medical clinic. We wanted to renegotiate our contracts with all insurance companies. If they paid less than Medicare we would not contract with them. The is not enough revenue from most insurance companies to run a clinic. The only way we could have made money was if the doctor's got paid less and they paid their own malpractice insurance. We cut costs until there was no more to cut and yet we could not pay the bills. Of course the doctors refused to take cuts. They would leave and go somewhere else.
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K Gardner Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 11:20 AM
Response to Original message
7. Wage garnishments, collection agencies, etc., etc.
This actually came out in one of the mandate plans of the top two. I'm not going to elaborate, because this doesn't need to be a flame war. It needs to be a concise discussion of why mandated plans will not work, cannot work. Now, maybe they're only doing what they need to do to get campaign money from Big Pharm, Big Ins, blahblah. And then, if elected, they'll slide into single payer universal. But I don't like bait and switch. Most people don't understand "mandates". Research it. It hasn't worked in Mass, it hasn't worked in California. People rebel against it. It won't work nationally. It's only a cave in to the Insurance Companies and they tack "universal" onto it to make it easier to swallow. I just don't know if anyone, in the primaries, is going to be brave enough to address it. (except for Kucinich, of course)
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LSK Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 11:26 AM
Response to Original message
9. maybe you should actually read the plan and not go by heresay?
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zulchzulu Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 11:43 AM
Response to Reply #9
13. Perhaps you have a simple explanation to share
I could wade through the issue overview (I did already), but I want to hear it from people who support their candidate that supports mandated healthcae coverage how it works.

Imagine someone on the street asking you how it works. Do you just say "go to the web site"?

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LSK Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 11:52 AM
Response to Reply #13
14. a simple answer, his plan does not mention any mandated coverage
Tell me where it does please?
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K Gardner Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 12:04 PM
Response to Reply #14
15. It's on his own website... link provided
http://johnedwards.com/news/press-releases/20071128-hea... /

Even the Title is "Health Care Mandates". Read down to the last paragraph.
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slipslidingaway Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 12:17 PM
Response to Reply #15
17. The title! Also I had not seen this...wage garnishment, collection
agencies etc.

"Families who lose coverage will be expected to enroll in another plan or be assigned one. For the few people who refuse to pay, the government will help collect back premiums with interest and collection costs by using tools like the ones it uses for student loans and taxes, including collection agencies and wage garnishment."

Thanks for the link.
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1corona4u Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 07:52 PM
Response to Reply #17
31. Well, that sucks.
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slipslidingaway Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 07:55 PM
Response to Reply #31
33. Sure does! n/t
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slipslidingaway Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 12:10 PM
Response to Reply #14
16. Everyone will be expected to obtain health coverage and then he
mentions a few exemptions, extreme financial hardships (so do they have health care?) and religious beliefs.

And then in the second paragraph he mentions the 2004 plan where parents would have been required to purchase insurance for children and then says today he proposes to expand that approach to make coverage universal.

Sounds close to a mandate IMO...you have to purchase???

"Finally: Individual Responsibility. Once insurance is affordable, everyone will be expected to take responsibility for themselves and their families by obtaining health coverage. Some Americans will obtain coverage from public programs like Medicare, Medicaid, and SCHIP and others will get coverage through their jobs. Other families can buy insurance through the regional Health Care Markets. Special exemptions will be available in cases of extreme financial hardship or religious beliefs.

The emphasis on shared responsibility builds on Edwards past proposals to insure all children through shared responsibility and contain health care costs. In 2004, his plan would have made childrens health insurance affordable and required parents to purchase coverage for their children. Today, he proposes to expand that approach to make coverage universal."

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ThomCat Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 01:04 PM
Response to Reply #9
21. Wow. From the responses you got, and the provided
link and quotes, it appears that you owe people an apology. :)
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MGKrebs Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 11:30 AM
Response to Original message
12. Probably something similar to the way France does it.
Generally considered the best, most effective healthcare system in the world.
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slipslidingaway Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 12:21 PM
Response to Original message
18. Great question, K&R for more discussion. Also see link provided
in this post, the last paragraph referenced is copied below.

http://www.democraticunderground.com/discuss/duboard.ph...

"Families who lose coverage will be expected to enroll in another plan or be assigned one. For the few people who refuse to pay, the government will help collect back premiums with interest and collection costs by using tools like the ones it uses for student loans and taxes, including collection agencies and wage garnishment."
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flpoljunkie Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 12:27 PM
Response to Reply #18
19. Edwards doesn't seem to be touting this part of this plan lately. I can see why.
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slipslidingaway Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 12:31 PM
Response to Reply #19
20. I can see why also, I had not read that part of his plan before. n/t
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1corona4u Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-01-07 01:57 AM
Response to Reply #19
44. No doubt.
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bunnies Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 04:13 PM
Response to Original message
23. Does Obamas plan explain how he'll enforce mandates for children?
Honest question.
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rinsd Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 04:33 PM
Response to Reply #23
26. He would fine parents not complying with the mandate.
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bunnies Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-01-07 01:01 PM
Response to Reply #26
54. Thanks for the info.
Much appreciated. :hi:
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cuke Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 04:30 PM
Response to Original message
25. There is no way to get to UNIVERAL health care without a mandate
Even single payer mandates that we pay for it through income taxes. Single payer also mandates that your insurance be from the govt.
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K Gardner Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 07:29 PM
Response to Reply #25
28. I can't believe even Dems now are using the "raise your taxes" scare on healthcare !
Our police protection is "mandated" by this definition.
Our fire protection is "mandated" by this definition.
Our mail is delivered by "mandate" by this definition.

Take away the word mandate. It is a badbadbad word to associate with providing medical care for the citizens of our country. Watch Sicko, if you haven't. Do some independent research. Don't believe everything a politician says.. or even people on this board for that matter, LOL.

Medicaid has a 3% overhead operating budget as compared to 30% for filty, scumsucking insurance companies who are killing our fellow Americans. There are 2 million people employed by insurance companies whose SOLE job is to find a way to deny claims, deny care, deny medicine to sick people. These are people who would continue to be employed without Universal Single Payer, i.e., Medicaid for all.

I didn't mean for this to end up a rant.. sorry.. this is my pet peeve issue. I go to work everyday in a place where people (most without insurance) come to die. This issue needs to be transparent.

:rant:
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cuke Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 07:55 PM
Response to Reply #28
32. You have, once again, misinterpreted my post
1) I said nothing about raising taxes, but for the record I am in favor of raising taxes

2) There is nothing rightwing about mandates. Arguing against mandates is the rightwing meme.

3) While single payer is the best solution, mandates will also provide the uninsured with insurance. Opposing any plan that provides insurance to the unisured is rightwing. I wish you wouldn't do that

4) As one of the uninsured who cannot afford the meds I NEED, you may end up seeing me soon, thanks to people like you who oppose mandates (just like the rightwing opposes mandates)
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K Gardner Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 08:15 PM
Response to Reply #32
35. I never mentioned the word "rightwing"...
And I apologize if I misinterpreted your post. For the record, I don't have health insurance. I'm lucky I'm healthy, but I'm one illness/car wreck/injury, etc., away from bankruptcy. And I do agree that "mandated insurance" coverage is better than NO insurance coverage. I've said before if I have to hold my nose and support a candidate who will only talk about mandates, I'll do it. Hopefully, they'll eventually see the light. Again, sorry if I offended or misterpreted you.
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cuke Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 08:17 PM
Response to Reply #35
36. My apologies
but your reference to "raising taxes" made me think you were complaining about the rightwing because they are the ones who use that argument.

And I'm not insulted or anything. You give off strong vibes of being reasonable. I have no problem with reasonable people. And I like reasonable debate. So don't you worry about it one bit. You're OK in my book
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slipslidingaway Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 07:16 PM
Response to Original message
27. Kick for answers
http://johnedwards.com/news/press-releases/20071128-hea... /

"...Edwards' truly universal health care plan will ensure that every American has health insurance. He will require proof of insurance when income taxes are paid and when health care is provided. Families without insurance will be enrolled in Medicare, Medicaid, SCHIP or another targeted plan or be assigned a plan within new Health Care Markets.

Families who lose coverage will be expected to enroll in another plan or be assigned one. For the few people who refuse to pay, the government will help collect back premiums with interest and collection costs by using tools like the ones it uses for student loans and taxes, including collection agencies and wage garnishment."
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K Gardner Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 07:38 PM
Response to Reply #27
29. link
http://www.guaranteedhealthcare.org

That's the only answer I have :-)
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slipslidingaway Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 07:51 PM
Response to Reply #29
30. Thanks for the link and I agree with single-payer, I had no idea
that people could face collection agencies and even have their wages garnished under the Edwards plan until you posted the link earlier.

People need health care not a nightmare of health insurance plans :)

Although since my daughter is a first year Med student I do worry about the potential for lower salaries considering all the debt she will have accumulated :(
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hedgehog Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 08:20 PM
Response to Reply #27
37. How would a family lose coverage? nt
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slipslidingaway Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 08:50 PM
Response to Reply #37
38. Best to ask the Edwards camp why they envision a scenario
where they will use collection agencies and garnish wages??? There are too many pieces to some of these plans IMO and too many holes that people could fall into, not to mention the separate plans for Medicare, Medicaid, Veterans, SCHIP etc. Also the potential for fraud with the health care markets and competition from different insurance companies, too many scenarios to list.

And what might be affordable when the plan starts out could turn out being not so affordable in the future through increased deductibles and premiums. Too many moving parts, tax credits for some people etc.

We just need health care for all with a collective purchasing power.



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zulchzulu Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-01-07 01:19 AM
Response to Reply #27
41. Thanks for the input
The part where families "will be expected to enroll in another plan or be assigned one" is a bit troubling to me when it comes to having to be forced to go through a healthcare insurance package that they are "assigned to".

If anyone has ever been through the situation of even simply choosing a healthcare insurance package, it can be daunting as well as seem like the small print of pre-existing conditions factored out causing extraordinarly costly coverage with little guarantee of quality or access.

If a family where several sick individuals can't get healthcare insurance and are additionally fined for not being able to get coverage, who wins? Are they crossed off as "covered" because they will continue to be "assigned" to another loop of healthcare insurance coverage?

Mandating makes no sense and it certainly doesn't make healthcare more affordable. It allows healthcare insurance companies to make a killing.

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slipslidingaway Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-01-07 12:21 PM
Response to Reply #41
52. You're welcome and thanks go to DU'er K Gardner above
for providing the link. There are so many moving parts in some of these plans it makes my head spin and you are right mandating insurance helps the insurance companies.

Unfortunately, not too many answers have been provided.
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slipslidingaway Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-01-07 12:58 PM
Response to Reply #41
53. And just to clarify, I know you were speaking of the assigned
health care package in your reply. I still have step one in mind :) the difference in the candidate's plans.
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1corona4u Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-01-07 10:55 AM
Response to Reply #27
51. Punt...
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BootinUp Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 08:02 PM
Response to Original message
34. All this concern is quite hilarious
Whats better, to get billed by the hospital and hassled by collectors or be enrolled in a healthcare plan that is designed to lower costs across the board and cover everyone.
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cuke Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-01-07 01:22 AM
Response to Reply #34
42. They won't dare answer that one
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1corona4u Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-01-07 01:22 AM
Response to Reply #34
43. I'm not ok with wage garnishment...
and I am not ok with paying for insurance when I pay my taxes. It should be totally separate. As in, you enroll, you pay. End of story. Collection agencies? Yeah, that's going to go over well...
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BootinUp Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-01-07 07:07 AM
Response to Reply #43
45.  I am not sure what you want or what plan you favor.
collection agencies is what you have now. Paying for insurance when you pay your taxes is essentially the definition of single payer.




My point was that people would be enrolled in a insurance plan that fit their needs and ability to pay when they attempt to access the medical system, or we can leave it like it is now where they battle directly with hospitals and collection agencies because they do not have insurance or have insurance that is not regulated and does not protect the insured sufficiently. I have looked at Clintons plan and read lots of other peoples opinions on it. It is definitely a move in the right direction.
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1corona4u Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-01-07 09:25 AM
Response to Reply #45
48. I like Joe's the best, but...
I'll take Hillary's over Edwards anyday.
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calteacherguy Donating Member (1000+ posts) Send PM | Profile | Ignore Fri Nov-30-07 08:53 PM
Response to Original message
39. Clinton has no plan for this. She is lying when she says she has a plan.
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zulchzulu Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-01-07 08:53 AM
Response to Reply #39
46. You can bet that in the next debate, mandated healthcare insurance will be a topic
Since Hillary has been attacking Barack on the issue, you will see him come out asking her just how she plans on forcing people to be covered on healthcare plans and how that doesn't reform the process...just makes a lot of money for the healthcare insurance industry.

It should be an interesting exchange.

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1corona4u Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-01-07 10:07 AM
Response to Reply #46
50. She's already said...
Edited on Sat Dec-01-07 10:07 AM by 1corona4u
the way her healthcare is structured, it's a tax CREDIT;

Affordable: Unlike the current health system where insurance premiums send people into bankruptcy, the plan provides tax credits for working families to help them cover their costs. The tax credits will ensure that working families never have to pay more than a limited percentage of their income for health care.

Available: No discrimination. The insurance companies can't deny you coverage if you have a pre-existing condition.

Reliable: It's portable. If you change or lose your job, you keep your health care.

So, the incentive to pay for it is built in. It's one thing to build a plan around a tax break, and it's quite another to mandate that you pay insurance WITH your taxes.

Again, I'll take Hillary's. Well, Joe's first...but Hillary's if I have to.
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BootinUp Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-01-07 01:13 PM
Response to Reply #50
55. I'll have to read Biden's nt
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zulchzulu Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-01-07 05:23 PM
Response to Reply #50
57. "The insurance companies can't deny you coverage if you have a pre-existing condition"
That I'd like to see... a policy that allows healthcare insurance companies to due the bidding and have the government fine you if you don't get coverage... how are these mandates enforced? How is forcing people to have healthcare insurance going to change how they already operate?

:rofl:

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nealmhughes Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-01-07 03:30 PM
Response to Original message
56. The insurance police would enforce it, their office is right beside the copyright police.
Right down the hall is the "Missing Billions from Iraq Taskforce." In Alabama, the dildo police will keep our precious orifices free from foreign intervention.
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AtomicKitten Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Dec-01-07 05:26 PM
Response to Original message
58. Baby Jesus will make it so?
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