"Progressives need to stop defending the individual health insurance mandate. It isn't progressive"

[Better Believe It]

The President Adams Payroll Tax: Nothing Like an Individual Mandate
By: Jon Walker
January 21, 2011

The incredible degree to which many “liberal” writers have gone all-out to defend the previously conservative idea of an individual mandate requiring people to give a private corporation their money is bizarre. That latest attempt seems to be a dishonest interpretation of a 1798 law that created a payroll tax to pay for federal socialized medicine.

The fact the founders supported the completely uncontroversial idea that the government could levy taxes on individuals and use those funds to provide government services–such as health care–in absolutely no way indicates, one way or another, their support for using government power to require people to buy an expensive product from a private corporation. Just because this law deals with health care is immaterial. This tax no more indicates support for the individual mandate than anyone of the other hundreds of laws that “mandated” individuals pay a tax to the government.

Progressives should be pointing to this law to show that the founders had no problem with the basic design of the honestly progressive solution of single payer. However, using it to defend the idea of the individual mandate seems to be a real distortion.

Progressives really need to stop defending the individual mandate. It isn’t progressive, it isn’t popular, it isn’t necessary, and, most importantly, it is an inherently inferior way of expending coverage when compared to a truly progressive approach.

Read the full article at:

http://fdlaction.firedoglake.com/2011/01/21/the-president-adams-payroll-tax-nothing-like-an-individual-mandate/

[Catherina]

1. Never did, never will, defend that terrible mandate. Rec'd n/t

[Tansy_Gold]

5. Ditto on all four points.

[harun]

100. Me either, only ones asking for a mandate are Insurers.

[liberalmike27]

120. I don't care for it either

I wonder if anyone knows what the program is for those who are unemployed, and can't buy insurance?

I know that anyone under 80 grand a year is going to get a stipend to help buy insurance with. I think most who earn over 80 grand probably already have insurance. So, how much is that stipend going to be for different groups, to help purchase insurance?

And isn't this insurance premium money coming out of 40 million or so people's paychecks, that they were using to buy food, and "stuff," going to hurt the economy?

I wonder what'll happen if the SC tears down the mandate? Will they just keep the rest of the bill, which does contain at least some mild improvements.

[theFrankFactor]

127. I'm In Too

[Echotrail]

168. Forcing people to buy from co's screaming "no regulations" is just wrong

The only parts of the bill I like is that companies can't deny coverage for a pre-existing condition, it removes caps or limits on coverage, and allows a student/young adult to be covered under a family policy till they're 26 or whatever. I like that it expands coverage to more people but not at the expense of mandates.

The rest of the bill just maintains the same old wasteful insurance bureaucracy that comes between you and your doctor, and adds to costs.

I don't see a lot of long-time health reform advocates rallying to save the bill. That tells me a lot.

[rko_24550]

186. +1

[Fumesucker]

2. K&R, thanks for posting..

[sabrina 1]

3. It's a rightwing idea. I never supported it. I agree with the article.

What's ironic is to see rightwingers supposedly against one of their own ideas.

And to see Liberals now supporting one the ideas they used to oppose, (including this president) so strongly.

Party politics are destroying this country, just as predicted by the FFs.

Those pulling the strings must laugh their heads off when they see Liberals defending this.

I'd like to hear why Obama, who before the election stated that mandating people to pay for insurance would be 'unfair' flip-flopped on this issue also. He was eloquent about it, slammed both Hillary and McCain for supporting it.

I was against it when Romney proposed it (so was every Dem. I knew back then) I was against it when McCain proposed it, and Hillary, and I'm still against it.

[indepat]

93. If this centerpiece of BHO's accomplishments is a right-wing idea, where, pray tell, are the

left-wing/centrist ideas in his arsenal? :shrug:

[sabrina 1]

116. Good question ~

[Nuclear Unicorn]

187. FWIW the RW hates the mandate as well.

Lawsuits and all that.

[Matariki]

4. I'm old enough to remember how much car insurance cost increased when it became mandated.

I don't think having insurance to own and operate a car is in any way the same as health insurance - just that it's an obvious example of what insurance companies will do once we're required by law to buy their product.

Single payer - the way to go.

[bluestateguy]

6. That's fine, but don't defend an individual mandate under a public option or single payer system

You are either for a mandate or against it, no conditions and if, if, iffs.

[Better Believe It]

8. The difference between a single payer mandate like Medicare and a private insurance mandate is clear

[Hello_Kitty]

15. False choice. The OP lays a clear case out for why they are different. eom

[dflprincess]

21. Medicare or another single payer system would give us access to care

the mandate we got only requires we continue to pay premiums to a private insurance company for "coverage". And it comes with no guarantees that the out pockets won't be so high we still won't be able to get care when we need it.

[grahamhgreen]

130. There is no mandate under single-payer, it is a tax.

[liberation]

153. Oh, yes if only it was that easy

to make up some bullshit fallacy and expect truth and logic to abide by it. Bush tried that "either for or against" too bad "reality" was such an uncooperative bitch. Right?

[Texasgal]

7. I agree.

I think that mandate sucks. We need to REALLY reform healthcare, not just half-assed.

[Curmudgeoness]

9. I, too, have always been against it. Totally agree with this article.

So many people are against it, I have to wonder how it got into the law.

Compromise, shmompromise.

[DJ13]

10. Obama & Congress supported the mandates because the Ins Co's were afraid

that a tax would more easily lead to a real single payer system.

As far as Im concerned thats also why I have always said the only constitutional way to pay for the required insurance is through a modest increase in income taxes applied to everyone.

It wont be too far off in the future before the need for the insurers to increase profits will force the government to offer its own nationalized healthcare because too many people can no longer afford to buy insurance, so setting up a mechanism to pay for it now is the smart way to approach it.

[harvey007]

11. I concur

No one should be forced to buy conventional health insurance.

[jaxx]

12. "It does show the founders supported socialized medicine"

The only people who use that phrase, "socialized medicine", to describe the Health Care Reform are the rightwing. It looks like FDL has completed the flip and is now republican. Interesting.

[Hello_Kitty]

16. Are you opposed to socialized medicine?

[jaxx]

20. I am for universal health care.

Socialized medicine is a rightwing phrase that I don't use.

[leftstreet]

23. Obama calls mandated for-profit insurance "universal health care"

:shrug:

Might be better to let people who endorse socialism decide if "socialized medicine" is a rightwing term

[Hello_Kitty]

26. Socialism has a 36% approval rating. The Tea Party is at 35%.

Yet we're letting teabaggers dictate what terms we get to use.

[leftstreet]

29. Both 'sides' are flat out demonizing socialism

:banghead:

[jaxx]

34. So now it's ok to use that phrase?

I can't believe it!

[Hello_Kitty]

35. What do you consider active duty military and VA health care?

[jaxx]

36. Government sponsored health care.

[Hello_Kitty]

45. "Government sponsored health care." Also a RW scare meme.

And another way of saying socialized medicine.

[jaxx]

47. LOL

[Hello_Kitty]

56. Shuts 'em right up

I'm a Navy vet and I point out that I got "socialized medicine" the entire time I served.

[jaxx]

33. Ah a vote for the use of the words "socialized medicine".

You can call it that if you want. Me, I won't.

[Hello_Kitty]

25. What do you think the U.S. Military health care system and the VA are?

[ehrnst]

183. You mean socialized health care coverage? Or government run hospitals/Clinics?(nt)

[ThomCat]

41. That isn't entirely true.

From the beginning, people on the left have been taunting the tea party people by pointing out to them that their own VA benefits, their Medicaid and their Medicare are all socialized medicine all while they screamed about not wanting socialized medicine.

[ehrnst]

184. VA hospitals are socialized medicine. Medicare is socialized coverage.(nt)

[harmonicon]

119. maybe in the US

Many people around the world are very proud of their socialized medical care and other social services.

[cbdo2007]

13. either way we're paying for it, so it's a wash

[Hello_Kitty]

17. Not really.

Lower income and middle class people would get a much better deal under single payer.

[Edweird]

61. No, it's not. One way you get health care, the other you pay someone to deny you healthcare.

[Starry Messenger]

14. It's not even centrist.

It's a shitty neolib trick.

[KG]

68. +eleventyhundred

[me b zola]

18. K&R

[girl gone mad]

19. k & r

[stillwaiting]

22. I've said from the beginning: Phuck the mandate! nt

[leftstreet]

24. K&R

[Kurovski]

27. It's awful, I think it's the one thing Tea baggers and me agree on.

PUBLIC OPTION, please.

[rhett o rick]

28. If not the mandate then a penality similar to medicare for those that choose not to play until they

are sick. No far not paying for insurance when you are healthy then expecting to buy in when you get sick. Medicare takes care of that with a strong penalty if you try to buy in after your initial eligible sign up period.

Without the mandate or a similar penality for late sign up, it would be like allowing everyone to go without car liability until they have an accident. No fair.

[leftstreet]

31. Okay....then no fair letting Insurance Execs profit until I actually get sick

Right?

[rhett o rick]

42. That has nothing to do with this. nm

[girl gone mad]

57. It has everything to do with this.

What about the people who have paid tens of thousands to the insurance companies, only to have their claims denied? Do they get all of their money refunded?

What about the people who never get sick until old age, by which time the insurance companies have kicked them off through insane premium hikes? Do they get refunded?

[BzaDem]

60. You are confusing two distinct issues.

The first issue (denial of claims) is dealt with in the bill.

The second claim misunderstands the concept of insurance. If you don't get sick, you don't get a penny back in premiums (just like if you don't get in an accident, you don't get a penny back for car insurance premiums).

The reason the mandate is required if you cover pre-existing conditions is that if healthy people (i.e. people who don't use insurance) don't buy insurance, than the premiums have to cover one's medical expenses. In other words, the premiums you pay have to cover an average person's medical expenses per year. If only sick people are in the pool, then your insurance policy is going to be thousands per month.

[girl gone mad]

76. Denial of claims is not dealt with.

Claims can and will still be denied. Certain customers will now have the right to appeal, but there is no guarantee the claims will ultimately be approved.

As has been addressed numerous times in this forum, uncompensated care accounts for less than 5% of total health care costs in this country. That 5% does not add thousands of dollars a month to the cost of premiums. What's more, there is ample evidence that because the uninsured use much less health care than do the insured, they are keeping overall costs down.

I know that had I been forced to purchase health insurance in my youth, you damn well better believe I would have been going to the doctor for every scrape, bump, sniffle and ache. I would have demanded to get my money's worth++.

[BzaDem]

111. This seriously shouldn't be that hard to understand. The level of uncompensated care right now is

completely IRRELEVANT to the level of uncompensated care that would occur if we banned discrimination on the basis of pre-existing conditions, but had no mandate.

Why do you keep acting as if it is at all relevant? Let's say we have a low rate of damage due to uninsured motorists right now. Do you REALLY think that we would still have a similar rate of damage due to uninsured motorists if we allowed people to get insurance for their previous accidents, and had no mandate? Really?

[rhett o rick]

82. Exactly. If you choose not to buy private insurance until you are sick, they will

not accept you because of preconditions. This is how insurance works. You pay when you are well to get a pool of money to get back when you are sick. But the HCR bill doesnt allow insurance companies to deny coverage, therefor if you let millions go without coverage until they got sick, the system fails.
Every other modern country mandates coverage.

[Romulox]

87. You're trying to force the square peg of government enforced purchases into the round hole of

PRIVATE insurance.

Basic actuarial principles cannot be applied to a transaction that is mandated by the government. :hi:

"In other words, the premiums you pay have to cover an average person's medical expenses per year."

And a government mandated profit margin. :hi:

[rhett o rick]

117. You cant have it both ways. The healthy have to support the sick. That is insurance.

Currently private insurers dont mandate you buy when healthy but then they can refuse to cover you when you become sick. The HCR bill mandates that insurers cover all. Therefore all must participate. The healthy have to be mandated or they will opt out until they are sick.

Other modern countries mandate payment via tax.

[Romulox]

146. Nonsense. There is no requirement for private insurers to profit before we treat the sick.

You start from a bogus premise.

"Other modern countries mandate payment via tax."

Most of those have universal, not-for-profit care. :hi:

[rhett o rick]

180. I understand they have universal, not for profit care. But everyone is required to

pay for it. Same as a mandate.

Without a mandate a person could opt out for 20 years then get cancer and opt in. That is not sustainable.

I dont like the HCR system, but for it to work at all, if the government is going to mandate the insurers to cover everyone, then everyone must buy in.

[Romulox]

189. No, everyone is not required to pay for "it", where "it" is defined as legislatively mandated

private insurance. You keep asserting that private insurance and universal healthcare are similar in that the burden is universally shouldered. I concede this point.

However, you blithely ignore the massive difference between the two systems; under European style systems, everyone is covered, regardless of ability to pay. Arguing that everyone pays in Europe doesn't address this second point. Not in the least.

[Romulox]

85. LOL! "That point that you made (the one that SKEWERED my whole argument)? IRRELEVANT!"

:rofl:

[BzaDem]

112. I think the issue was that the point made actually didn't refute the argument at all

not that it did.

[Romulox]

148. Sure it did. You're trying to argue that the gov't should guarantee private profits on the backs of

mandated purchases. There's no "actuarial" argument for this principle, and there's certainly no free market argument for this enforced purchase, either. :shrug:

[BzaDem]

154. Again, if you don't want to "guarantee private profit," then make the argument for why pre-existing

conditions shouldn't be covered. Reality doesn't change just because you don't like it. Until the country enacts single payer, we have a private, for-profit insurance system, and people are either going to use it and get healthcare, or not use it and not get healthcare.

Now, the bill limits all non-medical expenses to 15% of premiums. When you subtract administrative expenses like marketing/non-executive low-level salaries from that, you get a single digit percentage that goes to insurance company profit/executive salaries/etc.

What you are saying is that for the time period between now and when we end up getting single payer (if ever), that single digit percentage is so abhorrent to you that we should simply screw people with pre-existing conditions by not having a mandate (making people with pre-existing conditions pay the unaffordable market rate for their health insurance). If that is your view, that is fine -- but you should come right out and say it, and justify it. Not pretend otherwise, or act like we live in an imaginary world with single payer right around the corner (making the pre-single-payer pre-existing-condition problem irrelevant).

[Romulox]

158. "Mandatory insurance company profits...OR THE PUPPY GETS IT!"

What a crude sort of extortion! :puke:

[BzaDem]

161. Extortion is a great analogy. A hostage situation doesn't go away just because you don't like the

situation. Denial isn't a choice -- the situation exists whether you like it or not. You can either pay what you would call a "ransom" (mandate + fix pre-existing condition problem), or shoot the hostage (i.e. all those with pre-existing conditions).

Which is your choice?

[Romulox]

190. If it's "extortion", the President is an accomplice; it's HIS bill that mandates private purchases

He could've pushed for universal care, but that would apparently clash with the President's triangulated version of "free market" ideology.

[Fumesucker]

32. Why not single payer, run by the government?

The money for which comes out of a progressive income tax..

Why does it have to be penalties for not buying overpriced and crap private insurance?

[rhett o rick]

43. Of course I am for single payer. nm

[Better Believe It]

38. Everyone who is employed pays for Medicare. It's a tax. It's not the same as car insurance.

[rhett o rick]

44. Yes for part A. But for part B you must pay. And if you decide you dont want to pay while you are

healthy but wait until later, you must pay a penalty. Insurance wont work if you let everyone stay out (not pay premiums) until they are sick.

[Hydra]

46. "Healthy but wait later"

I have a disabled relative who couldn't afford it. Now she has to pay all of it back if she wants it.

This whole thing of "fairness" is a false equivalency. Everyone pays into the system as a tax, and everyone ahould gets coverage with no co-pays or deductibles. Why is this such a hard idea, beyond the fact that someone's trying to make a buck off it?

[rhett o rick]

51. Every one pays into it (part A) but if you want part B you need to buy in.

At $115 a month it is pretty cheap insurance. If you cant afford it, then maybe Medicaid is your answer. The point is that we dont want slackers to get the benefits of Part B without paying up front.

[Hydra]

53. Right, the slackers that apply for SSDI in the first place

Because they have other viable options. It was $95 a month, but that was more than she had at the time.

[rhett o rick]

69. Dont misunderstand me. I favor Medicare for all. nm

[Better Believe It]

52. I'm in favor of Medicare without co-pays or deductibles. The health insurance industry law ....

is a giant step away from that.

If the trillions of dollars given to the health insurance industry in premiums were instead paid into Medicare we could have Medicare for All.

[Hydra]

54. Yup, but then we wouldn't have happy people on Wall St.

Why did we want that again? So they could ship more jobs away and kill more people via rescission?

[Better Believe It]

50. The insurance industry isn't working now for people who need health care. They are parasites.

The public only gets back at most 80 cents out of every dollar they pay the insurance industry for health care expenses.

The insurance industry contributes absolutely nothing to health care in this nation.

They are a parasitic drain on it.

[grahamhgreen]

131. Like the insurers have EVER played fair. They don't repeal the mandate, keep the rest.

[muntrv]

30. 3 words: MEDICARE FOR ALL.

[jtrockville]

49. ^ It's just that simple.

[grahamhgreen]

132. +1

[Senator]

37. Because ... Healthcare Is NOT A Commodity.

It is not a "product" like other things. Because -- exactly like national defense -- we ALL need it in exactly the same quantity. Which is "as much as we need, when we need."

You can't "project" your individual costs or your company's. You can't "contain" expenditures predictably. And there really is no "insurance pool" from which only some risk-sharers get sick and die (sudden, youthful, "cost-free" deaths of premium-payers are simply not that common).

So it can't function well within markets and capitalism. In fact, it damages them.

That is why it has no place in the private sector. Because literally all the "profit" is blood money -- that could have made a fellow American well, or saved their life.

Now mandated "blood profits."

---

[WinkyDink]

40. Here's the deal: TPTB DON'T CARE.

[WinkyDink]

39. Beyond bizarre to Bizarro. There is NO KNOWN EQUIVALENT, not auto tax, not nothing.

[johnaries]

48. This article has no basis in reality. Typical of FDL.

[girl gone mad]

55. Sounds personal.

[Recursion]

58. Find a way to require insurance companies to cover anyone who wants insurance...

...without a mandate that doesn't either drive insurance companies into bankruptcy or raise premiums so high that nobody can afford them. It's there for a reason.

[BzaDem]

59. If you don't think the mandate is progressive, then you don't think requiring coverage of

pre-existing conditions (from now until when single payer is enacted, if ever) is progressive.

There's little else to it. One doesn't work without the other, unless you want policies that cost thousands per month.

[Edweird]

62. The individual mandate is RW crap, just like the 'cadillac tax'. Both of which McCain ran on

and Obama ran against. In fact, Candidate Obama made quite a case against both of them.

[BzaDem]

63. Actually, McCain didn't run on the mandate. If you think otherwise, please prove it. n/t

[Edweird]

66. You're right about 2008. My mistake. However, he did openly support it.

But the "truth is this is a Republican idea." Linda Quick, president of the South Florida Hospital and Healthcare Association, told the Miami Herald that she first heard about "individual mandate" in a Miami speech delivered by John McCain. That was back in 1993 when Republicans were hitting the countryside with messages to counter the health care reforms being pushed by the Clinton administration.

McCain did not embrace the concept during his 2008 election campaign, but other leading Republicans did, including Tommy Thompson, secretary of Health and Human Services under President Bush.
Seeking to deradicalize the idea during a symposium in Orlando in September 2008, Thompson said, "Just like people are required to have car insurance, they could be required to have health insurance." <--- I hear that one a lot from a certain group of people here...

http://www.examiner.com/populist-in-national/republicans-once-supported-the-individual-mandate

"As recently as last September, former Senate GOP leader Bill Frist endorsed the individual mandate"

"Last December, Utah's Orrin Hatch claimed that "Congress has never crossed the line between regulating what people choose to do and ordering them to do it," yet the last time Congress debated a health overhaul in 1993, Hatch was among 21 Republican Senators who supported a 1993 GOP bill requiring an individual mandate. Four of those lawmakers remain in the Senate today: Charles Grassley of Iowa, Robert Bennett of Utah and Chris Bond of Missouri."


oh and who can forget uber progressive Newt Gingrich supporting it:
"The reality of an individual mandate (when coupled with subsidies so that insurance is affordable and market reforms so that coverage is accessible), is that it would not only address the "free rider" problem, but also serve as a tool to enhance insurance market competition. When combined with market reforms and subsidies, the mandate would help move insurers away from a business model that relies on marketing and underwriting and towards a strategy that involves competing for customers based on performance and price. This is a good thing...and something those in favor of market competition could get behind."


http://health.newamerica.net/blogposts/2008/reform_newt_gingrich_on_free_riders_and_the_individual_mandate-18127

So, congratulations. You were technically correct about a minor point while still being completely wrong. Good job.

[BzaDem]

70. Both parties have supported it. Sure -- Romney signed one into law. After an 8-1 dominated Dem state

legislature passed it into law for him to sign.

The truth is, without an individual mandate, guaranteeing pre-existing condition coverage would cost thousands per month per policy. If you want to pay that, then you should continue to bash the mandate.

[Edweird]

71. The individual mandate was the brainchild of conservative health economist Mark Pauly, who developed

the idea for George Bush, Sr, to counter the employer mandate Democrats were supporting at the time."

"Both parties"... what a crock.

[BzaDem]

73. So did an 8-1 Democratic-domainted state legislature NOT pass one into law now?

Is that what you are saying?

[Trekologer]

160. Yes, the Republicans wanted the mandate

What they didn't want is requiring the health insurance companies actually spend money on health care. That is why the GOP is trying to drive repeal: there isn't some altruistic sense that the government shouldn't enforce a mandate, it is because the insurance companies now have to pay for health care.

[Bluenorthwest]

78. Other nations that mandate purchase do not allow profit to be

made from the mandated products. So, kid, they cover everybody, pre-existing conditions and all, and they do it without a mandate to contribute to the profits of private companies.
Those who support the for profit mandate clearly feel people should pay for care they do not get, so that others can profit. There is no reason at all to mandate purchase of for profit insurance.
What do you do for a living?

[harmonicon]

121. b.s. argument

That's like saying if you don't support the death penalty, you should support one form of killing over another, because, well, maybe it's somehow better or something. Your basic argument here is that if you pay for a sack of shit, it's fine, as long as it's really good shit.

[BzaDem]

155. Actually, the two aren't at all analogous. Your post makes no sense.

All I am saying is that for the next however many years/decades we don't have single payer, if you want policies that don't cost thousands of dollars per month, you can't fix the pre-existing condition problem without a mandate. So if you oppose a mandate because it isn't progressive, you should be prepared to justify why you don't think covering pre-existing conditions is progressive. Not deny reality just because you don't like how it works.

[harmonicon]

157. No, my post does make sense. Logic for the win.

You're using false logic here. So, lets say that I don't think a mandate is progressive. How does that logically lead to not thinking covering pre-existing conditions is progressive? It's illogical. The only thing that ties these two things together is bad legislation. If the legislation said that the only way to cover pre-existing conditions was to demand organ and tissue donation by people at the whim of a medical company, would forcing that then be the progressive policy? "Hey, buddy, you want healthcare, right? Ok, then if we need a kidney we may just call you up and take it." Would that be ok? A sack of shit is a sack of shit. I think our nation needs a good infrastructure, but I don't think it should be constructed by slaves, though one sure could make the argument that a way to ensure a good infrastructure would be to demand slave labor from the populace.

As for reality, I'm fine with the way that it works. I live in the UK, and I can tell you from experience that the NHS is awesome. I get great healthcare for which I don't pay a dime unless I'm working and paying taxes. To get this healthcare all I had to do was sign-up at my local clinic and give them my name and address and get a quick physical.

[BzaDem]

163. If a certain method is the only way to achieve a goal that gets more than 5 votes in the Senate

that reality doesn't change just because you don't like that reality. So it would seem that the logic fail goes to you -- not me.

[Edweird]

64. The individual mandate is RW crap, just like the 'cadillac tax'.

[BzaDem]

65. The current employer tax break is a giant subsidy from those without employer based health insurance

to those with employer based health insurance. The cadillac-tax (and the subsidies they fund) is a small step to reverse a dumb policy. People who have employer based health insurance should not have a tax advantage at the expense of those who don't.

[Edweird]

67. So you supoprted McCain over Obama on this during their campaigns?

[BzaDem]

72. McCain had a cadillac tax, but no progressive sliding-scale subsidies.

He just would give everyone a check that wasn't big enough for anyone to buy health insurance, which wouldn't help poor people at all. The same exact dollar amount would go to everyone (under McCain's plan). What we ended up getting is much better -- subsidies on a progressive scale, with more going to those who need it most. Under the current plan, people making 133% of the poverty level (or below) get free Medicaid, and those making 133%-400% of the poverty level get sliding scale subsidies (making them only have to pay anywhere from 2.5%-9.5% of their income).

[Edweird]

74. So that's a 'yes'?

[BzaDem]

75. That's a 'no' for McCain's plan, for the reasons described explicitly in my post. n/t

[Bluenorthwest]

77. Our mandate will make the US the only nation ever to impose

a mandate to buy for profit insurance policies. All other nations which mandate the purchase of basic health insurance also consider profiting from the mandated purchases to be immoral, and thus it is illegal.
We will have the world's first mandate to contribute to private profits.

[jeff47]

113. They're not as evil as portrayed on the Internet

The "Cadillac Tax" is designed to break the tie between health insurance and work. Which is also why it won't completely kick in until businesses are allowed to offload their employees onto the exchanges.

The "mandate" is necessary in that all forms of insurance require people to pay in when they are not getting paid out.

Instead of railing against the evils of the mandate, what we need to be doing is getting a public option onto the exchanges. From there, basic market forces will result in the public option being the major insurer. At that point, it's pretty easy to implement universal healthcare.

Instead of complaining about what we did not get today, let's use what we got to make tomorrow into what we want.

[Edweird]

128. I'm not as upset about 'what we did not get' as I am about 'what we actually got'.

What we actually got was a RW wet dream. People are trying to sell it as 'progressive', but anybody that cares already knows the truth. I suspect that you are right about how 'they aren't as evil as they are portrayed on the internet', but only because how they are portrayed on the internet is likely a gross underestimation of exactly how evil these policies will turn out to be. The 'cadillac tax' is nothing more than an assault on union members. It is despicable RW garbage.

[jeff47]

150. What we got was a framework

It's obviously not complete. But it provides a good framework in which we can implement what we want over time. To spend our energy railing against the program today weakens our ability to get what we want tomorrow.

And as I mentioned above, the 'cadillac tax' breaks the link between work and health insurance. Breaking that link is very good in the long run - the idea that the quality of your healthcare is controlled by the suits at your workplace (or your union negotiators) is insane. Yes, the implementation is crude, but it will also be effective.

Instead of fighting against that, we should be spending our energy getting a public option into the exchanges so that we have a non-profit alternative when the tax kicks in.

[Edweird]

173. What we got was "more of the same" only WORSE. There is no 'framework'.

Rahnm and Obama broke their arms patting themselves on the back for maintaining the status quo. The 'cadillac tax' doesn't 'break the link' - it punishes union members. It lowers the standard of care. So you and Newt and Orrin and McCain can sit around and talk about how great the Individual Mandate and Cadillac Tax is. The rest of us know what putrid conservative policy it really is.

[jeff47]

178. Not really reading what I'm writing, are you?

Since you're not reading this anyway, I think I'll use Google translate to reply in Welsh.

Wrth gwrs mae'n fframwaith. Mae'r mandad a'r cyfnewid yn creu rhyw fath o ofal iechyd cyffredinol. Yn amlwg, mae'n ddelfrydol ac nid dyna'r pwynt o'i wella.

Ac mae'r 'Cadillac' dreth yw ystyr i wneud eich aelodaeth o undeb amherthnasol pan ddaw i yswiriant iechyd. Y syniad yw i gael pawb i mewn i'r cyfnewidfeydd. Mae hynny, yn ogystal â dewis y cyhoedd, yw y llwybr i ofal iechyd gwirioneddol cyffredinol.

[quaker bill]

79. I prefer a more collectivist approach

where the government collects a tax from everyone and then purchases healthcare with or preferably without the insurance companies involved. This would only be somewhat different than a mandate, because everyone will have to pay the tax by mandate of law, but they write the check to the government instead of an insurance company. Of course, if you keep the insurance companies involved in administration of the plans, the difference dissolves to near zero.

[derby378]

101. Like you hinted...

...it still puts the insurance companies in direct control of my healthcare. They've screwed that up long enough without Obama helping them out.

[quaker bill]

177. They do not need help

They have been doing fine on their own. Any change that reduces recisions has the potential to restrict their enormous profits. I would be happy to see them out of the business, but as it is, they control it. As they say, "he who has the gold makes the rules" and they have the gold.

[pampango]

80. Dean: ""This is a libertarian country.... That is why the individual mandate ... is doomed ..."

http://www.csmonitor.com/USA/Politics/monitor_breakfast/2011/0120/Q-A-with-former-DNC-Chairman-Howard-Dean

"This is a libertarian country.... That is why the individual mandate ... is doomed – whether it gets thrown out in court or thrown out in the legislature or just ignored. Americans can't stand to be told what to do, no matter what party."

[WinkyDink]

84. Did I miss the election of Rand Paul to President? We LOVE being told what to do!

Actions speak louder than our words.

[Romulox]

88. Because forcing people to buy private insurance is JUST how they do it in Europe!

Also, FDR. And if you disagree? RACIST! :hi:

[Marr]

174. Dean is wrong-- this is a corporate fiefdom, and the mandate will remain.

It's the last part of "healthcare reform" that will go away, because it's the part big business wants, and in this country, big business gets what big business wants.

Sure, there may be millions upon millions of people walking about with libertarian ideals on this subject, but their opinions simply do not matter.

[blindpig]

81. Tells ya what 'progressive' means.....

well, nothing that you can really nail down.

[rhett o rick]

83. This is progressive legislation. Without the mandate it would be closer to libertarian legislation.

What people are using to scare others is the word mandate. Heaven forbid we let the government mandate. We already are mandated to pay for Medicare Part A thru our payroll taxes. Then if you want to be covered by Part B, you are required to (mandated) to buy in (pay for coverage) if you do not buy in when first eligible you will be penalized (mandated) for later buy ins.

European countries and Canada all mandate coverage. Everyone is covered and you pay thru taxes. MANDATE.

Personally, I dont like the HCR program. I would rather have single payer which would not have a mandate (except you pay thru taxes, so same difference). But the only way this program will work is if everyone buys in. That's how insurance works.

If you want guaranteed coverage you have to have a mandate (or penalty system like Medicare Part B, same as mandate).

[Romulox]

89. Medicare is a universal program administered by the Federal gov't. It isn't private insurance

that everyone is mandated to purchase. :hi:

[rhett o rick]

109. I understand that. I agree that it would be better if admin by the governmet but

the reality is that it isnt. Will private companies rip us off, yes of course. But we will get totally burned if we allow millions to opt out until they are sick then allow them in without paying their fair share. If we allow that, then why would anyone buy in until they are sick. The healthy have to cover the sick. If the healthy are allowed to opt out then get in later, the system will fail. I dont like mandates but it's where we are.

[Romulox]

147. The Court will strike it down, (as they should). The U.S. can't force us to buy products.

Nor can the government mandate a certain profit margin to be extracted from each and every American and to be directed toward the personal enrichment of powerful private contributors. Our Constitution won't allow it. :shrug:

[BzaDem]

156. Actually, our Constitution does allow it.

It's called the necessary and proper clause. Despite those who deny basic economics, the mandate is necessary to bar insurers from discriminating on the basis of pre-existing conditions. Since the latter is undisputedly within Congress' power, the former is too (by the necessary and proper clause). See McCulloch vs. Maryland.

So far, out of the 10 or so cases, only one struck it down, and the one that did ignored the necessary and proper clause (eliciting laughs from even conservative, anti-mandate litigators and analysts).

[Romulox]

192. The "Necessary and Proper" clause is not an independent grant of power

If any power is available to the Congress if it should deem, solely in its own judgment, that that power be "Necessary and Proper" to administering any of its self-set goals, then the clause would swallow up the rest of the Constitution, and allow the Congress to do virtually anything it deemed "necessary". However, our Constitution clearly describes a government of enumerated powers, and goes so far as to reserve unenumerated powers to the States and the people. Your argument is that the Necessary and Proper clause supersedes that carefully laid out structure (not to mention the Tenth Amendment) and the only check on legislative power becomes Congress' own judgment of what it deems "necessary and proper"?

This is not a good argument.

[zipplewrath]

106. A tax isn't profit driven

You're equating a taxation, with a fee a for profit company charges. Furthermore, if you are eligible for medicare/caid, you will receive it, even if you are found to have cheated on your taxes. With private insurance, miss a payment and you are without insurance, immediately.

It is dubious that the mandate, as currently structured, can be called "necessary". If it was truly economically necessary, it would have to be much larger. As it is, it would be cheaper for many to pay the fine, and wait until they truly get sick. This would be especially true if they could afford to "pay retail" for minor medical services. The reality is that many/most folks will put it off for a long time, but once they begin to get sick regularly, they will procure the insurance. Medical insurance isn't really insurance in the classic sense. Virtually everyone will use it during their lifetime. It isn't so much insurance as it is an extended payment plan.

The economic problem of health care isn't caused by the uninsured, and it won't be solved through mandates. Much like candidate Obama said, mandates for health insurance make about as much sense as demanding the homeless buy houses. The economic problem of health care is that health CARE is too expensive, and getting more so every day. No country spends what we spend on health care, even while delivering better care to more people.

There are solutions to the problem, HCR didn't address any of them.

[rhett o rick]

110. I totally agree that the system is screwed but it will be much worse if the healthy are allowed to

opt out. Then allowed back when sick.

[zipplewrath]

145. Not much worse

The system right now allows alot of people to "opt out" without penalty. It allows even more to opt out with an insignificant penalty. So formally acknowledging this reality wouldn't really make things "much" worse. It would be at the margins at best. Even more so, the economic impact of removing the mandate will pale in comparison to the effect of 6% per year inflation in health care costs for the forseeable future. That reality, one predicted by the White House even after all of the health insurance reforms kick in, will sink the entire system soon. And HCR doesn't do ANYTHING about that.

[Edweird]

133. Right, that's why it was touted by such 'progessives' as Newt Gingrich, Orrin Hatch and McCain.

They are all secretly 'bleeding heart' Liberals....

[Moral_Imagination]

175. Don't foget Hillary Clinton...n/t

[leeroysphitz]

86. The HCR bill is still shit.

[Romulox]

90. "Progressive" is just the new Third Way weasel word for "Centrist", anyhow. nt

[blindpig]

139. That'll work.

Been trying to figure that one out. And when people figure out that 'liberal' does not mean socialism lite then perhaps some clarity might be obtained.

[xchrom]

91. and yet you saw some weak attempt at it here. nt

[Gravel Democrat]

92. puntapié y recomendamos

Boycott the mandate! Resist Corporate Welfare!

[DirkGently]

94. Correct. "unconstitutional" or not, it just strengthens insurance co.'s hold.

... and we're not going to fix the core issue with healthcare by protecting health insurers. To paraphrase something we hear often. "Health insurance cannot fix the proble. Health insurance IS the problem."

[BlueDemKev]

95. With no mandate....

If there is no requirement that everyone take responsibility and carry their own insurance coverage, there is NO WAY that insurance companies will be able to cover everyone regardless of their medical condition without raising premiums to completely unaffordable levels.

Now, if the Supreme Court strikes down the requirement to buy private insurance, then fine, we'll have to create either a public option or a single-payer system. However, it may be years (or decades!) before we have another Congress or president that's progressive enough and brave enough to do that. Some of us can't afford to wait that long, folks.

[ehrnst]

96. Isn't the tax taken out for Medicare a mandate? (nt)

[JTFrog]

97. Shhhhhh.....

You're gonna spoil a perfectly good rant with facts.

[Better Believe It]

98. It's not a mandate to buy a product or service from a for-profit private corporation

It's a federal tax to pay for a federal health care program.

[ehrnst]

107. It's still a mandate. You don't get to opt out. Just like SS tax.

I understand the "for-profit" part, and I would MUCH rather a single payer plan be included in HCR.

But the only way that Medicare stays afloat is a mandated participation, and that's the only way that to finance a system that doesn't except pre-existing conditions.

[Better Believe It]

125. Medicare is not a mandated for-profit insurance policy.

Medicare is not set up to make a profit for private individuals, government officials or the government.

The sole reason for the existence of private health insurance companies is to make a substantial profit from premiums, not to provide people with health care. They have entire departments devoted to denying payment for health expenses claimed by purchasers.

And you're claiming mandated private insurance is the same as taxes for Medicare????

[ehrnst]

181. No - I'm saying that the uproar seems to be about a 'federal mandate'

Which medicare is - and was opposed by the right for that reason.

Why a state insurance mandate (like car insurance) is less offensive, I don't know.

[harmonicon]

123. Nope.

You don't have to pay into medicare if you don't pay taxes. Here in the UK everyone gets care. Sure, it's funded by taxes, but if you don't work, you don't pay, but you still get the care. It is in no way equivalent.

[ehrnst]

182. Ah - well, there would be no mandate in the US in that case either with HCR.

And you can get out of the HCR mandate for religious objections, and if the cheapest plan would cost more than 8% of your income, and you don't qualify for medicaid or medicare or tricare.

[SidDithers]

99. ...

Sid

[Still a Democrat]

102. Looks like the Obama-hate has driven FDL=GOP

They're adopting the same lines of attack.

You can't eliminate pre-existing conditions clauses without a mandate to buy.

[Gravel Democrat]

104. If it's as obvious as you and everyone else says...

Why did Obama campaign against it?

Why did he make that one of the only differences with Hillary?

Why didn't the Media ****OR ANY PROMINENT REPUBLICANS***** call him out for a very important flip flop?

I won't be taking part in any Health Insurance Mandate.

Many people are now calling those of us that don't pay the vultures "freeloaders".

Well that's funny to hear, because I'd be willing to bet a lot of money my nutrition is better than theirs and has been for a damn long time.

Most people don't even have a clue if they've eaten the *daily* essential nutrients.

Can't wait till someone calls me a Freeloader, they're going to find out what plastic surgery costs.

[Still a Democrat]

105. The GOP has crucified Obama over the mandate

It's probably their number one talking point and the basis for legal challenges.

[rhett o rick]

122. To secretly support then publicly denounce is a tactic used by the GOP.

They publicly denounce the illegal immigration policies but secretly work to keep them. The same for the mandate. They love it in private but publicly denounce it.

[Still a Democrat]

151. Gosh, makes me wonder who I should vote for

If they secretly back things they pretend to oppose, then up is down. Do the Democrats do the same? Not sure which way to turn with these conspiracies running loose.

[rhett o rick]

179. Sorry, I thought you wanted a serious discussion. nm

[TomClash]

103. Totally agree nt

[SanchoPanza]

108. Except not every private insurer is a for-profit corporation.

And the for-profit insurers will no longer be able to dump those with higher health risks onto the non-profit system. The insurers that everyone hates have been doing this for decades, driving up the costs of non-profits to such an extent that many of them have been forced to turn into publicly traded companies in order to compete. That's essentially how we got Anthem BCBS. As a side note, one of the major goals of the state-level policy enacted in Vermont was to strengthen their own non-profit insurers. A goal that was pretty much accomplished using similar provisions as the PPACA (guaranteed issue, community rating, etc).

If progressives want something to complain about, the mandate isn't it. It has all the proper exemptions, is structured so that only people who absolutely insist on not getting insurance will have to pay it, and the penalty itself is minor. This is hardly the vanguard of jackbooted fascism, nor is it a massive corporate giveaway since the most of the insurance reforms of the PPACA are designed to help insurers who are not accountable to the profit demands of private shareholders. It may not be perfect, but it is good enough.

The twelve year exclusivity given to drug companies before generics can be developed is far more worthy of condemnation.

[BenzoDia]

170. The more I think about co-ops, the more I'm sold on them

As long as they have enough members to negotiate good rates, then I think they should work out well.

[Stevenmarc]

114. There is only one kind of insurance mandate I could stand behind

Gun owners liability insurance just so I could sit back and watch the NRA and the Insurance industry beat the shit out of each other.

[Demeter]

115. Good Idea

But the bean counters(actuaries) would never get a price anyone could afford....

[harmonicon]

118. I agree completely; nothing more to say. (nt)

[democrank]

124. K & R

[on point]

126. Without single payer or public option, mandate is unfair

[ehrnst]

185. That's what they need to propose as a constitutional alternative - thought the GOP will kill it.(mt)

[mzmolly]

129. FDL needs to stop pretending they speak for all "progressives."

eom

[Better Believe It]

136. Do you have a link? I didn't see that claim in the article or anywhere on their website.

Or did you just make that up?

[mzmolly]

137. See the title of your OP.

"Progressives need to stop defending the individual health insurance mandate. It isn't progressive."

[underseasurveyor]

134. Totally against it!

Why should I be forced to buy a service/product from a system that is broken and controlled by big pharma?
I refuse!

[Politicub]

135. The bill is progressive, unless progress has no meaning

The mandate is required to ensure that both healthy and sick people pay into the system.

While a public option would have been a more progressive choice, it is not part of this bill. I support amending the bill and adding a public option, but this bill as it appears today requires the funding from everyone to work.

You are going to pay additional taxes, fees, whatever, for insurance, whether it be a public insurance plan or a private one.

These threads are frustrating to read since many people advocate throwing the baby out with the bathwater. That is definately not a progressive position.

We have this bill today. We need to build on this platform. To repeal the bill means starting from square one where at least 40 million people are fucked. I don't accept that as a progressive choice.

[Better Believe It]

138. The law doesn't require us to pay "into the health care system". It goes to the insurance industry

I don't know why people have difficulty understanding the difference. The insurance industry is a useless third party that contributes nothing to our health care. They stand between us and our doctors.

[mzmolly]

143. It also expands medicaid and allows states to create a public option.

Are you suggesting that nothing stands between doctors and medicaid?

[Better Believe It]

149. In what year? We'll see a lot more of that "reform" when Congress makes cuts in Medicare.

And your "reform" is contingent on Republicans and their Democratic enablers in Congress providing billions in funds to help low wage workers pay for bare bones health insurance which won't cover jack shit.

And after Congress is done cutting Medicare and Medicaid what makes you think Congress will want to vote generous economic assistance to people who can't afford quality health insurance?

Now please say you don't really believe all of that health insurance industry propaganda about the wonderful health care system they are creating for us.

[mzmolly]

152. 2014. And as of NOW, children with pre-existing conditions are covered.

It's not a matter of believing the health insurance industry, it's a matter of believing what's in the fargen bill. The "industry" spent millions fighting the legislation. "Death panel" ring a bell?

[Politicub]

165. +1 - This piece of the bill is so vital

The elimination of pre-existing conditions is groundbreaking. I'm still surprised we were able to get that in.

[mommalegga]

162. The mandate is fascist

If one beleives fascism is the joining of State and Business, then this law is prima facia evidence of it. No wonder its unconstitutional.
Scrap this atrocity and start a single payer system or expand Medicare.

[Politicub]

164. I vehemently disagree with you. Too many people will be harmed if this bill is scrapped

It should be built upon -- Kind of like the idea behind "in order to build a more perfect union."

[mzmolly]

169. LOL. So is mandated auto insurance

apparently. And for that matter, mandated vaccinations. I guess no one paid attention, until now?

[Better Believe It]

171. You don't have to own a car but we all do need health care.

[mzmolly]

172. We don't need it if we're healthy.

And, due to this legislation we can't be refused when we're sick. Regardless, the point I responded to was not about need. It was about the supposed "fascism" involved in various mandates.

[108]

140. not defending it, but good luck getting all those insured

without it in today's political climate

[usregimechange]

141. Amen

[WiffenPoof]

142. I Honestly Don't Know...

...what those that put the bill together was thinking. It is a non-starter.

-PLA

[defendandprotect]

144. The "reform" is nothing but deform -- and not what we deserve: MEDICARE FOR ALL ---

Keep fighting for it -- we should all be wearing buttons proclaiming that!

And, Dems should be circulating those buttons!

What we have to recognize is that things have gone so wrong in this nation NOT

because of corporations, but because of those pre-bribed and pre-owned elected

officials WHO HAVE GIVEN LICENSE TO CORPORATIONS IN OVERTURNING NEW DEAL SAFETY NETS --

AND NEW DEAL REGULATIONS WHICH PROTECTED US FROM THIS ORGANIZED CRIME.

It is those officials who are supporting corporate license vs empowering the people

who we must rid ourselves of --



PS: And we saw this again in the very corporate decision the other day giving COMCAST

control over NBC/MSNBC. Corporate wealth bought our elected officials, but it is those

elected officials who are moving their agenda along.

[bowens43]

159. Had to look twice

I thought I was on the freeper site.

Between the attacks on the health care bill and all the folks supporting the sale of semi-automatic weapons and high capacity clips to the mentally ill it's easy to confused.....

[Better Believe It]

166. "I thought I was on the freeper site." Now be honest. You really didn't think that now, did you?

So why did you write that sort of attack on the progressive writer?

That's not civil and that's not a nice thing to do.

Save those sort of remarks for actual right-wingers.

[Better Believe It]

167. Can insurance companies jack up their premiums for those with pre-existing conditions?

Or has the government implemented some firm price controls?

[Moral_Imagination]

176. You can opt out by paying a fee...

... if you feel that strongly about none of your money going to a private corporation. So where do you buy your groceries? at the government food store?

[TicketyBoo]

188. No, it isn't progressive,

but it's essential in keeping premium costs down so that everyone (almost) can afford insurance.

If we can't get universal coverage through Medicare for All (which, apparently, we can't), then this is the only way I see to do it.

Without mandates, it's just more of the same of what we have now, which doesn't work for anybody but the very wealthy, really. If you can't afford insurance, then you can't afford to get sick or have an accident. It will bankrupt you. If people can wait until they're sick to buy insurance (a ban on excluding pre-existing conditions), then we have to have mandates so that the healthy are helping to foot the cost.

[Rex]

191. Never did.