Editorial
Don't get sidetracked by the mandate debate
Monitor staff
December 07. 2007 12:40AM
The great health care mandate debate is a sideshow. Democratic presidential candidates Hillary Clinton and John Edwards insist that
forcing individuals to buy a policy is crucial to providing universal health care or something close to it. Rival Barack Obama disagrees.
A mandate may be necessary to force those who refuse to sign up once affordable options are available, he says, but that step should
come at the end of the march to universal care, not at the beginning.
The debate has degenerated into arguments over who is or isn't being honest with voters. The question voters should focus on is which
candidate, if elected, can convince enough Republicans - who will use words like "confiscation" to describe any mandate - to go along
with a plan. The next question should be: Is this plan the best and most affordable path to universal coverage?
On the honesty question, when it comes to health care mandates, the edge goes to Obama. He rightly says they force people to buy
something before they know what it will cost and how good it will be, and many won't comply...
Government mandates have been used to force people to buy auto insurance, immunize their children, pay child support and pay workers a
minimum wage. But compliance rates, according to the journal Health Affairs, are far from universal; just 77 to 85 percent for immunization
and 30 percent for child support. Some studies have found that despite mandates, about 20 percent of people still don't buy auto insurance,
which is why the rest have to pay extra to guard against uninsured motorists.
http://www.concordmonitor.com/apps/pbcs.dll/article?AID=/20071207/OPINION/712070340/1270/NEWS97Former Clinton Secretary of Labor and Social Security Trust Fund trustee Robert Reich has already noted that:
But in my view Obama’s would insure more people, not fewer, than HRC’s. That’s because Obama’s puts more money up front and
contains sufficient subsidies to insure everyone who’s likely to need help – including all children and young adults up to 25 years old.
Hers requires that everyone insure themselves.
http://robertreich.blogspot.com/2007/12/why-is-hrc-stooping-so-low.htmlIt's easy to see that if noncompliance rates are anything like those in other mandate situations, the Clinton plan will also leave millions or even
tens of millions uninsured. (We can get 15 million uninsured by taking about 5% noncompliance for the country or about 30% noncompliance
for presently uninsured, and we would be as likely to be right as any other expert.) The bottom line is that we have little reason to think that
mandates are important, and that Obama is open to considering them if experience proves they will help.