Jon Walker, on the flawed "But the Netherlands has a mandate too!" argument

[mcablue]

WALKER (Firedoglake): "I have long maintained the progressives should accept an individual mandate only as part of a broad social contract with the government guaranteeing everyone access to quality, affordable health insurance. This is what the Netherlands does, and this is what the Senate bill does not. The Senate’s version will only be a rusted out hull shaped to kind of look like a working health care system from a distance.

This bill is a sham BS imitation of a true universal health care systems built on the government guarantee of access to quality, affordable health insurance and an individual mandate. Countries like the Netherlands have important regulations ensuring all their citizens have access to quality, affordable health insurance, regulations that are completely lacking in this bill. Things such as:



I see the argument being floated here. That's why I brought up the excellent above-mentioned post by Walker, written a few years ago. Here's the link: http://fdlaction.firedoglake.com/2009/12/17/this-is-nothing-like-the-netherlands-that-is-why-individual-mandate-is-unacceptable/

[mzmolly]

1. Firedoglake is being dishonest.

http://voices.washingtonpost.com/ezra-klein/2009/12/jane_hamshers_10_reaons_to_kil.html

For example:

1) Forces you to pay up to 8% of your income to private insurance corporations -- whether you want to or not.

"You," huh? For the 85 percent of the country already covered by health-care insurance, it doesn't force "you" to do anything at all. People on Medicare are not going to be paying money to private insurance. People with employer-based care will not see their situation change.

For the nearly 50 million Americans caught in the ranks of the uninsured, here's the deal: The bill expands Medicaid, a public program, to cover about 20 million of, uh, "you." Private insurance gets nothing. If you make more than 133 percent of the poverty line, but less than 400 percent, there's a huge system of new subsidies to help you afford private coverage. There are also new regulations on insurers forcing them to spend between 80 percent and 85 percent of every premium dollar on medical care, barring them from rejecting you or charging you higher premiums due to preexisting conditions, ensuring they can't place any annual caps on insurance benefits, and more.

But here's the catch: So long as insurance won't cost more than 8 percent of your monthly income, you have to buy into the system. You can't wait until you get sick or get hurt and and then buy insurance, shifting the costs onto everyone else. The cost of having a universal, or near-universal, system is that people have to participate. The promise is that, for the first time, participation will be possible.

[eridani]

3. People with employer based insurance will see premiums and co-pays increase--

--and coverage made a lot worse.

I recognize no "reponsibility" to pay into a shitty unregulated corporate system. The Netherlands DICTATES to private insurers what benefits must be offered in the basic comprehensive package, and what it must cost. Curently that is 100 euros/month, which is a mandate I could happily live with.

[mzmolly]

4. What is your source

for this statement? Also, $100 euros is about $150 per month, which may not be affordable for many in the US. Further, most Americans will qualify for subsidies and many will actually pay LESS than they do in the Netherlands.

[eridani]

5. The source is the legislation itself. Subsidies do not start until 2014

Taxes kick in well before that. I'm predicting dramatic price increases solely on the basis of past behavior of insurance companies.

In the Netherlands and in US single payer proposals, subsidies are available for people who cannot afford the premium. And unlike the shitty worthless garbage that we are FORCED to buy, those amounts cover EVERYHING. Who cares if you get a subsidy for a goddam worthless piece of crap that only covers 60-70% of your actual expenses?

[mzmolly]

6. That assertion appears to be a rumor? Here's a bit more info:

Below Ezra Klein responds to Jane Hamshire's rationale for killing the bill:

FDL claims ~ Paid for by taxes on the middle class insurance plan you have right now through your employer, causing them to cut back benefits and increase co-pays.

"You" probably don't have these plans, which are tilted towards the rich, not the middle class. Your plan probably doesn't cost more than $23,000 a year. And if it does, the only part that gets taxed is the part in excess of $23,000 a year. The average family health-care plan costs about $13,500 -- almost a full $10,000 less than the plans this policy taxes. If we don't manage to slow the growth in health-care costs, this policy will, over time, hit plans that are less generous. But economists consider the excise tax, which functions as a tax on insurers who let premiums grow too quickly, one of the most effective cost-control mechanisms in the bill.

There's an equity aspect here, too: The problem with the excise tax is that it doesn't go far enough. All plans should be fully taxable. This policy begins to chip at the edges of one of the most regressive elements of our system: Health benefits, which are mostly given to better-off workers, are protected from taxes, while income isn't. A worker at Wal-Mart with no health benefits sees his entire paycheck taxed. If that worker goes to buy insurance on his own, the money he uses to buy it is taxed. A worker at Goldman Sachs with a $40,000 health-care plan is getting $40,000 of his paycheck tax-free. It's wildly regressive, and not something that liberals should support. More here.

6) FDL claims ~ Many of the taxes to pay for the bill start now, but most Americans won't see any benefits -- like an end to discrimination against those with preexisting conditions -- until 2014 when the program begins.

It's not even clear what Hamsher is referring to here (the accompanying link is broken). The main tax in the bill is the excise tax, which starts in 2013, not "now." And the bill isn't funded primarily by taxes. It's funded primarily by changes to Medicare. It would be useful if Hamsher explained what tax changes people are going to notice in, say, 2011. My understanding is that the answer to that is, essentially, "none at all." The word "many" is obscuring a lot more than it's illuminating here, making it seem as if the majority of the bill's funding mechanisms trigger immediately. They do not.

More here: http://voices.washingtonpost.com/ezra-klein/2009/12/jane_hamshers_10_reaons_to_kil.html

[eridani]

7. Those "middle class" plans are actually UNION plans.

Why do you think unions are opposing this?

[mzmolly]

8. Some are yes.

And, I would like to see that portion of the bill rectified somehow, personally.

[eridani]

9. And you are OK with labor sitting on their hands in 2010 if it does not? n/t

[mzmolly]

10. I'm not.

And, I'll wait and see what labor says when the bill is finalized before I make that assumption.

[joeybee12]

11. Where'd you pull that 85% out of? With 40-50 million uninsured...

...that's closer to about only 65% insured...and most people will be paying about 20-25% of their income on health care according to some brilliant "MIT chart" posted by another apologist recently.

[slipslidingaway]

2. knr nt