From The Archives: Dump The Individual Mandate
[Program Note: I've got an airport run to take care of today, so I didn't have time to put together a new column. However, a federal judge's ruling has given me the perfect opportunity to re-run the following column, which originally appeared here on 9/21/10. This is a losing issue for President Obama and the Democrats on any number of levels -- the most obvious being that they'd be fighting squarely in the corner of the insurance companies against pretty much everyone else. In any case, as I said, it seemed the perfect column to run today. Regular columns will resume tomorrow.]
Howard Dean is (as he is often wont to do) making all kinds of sense on healthcare reform today. His idea is to jettison the "individual mandate" part of the healthcare reform law passed this year. And he's right, on both political and practical grounds.
The individual mandate is the least-liked part of healthcare reform. It really has no natural constituency other than insurance companies. There was no call from the public to include this in the final law (as there was with the "public option," in comparison). The Left wasn't in favor of it, and it causes apoplexy over on the Right. President Obama did not campaign on the individual mandate (although Hillary Clinton did, I should point out), so he obviously didn't think it was all that important (or all that good an idea, take your choice) before he got elected. Since the mandate appeared, very few people have bothered defending it in public. Its appearance in the debate was obviously a direct result of demands from the health insurance industry, who will be the obvious beneficiary of the plan.
But, as Howard Dean points out, healthcare reform can succeed without it. Which means there shouldn't be anything standing in the way of throwing the whole idea of the mandate under the political bus, so to speak. Or, since the Tea Partiers hate it too, perhaps "throw it overboard" would be a better metaphor.
Personally, I've never been a big fan of the mandate, although it likely wouldn't affect me in the near future. The idea of paying a fine, or extra taxes, because you can't afford health insurance doesn't exactly have a whole lot of support from anyone these days (again, other than insurance companies). In fact, several states are currently suing the federal government over the constitutionality of the law. The mandate was even put to a popular vote during the primary season, and it lost in a big way (around 70/30). Which means repealing it would be wildly popular, for either political party. Right now, Republicans are drooling at the chance of doing so, but that shouldn't stop Democrats from joining the effort. It's a little late for them to be "leading" the effort, but such a repeal would likely have wide and bipartisan support, so politicians of either stripe could benefit in the end.
Now, the mandate isn't slated to go into effect for another few years. Repealing it would have no immediate impact on the status of health insurance. It would impact the future projections of healthcare, but the only ones who would be screaming about this would be, once again, the insurance companies. But, this time around, they're not going to find a whole lot of politicians willing to champion their position. Especially since the push to repeal it is coming from the Right in the first place. Republicans would be faced with the choice of parroting the insurers' talking points and carrying the legislative water for the industry (as they did in the whole healthcare reform battle over the past year and a half) -- or jumping on the "Repeal!" bandwagon wholeheartedly. This seems to be a no-brainer for them, since a large segment of the folks advocating repealing the mandate are from the Republican rank and file. And Republicans have already burned their fingers on a few hot teakettles this election season, meaning they would likely be very wary of siding with the insurers against their own political base's voters.
Democrats should also realize that defending the mandate is a losing battle for them as well. The mandate, as I said, is the least popular part of the healthcare law they managed to pass. It is the biggest target for those who are against the new law. But while Republicans seem to be dedicated to repealing the entire healthcare reform law (either as a whole, or bit by bit), Democrats could yank the rug out from under the GOP by getting rid of what is seen as the worst part of it, pre-emptively.
The other parts of the new law are a lot less contentious, and benefit families directly. By removing the mandate as the focal point of the opposition, it would force them to attack the other parts of the law instead. And while the Republicans have been making lots of political hay over the mandate issue, it's going to be a lot harder for them to do so on the issues of, for example, getting rid of the concept of pre-existing conditions or letting children stay on their parents' policy until they're 26. Neither of these has been put to a popular vote anywhere yet, but I would be willing to bet that they're a lot more popular with the public than the mandate.
Getting rid of the mandate would remove it as an issue from the debate. It would end the ongoing court cases. It would end the talk of constitutionality by healthcare reform critics. It would focus the debate on the parts of the new law that are much more popular. And even Howard Dean is now arguing that doing away with the mandate doesn't mean the rest of the law won't be successful. The insurance companies would howl, but this time their legislative lapdogs on the Right will be much more concerned with saving their own political skins than with placating the insurers.
Of course, repealing the mandate is not going to happen before the midterm elections. The legislative calendar is just too short. It might be brought up as an issue in the political arena before the elections, but it isn't going to make any legislative progress until afterwards. Democrats might not be inclined to vote for repeal in the next Congress, because the effort will be seen as a Republican one, and Democrats would likely not be happy about "giving the Republicans a political victory." Also, there is the bunker mentality which says the issue is the start of a slippery slope of repealing the entire healthcare law. Democrats may adopt a "circle the wagons" defense of the whole bill, and fight the repeal of the mandate tooth and nail. This would be a mistake, as I see it.
President Obama would also face a choice, if Congress passed a mandate repeal and put it on his desk. No matter what happens in the midterms (no matter which party holds which houses, in other words), he's still going to have enough Democrats in both houses to sustain his vetoes. Meaning he could fight hard for the mandate, and veto any repeal which crosses his desk. This would also be a mistake, as I see it.
Of course, Obama and the rest of the Democrats would have to eat a little political crow during the repeal effort. They'd have to essentially admit "we were wrong about this part," which is never easy for a politician to do. But, in the end, they would benefit politically by going along with the Republicans on a limited basis -- repealing the mandate, not repealing the entire law. Man the barricades and fight for the rest of it, in other words, but dump the mandate part with grace.
No one issue in the healthcare law which actually exists in reality (unlike, say, "death panels") has galvanized the opposition to such a degree. And this opposition is winning the argument in the public arena. The individual mandate has no natural constituency behind it other than the insurance companies themselves. Outside the Beltway, Republicans hate it, independents don't like it, and (at best) Democrats are lukewarm on it. Getting rid of the mandate won't kill the entire healthcare reform law. I hate to say it, but the Right is right on this issue. Jettisoning the mandate is a good idea politically, and the Democrats should realize it and get behind it themselves. It removes a potent issue from the political debate (and from the courts), leaving behind much better issues for Democrats to draw lines in the sand on (again, like eliminating "pre-existing conditions"). Democrats have a choice -- they can either throw their support behind the issue, or wait until after the elections and watch the Republicans talk about it for approximately the next six or seven months, before they repeal it without Democratic help. Getting on board sooner is the smart thing to do in this case.
-- Chris Weigant
Follow Chris on Twitter: @ChrisWeigant
The problem with the mandate is that the entirety of the alleged "success" of CrapCare rests on it...
Democrats truly pushed thru an "Edsel" (to borrow the word from Americulchie) and it was likely a direct contribution to the "Shellacking" (to borrow the word from President Obama) that the American people handed the Democrats..
Michale
162
Correct, the mandate is not popular anywhere in the cosmos. Is your answer for covering the uninsured single-payer? You haven't presented an alternative.
OK, so after you dump the individual mandate, what happens to the ban on pre-existing condition exclusions? The only reason for having the individual mandate in the first place is to require insurance companies to take all comers, regardless of pre-existing conditions.
The problem with the mandate is that the entirety of the alleged "success" of CrapCare rests on it...
Michale I have to agree in entirety with your position on Crap Care;the whole thing was ill advised from the start.Until we take insurance companies out of the health care business there can be no true Health Care Reform;until that happens it is moose poop.
americangypsy and Quaker in a Basement -
Welcome to the site!
Just a quick technical note (I will answer your points in a bit, just wanted to post this right away) -- your first comments were automatically held for approval (we have to do this to cut down on comment spam), but from now on your comments should post immediately and automatically. If you post two or more links in a single comment, it will be held for moderation, but other than that you should not experience any wait time from now on. Just to let you know...
-CW
AG and QB,
THAT is why CrapCare is... well... Crap...
It does absolutely NOTHING to reign in costs, NOTHING to help people get coverage and NOTHING to prevent companies from denying pre-existing conditions.
The ONLY thing that CrapCare did was allow Democrats to point to it and say, "See!! We DID accomplish something"....
The irony of it is that the vast majority of Democrats were so ashamed of CrapCare, they didn't want to mention that they had a hand in it..
Oh... and...
"Welcome to the party, pal!!!"
-John McClane, DIE HARD
:D
Michale.....
163
It does absolutely NOTHING to reign in costs, NOTHING to help people get coverage and NOTHING to prevent companies from denying pre-existing conditions.
I'll grant that the bill doesn't do enough to rein in costs. (Any proposal that actually did so would never reach the floor for a vote.)
I'll even set aside the fact that this post and my response are about individual mandates and not any of the things you mention.
But noth...err, NOTHING to rein in costs and NOTHING to prevent denial on pre-existing conditions?
Are we talking about some OTHER health care bill than the one recently signed into law?
as you may know, i'm of the opinion that the 2010 healthcare law is better than nothing, in spite of its myriad flaws. i agree that either the individual mandate needs to be dumped or an inexpensive public option needs to be added, or both.
if the mandate is dropped, there has to be a provision making it illegal to abuse the pre-existing condition ban by not carrying insurance and then applying for extensive insurance right after the condition becomes serious (i.e. expensive).
since i'm on the left side of this debate, i'm obviously of the opinion that adding an inexpensive public option would be a better way to go, but that also has to be managed to keep the market for high-end care intact. in other words, we need to build a floor without caving in the ceiling.
in its current form the law is doing neither, which is essentially driving down the middle of a one-lane road. and if you do this, we all know what mr. mayagi says:
"squish, just like grape"
But noth...err, NOTHING to rein in costs and NOTHING to prevent denial on pre-existing conditions?
Correction:
But noth...err, NOTHING to help people get coverage and NOTHING to prevent denial on pre-existing conditions?
americangypsy -
I don't know that I have an overall answer to the problem. I thought including at least a public option was a smart thing to do, and was pretty unhappy with Joe Lieberman about exactly a year ago for killing it off in the bill. Single-payer ("Medicare for all" perhaps) would be nice, but I'm not holding my breath as it seems the least likely to actually be enacted any time soon.
Quaker in a Basement -
Can I just call you Quaker? I mean, that's a lot to type every time I use your name.
:-)
Ahem. Seriously, though, I think the pre-existing conditions ban should stay. Although with the ban, but without the mandate, prices might be hiked. The most interesting thing in the whole debate currently that I find is the rumors that some of the fiercest deficit-hawks in the Republicans are now taking a look at the public option, because it really is the only thing (the only thing they'll consider, I should say) that seems to actually drive the prices down over the long haul. Maybe it's just rumor, though, I dunno. But it'll certainly be interesting to see which way Republicans go on the whole healthcare issue next year, that's for sure.
-CW
Although with the ban, but without the mandate, prices might be hiked.
I'm not saying the individual mandate is the only way, but there has to be something in the law that addresses the free-rider issue.
I was discussing the issue elsewhere today. Young man, in his 30s, no health issues. Doesn't see why he should be required to carry health insurance.
Of course, if this same fellow is diagnosed with some awful disease tomorrow, he's going to want health insurance very much. If you rule out exclusions based on pre-existing conditions, young healthy people simply refuse to participate--until they need insurance.
And that, of course, is not how insurance works.
Oh, yeah. And Quaker is fine. Quake, QiaB, Q. Whatever, just not late for meals, you know?
It does absolutely NOTHING to reign in costs, NOTHING to help people get coverage and NOTHING to prevent companies from denying pre-existing conditions.
Precisely what Howard Dean said in this PBS documentary clip, which also reminds us how the infamous "mandate" came to be in the first place: http://www.youtube.com/watch?v=5PwqSCJmbxk ...
The Dems might as well have sent out engraved invitations to voters, asking them to hand the House over to the Republicans. It would've saved them a lot of time and money on the campaign trail.
FYI, when you take the mandate away, the entire law falls about.
Frankly, if Obama were smart, he'd repeal CrapCare himself before the Supremes or a Republican president gets hold of it. It'll look a whole lot better on his legacy if he and congress start from scratch. And he won't have to worry about defending it on the 2012 campaign trail. Rather, he can turn the tables and become the good-guy Mr. Fixit champion, with real reform at the end of the day. If he goes into the election still trying to defend that pig, he's gone. Sixty percent of likely voters want it killed. The majority had said "no" to enacting it all along.
QB,
Are we talking about some OTHER health care bill than the one recently signed into law?
Nope. We're talking about the one recently signed into law.
I can quote reliable source after reliable source that shows that HealthCare Costs have actually risen since CrapCare was passed and is likely to rise even further, once the real meat of CrapCare takes effect.
google.com/search?client=firefox-a&rls=org.mozilla%3Aen-US%3Aofficial&channel=s&hl=en&source=hp&q=HealthCare+costs+rising+after+Obamacare&btnG=Google+Search
I can also quote reliable source after reliable source that shows there are still plenty of loopholes that allow insurance companies to deny coverage based on pre-existing conditions.
http://www.google.com/search?client=firefox-a&rls=org.mozilla%3Aen-US%3Aofficial&channel=s&hl=en&source=hpq=HealthCare+costs+rising+after+Obamacare&btnG=Google+Search#sclient=psy&hl=en&client=firefox-a&rls=org.mozilla:en-US%3Aofficial&channel=s&q=Loopholes+Obamacare+deny+%22pre+existing+conditions%22&aq=f&aqi=&aql=&oq=&gs_rfai=&pbx=1&fp=87dedf703ab49d09
(You'll have to cut and paste the links)
The simple fact is that CrapCare was nothing but an attempt by Democrats to show the American people that they CAN do something with the power they were given...
Unfortunately, the Democrats misread the American people. The American people didn't just want Dems to do something.. The American people wanted Democrats to do something GOOD...
CrapCare ain't it...
CB,
Welcome back!! Missed ya!! :D
Yer right, though..
Obama repealing CrapCare on his own would do a lot to endear himself to the Independents and NPA'ers that totally decimated the Democratic Party..
But he would also lose his base in droves if he did that...
Like I have said, Obama and the Democrats have maneuvered themselves into a perfect Lose-Lose situation...
Michale.....
167
I can quote reliable source after reliable source that shows that HealthCare Costs have actually risen since CrapCare was passed and is likely to rise even further, once the real meat of CrapCare takes effect.
Costs have gone up? You're kidding! That never happened before the law passed!
Oh wait.
Don't tell me about the sources you could cite. Cite 'em!
But he would also lose his base in droves if he did that...
Like I have said, Obama and the Democrats have maneuvered themselves into a perfect Lose-Lose situation...
Except that lefties have a well-established habit of reelecting pols no matter how many times they're kicked in the teeth by them. So Obama's best move is to play to the center and hope for the best. Not that I think it's the formula for his success. I went on record long ago predicting he's gonna be a one-termer. He's way too ideologically driven to pull off a move to the center, like Clinton did. Unless he takes dramatic steps to dispel that impression — like vetoing that hideously pork-laden budget proposal and repealing HCR himself — Indies have no reason to believe they'll get anything other than four more years of leftie leadership from him — if you can even call him a "leader" at all. He's such an inexperienced rookie that the Left would be really wise to find themselves somebody else to go up against the Republicans. Even Sarah Palin could beat Obama, at this point.
QB,
Costs have gone up? You're kidding! That never happened before the law passed!
The point is that we were assured that costs would go DOWN, not up..
But costs HAVE gone up, despite CrapCare being passed.
And, further non-partisan research shows that costs will rise even higher, after the majority of CrapCare provisions take effect...
So, why bother passing CrapCare??
Don't tell me about the sources you could cite. Cite 'em!
http://google.com/search?client=firefox-a&rls=org.mozilla%3Aen-US%3Aofficial&channel=s&hl=en&source=hp&q=HealthCare+costs+rising+after+Obamacare&btnG=Google+Search
How much time ya got?? :D
Michale.....
172
CB,
Even Sarah Palin could beat Obama, at this point.
Can you imagine the combined apoplexy of the Left if we got President Palin??
That alone would be worth the price of admission.. :D
Michale.....
173
Thanks for the welcome. Cheers.
Dude, that's a Google search, not a citation.
Can you imagine the combined apoplexy of the Left if we got President Palin??
That alone would be worth the price of admission.. :D
I have long suspected that this is the sum and substance of conservative governance theory. Here we have it in writing.
QB,
Yes and from that search are hundreds (168,000, to be exact) "citations" that show how CrapCare has raised costs and will raise costs..
Do you have any citation that indicates costs are lower due to CrapCare??
If so, I am sure that I (and the Democratic Party) would love to see them... :D
Michale.....
174
Do you have any citation that indicates costs are lower due to CrapCare??
No, no. I don't play that way. Here's how it goes:
1) You make an unfounded claim.
2) I ask, "What are you talking about?"
3) You provide your cite or don't.
I do NOT go for the "You prove the opposite!" routine.
I have long suspected that this is the sum and substance of conservative governance theory. Here we have it in writing.
Errrr... who elected the bullshooting fast-tracker with the nifty tag line, who'd never governed a day in his life? I wouldn't be looking down my nose at the Right if I were a liberal. You guys don't exactly have a prize on your hands.
QB,
I have long suspected that this is the sum and substance of conservative governance theory. Here we have it in writing.
Actually, when it comes to most things, I am more liberal than you are, I would wager. And, for the record, my political designation is "NPA", IE No Political Affiliation.
I am one of those Independent voters.. Ya know, the ones who actually DECIDE elections?? :D
But do you REALLY want to discuss "sum and substance" considering the abomination (from a leadership perspective) that we have put in office???
I mean, seriously...
1) You make an unfounded claim.
Dood...
How can you call 168,000 citations of the facts "unfounded"??
But, hay.. I'll be happy to spell it out for ya.. :D
WASHINGTON -- Health-care costs are forecast to rise after enactment of President Obama's new health law -- and the average American will have to shell out an additional $265 each year for care, a new government report concludes.
nypost.com/p/news/national/feverish_pike_in_care_QMdYsHo0Bz3IU1288B7hbM#ixzz18Mbcu0dd
President Obama and his supporters have said that one of the major benefits of the Patient Protection and Affordable Care Act would be a drop in health insurance premiums. But a new Hewitt Associates study shows that insurance costs will continue to rise for 2011.
blog.heritage.org/2010/10/04/side-effects-obamacare-fails-to-halt-rising-premiums/
WASHINGTON — AARP‘s endorsement helped pass President Barack Obama’s health care overhaul. Now the powerful seniors’ lobby is telling employees their costs will go up as a result.
theblaze.com/stories/citing-health-overhaul-aarp-hikes-employee-costs/
In the next several years, studies have confirmed that Americans will face far higher insurance premium costs. By the year 2019, it is estimated that U.S health spending will rise from about $2.5 trillion to $4.6 trillion. The Centers for Medicare and Medicaid services project that overall national health spending will increase by 6.3 percent each year over the next decade. In other words, health care costs will consume one out of every five dollars spent in the United States.
freedomworks.org/blog/jborowski/obamacare-predicted-to-increase-health-care-spendi
Aerospace giant Boeing is joining the list of companies that say the new health care law could have a potential downside for their workers.
In a letter mailed to employees late last week, the company cited the overhaul as part of the reason it is asking some 90,000 nonunion workers to pay significantly more for their health plan next year. A copy of the letter was obtained Monday by The Associated Press. …
Deductibles, the share of medical costs that employees pay annually before their plan kicks in, will go up to $300 for individuals, an increase of $100. For families, the new deductible will be $900, an increase of $300.
In addition, Boeing is instituting a copayment of 10 percent after the deductible has been met. The copayment will rise to 20 percent in 2012.
Those changes will reduce the value of the Boeing plan, but it’s unclear whether that will allow the company to escape the tax looming in 2018.
news.yahoo.com/s/ap/20101018/ap_on_bi_ge/us_health_costs_boeing
And that's just the first few of 168,000 citations that prove my position.
Now... Do you have any citations that refute my position??
Because, if all you have is "DEMOCRATS ARE GREAT!!! RAH RAH RAH!!!", I am going to be very disappointed..
"You guys aren't from the military, trying to train whales for retrieving torpedoes or some dipshit stuff like that, are you? Because if you are, I am going to be very disappointed."
"No Ma'am. No dipshit."
-STAR TREK IV, The Voyage Home
Something you will learn very quickly around here.. Never bring a knife to a gunfight. :D
The facts are these.
We were told that CrapCare would reduce HealthCare costs.
HealthCare costs are still rising, despite CrapCare being enacted.
HealthCare costs will continue to rise, even after the meat of CrapCare takes effect.
"These are the facts. And they are undisputed."
-Captain Jack Ross, A FEW GOOD MEN
CB,
Errrr... who elected the bullshooting fast-tracker with the nifty tag line, who'd never governed a day in his life? I wouldn't be looking down my nose at the Right if I were a liberal. You guys don't exactly have a prize on your hands.
Truer words were never spoken.
It's amazing how those on the Left will turn down their nose at Palin, yet it's an undisputed fact that she actually has executive leadership experience as the most popular governor in the nation. As opposed to Obama who, apparently, can't lead his way out of a paper sack with a map and a compass...
Michale.....
175
HealthCare costs will continue to rise, even after the meat of CrapCare takes effect.
Ducky.
Now kindly scroll back up and read what I wrote. (And yeah, I had to correct it. Senior moment. Sue me.)
I'll grant that the bill doesn't do enough to rein in costs. (Any proposal that actually did so would never reach the floor for a vote.)
Knives, gunfights, whales, torpedoes. Try to address the point. If you can.
QB,
I'll grant that the bill doesn't do enough to rein in costs. (Any proposal that actually did so would never reach the floor for a vote.)
It's not that the bill doesn't do ENOUGH to rein in costs.
It doesn't do ANYTHING to rein in costs.. Costs will continue to rise, even though we were promised by Obama et al that this wouldn't happen.
CrapCare is worthless.. It's WORSE than worthless as it is nothing more than a failed placebo..
Hell, it even failed at giving Democrats something to run their campaigns on...
No matter from which angle one looks at it, CrapCare is a complete and utter failure.
These are the facts...
Michale.....
177
No matter from which angle one looks at it, CrapCare is a complete and utter failure.
These are the facts...
No, that is called "an opinion," one that you have failed to support with any facts. It's also off-topic, argumentative against that which was stipulated, and merely a subset of your initial similarly unsupported post.
If you're going to haul out the old saw about knives and gunfights, you might also need to broaden it to include the spork.
Simply yelling "CrapCare" is not an argument.
Instead of repeating bumper sticker slogans, why not read some actual reporting on the subject.
You can read, right?
Now here's how you do a citation:
The Truth About Health Insurance Premiums, Factcheck.org.