Worrying About Mandates

By Big Tent Democrat, Section Other Politics
Posted on Tue Dec 15, 2009 at 05:06:42 PM EST
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Josh Marshall writes:

The best argument I've heard from people who say the emerging bill isn't just insufficient but just bad law is this: If you're going to force people to buy coverage (mandates), you need to provide them an alternative to buying private sector health insurance to prevent them from getting gouged by the insurance companies. In the abstract that makes a lot of sense. And it even makes a decent amount of sense in the non-abstract, real world. [. . .] My point though is that if you are worried about mandates now (and I think that's a very legitimate worry) you should have been worried about them with a Public Option too.

(Emphasis supplied.) Heh. Apparently Josh missed that whole months long debate. Pretty sure I posted on it a few times. Pretty sure I saw other people do so too. But hey, we're not Very Serious People so . ..

Speaking for me only

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Worrying About Mandates | 27 comments (27 topical)

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No Josh, wrong (5.00 / 1) (#1)
by andgarden on Tue Dec 15, 2009 at 05:14:52 PM EST

Mandates make sense with a public option, and no sense without. This was always the agreement as I understood it: insurance companies get a mandates, and liberals get a public option.

But if you remove the public option, the agreement on mandates is busted. To put it in terms Just and Ezra might understand: but for the public option, I would not have agreed to the individual mandate.

My point was a bit diffeent (5.00 / 1) (#3)
by Big Tent Democrat on Tue Dec 15, 2009 at 05:16:53 PM EST

To wit, a whole bunch of us Not Serious People have been arguing for contouring the Mandate around eligibility for public insurance.


Right, because they were living in their bubble (none / 0) (#5)
by andgarden on Tue Dec 15, 2009 at 05:19:00 PM EST

where the magic exchange would solve everything.


: Interestingly (none / 0) (#6)
by Big Tent Democrat on Tue Dec 15, 2009 at 05:20:50 PM EST

The PO eligibility/mandate group was coterminus with the Exchanges group.
which made it all doable under reconciliation. Ezra does not know that though cuz he is a wonk he does not understand reconciliation.

And I told (none / 0) (#4)
by Zorba on Tue Dec 15, 2009 at 05:18:53 PM EST

my Senators this, several times. All it got me were formulaic responses ("blah, blah, blah, I realize the seriousness, blah, blah) and I wound up on their email lists.


The scary thing (5.00 / 1) (#11)
by lilburro on Tue Dec 15, 2009 at 05:29:45 PM EST

about half of the so-called progressives not getting the problem with the mandates as they stand now is that it seems like common sense - who would want to be forced to buy private insurance? digby:

Nobody's "getting covered" here. After all, people are already "free" to buy private insurance and one must assume they have reasons for not doing it already. Whether those reasons are good or bad won't make a difference when they are suddenly forced to write big checks to Aetna or Blue Cross that they previously had decided they couldn't or didn't want to write. Indeed, it actually looks like the worst caricature of liberals: taking people's money against their will, saying it's for their own good. --- and doing it without even the cover that FDR wisely insisted upon with social security, by having it withdrawn from paychecks. People don't miss the money as much when they never see it.

There's no compact being created here in which people are putting their money to a more communal, more efficient plan, a permanent institution. I shell out to Aetna, you shell out to Blue Cross, we all have to shell out to somebody. Fun times.

Maybe it means Obama will have to face Ron Paul in '12 instead of Huckabee or Palin or Romney.

Mandate and Private insurance (none / 0) (#18)
by Socraticsilence on Tue Dec 15, 2009 at 05:48:08 PM EST

are key benchmarks of a ton of national healthcare systems-- Germany, France, Switzerland, etc.


The key piece (none / 0) (#19)
by Socraticsilence on Tue Dec 15, 2009 at 05:49:20 PM EST

is linking the mandate with guaranteed issuance- insurance companies can't deny anyone.


: One of these things is (5.00 / 2) (#20)
by Big Tent Democrat on Tue Dec 15, 2009 at 05:51:37 PM EST

not like the other - US - Switzerland.

: You seem to be missing a key piece (none / 0) (#21)
by nycstray on Tue Dec 15, 2009 at 05:54:35 PM EST

or two. Affordable and Care pop to mind . . .

I was going to post a link to that this afternoon (5.00 / 1) (#24)
by ruffian on Tue Dec 15, 2009 at 09:07:34 PM EST

but I was feeling too venomous, even for me.

Amazing, isn't it? I love how proud of himself he is for thinking that up - about 6 months behind the rest of us.

: Even if it were actually (none / 0) (#27)
by gyrfalcon on Tue Dec 15, 2009 at 11:41:10 PM EST

a brand-new thought, it's the worst kind of sophistry to say that an argument is invalid only because you didn't raise it earlier. IOW, it's not even slightly "serious" as an argument, it's just sophomoroic point-scoring. We're all supposed to say, "Oh, touche! Well, never mind," and then STFU.

Tomorrow at TPM: (5.00 / 1) (#25)
by ruffian on Tue Dec 15, 2009 at 09:15:12 PM EST

Hey you feeble non-wonks, if you were so concerned about health care for all, why weren't you asking for single-payer instead of that lame public option?

Now, now (none / 0) (#2)
by Zorba on Tue Dec 15, 2009 at 05:16:46 PM EST

BTD, sweetie. You're beginning to sound bitter. As are many of us. ;-)

I've been saying all along (none / 0) (#7)
by s5 on Tue Dec 15, 2009 at 05:22:59 PM EST

The mandate is good policy. It gets people signed up, even people who qualify for Medicaid but don't know it. And it makes regulations like guaranteed issue and a ban on recision possible. The low fine ($750) with hardship exemption is a reasonable price to pay.

But, if the whole bill is the Exchange, subsidies, and a mandate, then it's not a reform package. You need the real goodies to make it actual reform. When all this is over, we'll end up with a bill that leaves the employer based health system intact, doesn't create public competition, and doesn't put the private insurance industry on a leash short enough to effectively make them administrative units of the government. Any of those would have been reform, but we're not getting them.

What we have instead is a health insurance assistance bill with some annoying features. Passing this bill would help millions of people, but it wouldn't be reform. Which means we'll be back to having this debate again like Groundhog Day once the subsidies and regulations erode.

This is a real missed opportunity, and while, yes, the bill will help people as is, it's not reform, and it will need to be revisited again and again. Too bad, I was hoping for something of the "set it and forget it" variety.

: LOL (5.00 / 2) (#23)
by TeresaInSnow2 on Tue Dec 15, 2009 at 06:19:48 PM EST

Mandates good policy? LOL. You don't buy your own insurance, do you. You don't directly see skyrocketing premiums, skyrocketing today, I mean, even without mandates. Premiums will go through the roof with mandates and no premium controls. And there ARE NO PREMIUM CONTROLS.
And the fines? Okay by you? Obviously you won't have to pay them. And it's great for you that they can be waived for hardship. But what's that getting people? Not healthcare. It's getting them the requirement to prove every single year to the federal government that they're too poor to buy health insurance. And who might tend to be too poor to buy insurance? Lots of them will be...the sick. And what if they're borderline, just too "rich" for hardship, but too poor for insurance? And what happens when the Republicans get their grubby hands on hardship policy?
Sheesh, LOL. People who have no real dog in the fight and can talk in such high terms really make me laugh. And it's so obvious to me when people think the mandates without cost controls are okay that they have no dog in the fight.
Also, read the so-called "ban on rescission" before you decide it's worth mandates. Read what guaranteed issue means in the bill.

Mandates make more sense... (none / 0) (#8)
by kdog on Tue Dec 15, 2009 at 05:23:43 PM EST

with a low-cost government plan...the only way they make true sense is with full-on socialist tax funded single-payer, citizenship is your mandate.

Can we apply this to argument to auto insurance? No mandates without a low-cost public-option?

We have that now (none / 0) (#9)
by s5 on Tue Dec 15, 2009 at 05:25:23 PM EST

Don't want to pay for auto insurance? Then ride the bus, sign up for Zipcar, ride your bike, get a ride with someone else, etc. Auto insurance has a "public option" of sorts already.

Same with mail delivery, education, etc.


: In theory yes... (none / 0) (#13)
by kdog on Tue Dec 15, 2009 at 05:31:02 PM EST

in reality, in some places, no whip no work.

: Yeah, yeah, but (none / 0) (#26)
by gyrfalcon on Tue Dec 15, 2009 at 11:37:20 PM EST

paying for auto insurance won't eat 25 percent or more of your total income, especially if you keep or buy an old car and only get the minimum mandated coverage.
I would prefer a "public option" on auto insurance, too, don't get me wrong. But it doesn't loom anywhere remotely as large as a hit on my income as mandated private health insurance.
Can we please stop with the constant, absurd comparisons to auto insurance? The two things aren't comparable except in the vaguest kind of general principle.

My thoughts exaclty. (none / 0) (#10)
by sarcastic unnamed one on Tue Dec 15, 2009 at 05:26:23 PM EST

Um, "exactly," and that was in reference (none / 0) (#12)
by sarcastic unnamed one on Tue Dec 15, 2009 at 05:30:06 PM EST

to your auto ins comment.


I got all excited... (5.00 / 1) (#17)
by kdog on Tue Dec 15, 2009 at 05:44:14 PM EST

the wonks are gonna join forces in opposition to auto insurance mandates with the freedom-evangelicals...but then I got hit with the public option is the bus:(


: Yep, that happens sometimes mid-wank... (5.00 / 1) (#22)
by sarcastic unnamed one on Tue Dec 15, 2009 at 05:56:17 PM EST

and he's been commenting (none / 0) (#14)
by robotalk on Tue Dec 15, 2009 at 05:32:41 PM EST

on HCR how long? I mean this is basic, basic stuff.

How is this not unconstitutional? (none / 0) (#15)
by Key on Tue Dec 15, 2009 at 05:34:13 PM EST

So, the government will require me to buy health insurance (mandate) from a private company. How is this NOT the government forcing a transfer of my property to another private entity?

At least with the mandate/public option, the government would require me to buy health insurance but I would get a service in return from the government. In other words, a tax on a social service, much like taxes for education, defense, social security....

I'm okay with a mandate providing the government provides something for it. I'm not okay being forced to pay a private, for profit company....

So, with no public option, how would a mandate to buy private insurance not be an unconstitutional transfer of property?

: It isn't because (5.00 / 1) (#16)
by Big Tent Democrat on Tue Dec 15, 2009 at 05:35:34 PM EST

it is a tax if you do not buy insurance, not a requirement that you do buy insurance.
It would not be even if it was what you describe, but the case is even simpler than you think.