Requiring every American to own health insurance is tough medicine. A mandate to own health insurance can feel like a tax; it can be characterized as government overreach, and unless the subsidies are generous enough, it will feel like health care reform is putting the hammer to the middle class. And depending on which poll you look at, 50% to 70% of Americans oppose a mandate.
Nevertheless, a mandate is the key to creating successful health care reform. Without a mandate for every American to have health insurance, health care reform will fail. Ultimately, the polling data on a mandate doesn't matter; international experience tells us that people will warm to a mandate over time and will certainly not oppose it once they feel the positive impact it has on all of our health insurance coverage.
Here's why...
Right now, there are two ways for insurance companies to make money. They can improve the health of those they insure or they can invest their time and money trying to exclude the sick or the likely to be sick from buying coverage. In our current health system, it is far more profitable for insurance companies to focus on denying care, rather than improving the health of those they insure.
This is the opposite of every other country in the developed world. At the moment, the incentives in the US health system are for sickness care, not health promotion. Most American doctors get higher pay for delivering more care, not necessarily for providing better medicine. Likewise, insurance companies get rewarded for excluding those who might fall ill, rather than helping to improve the health of those that they already insure. And as long we keep these backwards, ill-conceived incentives in place, health care in the US will cost far more than it does any where else in the world and will continue to have patchy quality.
The only way to go from sickness care to health promotion is with both tougher regulation of insurance companies and a meaningful mandate for individuals to buy health insurance. If we require every American to have health insurance and we say that insurance companies can't make money by avoiding sick patients, the insurance companies will only survive if they focus on getting their insurees healthy and developing innovative ways to keep them that way. Those are the type of incentives we need for success.
Part of the political problem with a mandate is that it is precisely what the insurance industry wants. To many Democrats, this makes a mandate feel like a simple giveaway to the insurance industry with no quid pro quo. And, in light of the release of the blatantly self-serving and obstructionist report from the insurance industry's lobbying arm, the America's Health Insurance Plans, it's hard to blame anyone for feeling that way. But, this isn't the whole story. Turning a blind eye to a mandate as a form of revenge would be cutting of our nose to spite our face.
We usually think of the Republicans as the party of industry competition. However, over time, Republicans have morphed into the party of monopoly and their brand of monopoly is trouble. Their brand of monopoly enables insurance companies to be shielded from competition and exempted from having to step up their game to meet customers' needs. This has hurt us all. Private companies operating in monopoly markets are bad for the American public.
Think about it for a moment...we have about a sixth of our economy in a market that has no competition and zero pressure to slow spending.
That's where competition comes in. In addition to requiring everyone to buy insurance, we need to make the health insurance market more competitive. That competitive pressure is what's going to keep insurance companies honest. With healthy competition, insurance companies won't be able to sit there and charge outrageous prices. In a competitive market, if they do, they'll be priced out and forced to close, just like any other company failing to meet their customers' needs. That's why I'm encouraged by recent efforts to repeal the antirust exemption for health insurance companies.
We also need to go further and make sure every American has a meaningful choice of health care plans with one guaranteed viable option. More than ever, in the wake of the insurance industry's report, we now see why a public option is a must. If the insurance industry were really interested in improving health care reform, they would have published their report months ago, when it could have helped shape the debate. Dropping their report at the 11th hour only served to highlight that insurers are interested in their own welfare, not progress.
A final point. Health care polling has been all over the map over the last few months and is testing the resolve of policy-makers and politicians. However, even the best polls out there are a snapshot of an unfinished race. The polls that matter are the ones that will reveal how Americans feel about health reform feel once they've experienced it's benefits.
While we'll never know how the American public would react before legislators act, we can get a good clue from Switzerland. There, a mandate for citizens to own health insurance won by the slimmest of margins. Today, more than a decade and a half after the Swiss reforms passed, a far greater percentage of the electorate and vast majority of the population support the mandate and don't want to see it over turned. The Swiss perceptions of the reforms shifted once individuals felt the difference it made in their lives. That's a lesson we're going to need to take to heart in the US.
Sticks do not work on the American people, carrots work much better and have a much better chance of having a long term positive effect. Having a comprehensive public insurance option available for all Americans, that would obviously be way more affordable than the private insurance plans, and would offer better services because it would be focused on patient care rather than profit margins, would encourage people who don't have insurance by choice to seriously look into it and eventually, get health insurance.
You cannot have a mandate in this country on something that is not a priviledge but a human right. Health insurance is not like auto insurance! Owning and driving a car is a priviledge, and one earns that priviledge by obtaining a license, registration, auto inspection and insurance--all intended for the public safety. If you don't want to pay for auto insurance, you have a choice of not owning a car. A mandate on health insurance does not have that out. One cannot choose to no live if one does not want to own health insurance! A mandate on health insurance w/ hefty penalties is mafia style extortion authored by the private insurance cartels.
The arguments allowed in the present agenda are BS, based on lies and distortions. Motivated by money - profits for the insurance and drug companies and campaign contributions (bribes) for the politicians.
And the costs will be paid for by the common folks through higher taxes, enrollment costs and prices for drugs and services.
I'm on medicare. It works. Extend it to everyone and include dental and mental health care. Also scrap the senior drug program (which was designed to aid the drug and insurance companies) and include rug benefits in the new plan.
What Zack doesn't get is that most of us without health care insurance can't afford it and none of the proposals to help us pay for it have any chance of helping us cross the chasm. If we can't pay for it already, we surely won't be able to pay for it when forced, either. Well over 10% of us have no jobs - how are we supposed to pay for insurance, even with a subsidy?
What else Zack doesn't get is that this isn't Switzerland. Switzerland is a very wealthy country - far more wealthy than we are. I'd be VERY surprised if they have _any_ poor people - poor by U.S. standards. Switzerland has a far higher standard of living than we do. ...Don't try blowing any of that "the USA is the greatest nation on earth" smoke up my as, I'm not that dumb.
Zack had a whole article's space, I only have 250 words, there's not room enough for me to address his points one by one, but the very short of it is, what we need is single-payer, like the REST of Europe. Then, it won't matter if we are temporarily unemployed, etc, and everyone who can pay will be paying when they are able - no need for messy periods of time when a premium can't be paid, etc.
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Everybody needs health care, nobody needs health insurance. Single payer, now.
So you would mandate my 3 healthy hardworking children 20-24 to purchace a health care plan... Health care insurance is quite a bit more expensive than the liabilty insurance they are mandated to purchace for owning a car... One doesn't own a car so he has the option of not purchacing insurance he doesn't actually need... Your mandates will take the money they would invest to acomplish their dreams and goals(owning a car/starting a business)... Money that will not be used to build the economy... You desire this on a grand scale?
The American people may support Public Option but by far they do not support Mandates nor are we buying into the arguments being made for them...
This is what we voted for and supported by our votes - The Obama-Biden Plan-http://change.gov/agenda/health_care_agenda/
•Establish a National Health Insurance Exchange with a range of private insurance options as well as a new public plan based on benefits available to members of Congress that will allow individuals and small businesses to buy affordable health coverage.
A Commitment to Fiscal Responsibility: Barack Obama will pay for his $50 - $65 billion health care reform effort by rolling back the Bush tax cuts for Americans earning more than $250,000 per year and retaining the estate tax at its 2009 level.
Mandates are not "Public Option" and Mandates are a Tax On The Hard Working Class Of This Nation.
It is obvious health care reform is nothing more than a massive tax on the healthy low risk working class people of this country.
Imitating Hugo Chavez, Obama wants to nationalize everything, including our health care system! "Hey, Obama has just nationalized nothing more and nothing less than General Motors. Comrade Obama!" Chavez cheered on Venezuelan TV. He added that he and Cuba's Fidel Castro would now have to work harder just to keep up.
http://www.hacer.org/report/2009/06/us-obamas-red-chorus-investors-business.html
Fortunately, as we can see in the town halls and marches, most Americans have NOT been dumbed down. Most Americans DO NOT WANT to put the power of life and death in Obama’s ACORN-type bureaucracy. They will do whatever necessary to defend themselves, their children and grandchildren from the abomination of Obamacare and socialism/communism.
Our Government SHOULD be working for the BEST INTEREST of The PEOPLE of America, NOT the Health Insurance Industry!!!
The incentive to be healthy should not have anything or much to do with avoiding health insurance or getting cheap insurance!
News flash! The incentive to be healthy is an innate instinct hard wired into every living being on the planet. It goes hand in had with the innate instinct of survival--it is hard wired into our internal make up and that of every living being on the planet. That is why you (well most living beings anyway) avoid rotten food and can sniff out rotted food, because innately one knows that consuming rotted food will cause illness in your body and hence, diminish your survival outcome.
Thanks for the laugh though! I will have to share your joke with my friends, they will get a kick out of it, especially when they know that someone acutally thinks that! hah!
It would be like making us buy an overpriced big car that gets terrible mileage, breaks down constantly, and will fail to start when you need it most.
No Thanks..
Indeed, we'd better keep our ear to the ground or we'll be cutting our own throats.