THE BLOG
02/04/2008 09:19 pm ET Updated May 25, 2011

A Message to Sen. Clinton -- Forcing People to Buy Insurance is Not Universal Healthcare

Someone needs to tell Senator Hillary Clinton and her minions to stop practicing consumer fraud on healthcare. Forcing people to buy insurance is not "universal healthcare."

Especially when you let insurers continue to charge as much as they want, and do nothing to stop their callous, all too routine practice of denying medical treatment or blocking access to specialists or diagnostic tests because they don't want to spend the money.

Sen. Barack Obama is right on this point. And his mailer, which the Clinton camp has denounced, is right when it opposes "forcing everyone to buy insurance even if they can't afford it. Is that the best we can do for families struggling with healthcare costs?"

In analyzing what is wrong with an individual mandate, start with its flawed premise that treats health as a commodity which must be purchased.

"Having" insurance is not the same as being able to use it. You're only being mandated to purchase the premiums; they're not mandating the insurance companies to make sure you get the care you need.

Nor does "having" insurance protect you from financial ruin. Consumer Reports, for example, last year identified four in 10 Americans as "underinsured." Among those, more than half postponed needed medical care due to cost and a third had to dig deep into their savings to pay for medical expenses. Additionally, over a third postponed home or car maintenance repairs due to medical bills.

Add to those numbers the onset of a recession and it's not hard to imagine an individual mandate exacerbating financial insecurity and encouraging many families to self ration care because they can't afford the rising co-pays and deductibles while still having to pay the premiums. And threatening to garnish your wages or put a lien on your home if you don't go along.

The individual mandate cheerleaders claim that if you don't put everyone in the insurance pool, only the sick will buy healthcare and insurance companies will raise costs. Have any of them noticed that insurance premiums have gone up 87 percent nationally the past decade without a national individual mandate? Expecting the insurance industry to practice price restraint after marching 47 million more customers into their offices is like handing a lion more steak and expecting it to become a vegan.

That is part of why individual mandates are so popular with the insurance industry and those close to it. Insurers reap millions of new customers with minimal requirement to change their behavior. It further entrenches a dysfunctional system, expanding the reach of an industry that treats every dollar spent on care as a "medical loss ratio."

It distorts the role of government, which should be to protect people, not act as an insurance agent.

It transfers the health risk and financial burden from the healthcare industry to individuals and families; just a crushing burden on individuals to make it on their own.

Just ask Gina Dooley of Albuquerque, one of hundreds who responded to a California Nurses Association/National Nurses Organizing Committee ad describing the disparity of care available to Vice President Cheney and members of Congress and the rest of us (www.cheneycare.org).

"I found out when I was 36 weeks pregnant that my unborn daughter had a lung tumor. With this advance knowledge of the care and attention we would need, we did a lot of research and had a lot of contact with our insurance company. I was working for a pharmaceutical company and had the best medical coverage available.

"After several second opinions we were told by our insurance company that only one hospital in town would be covered. We went to that hospital and had a month of treatment, surgery and bills. Months later we learned that the NICU (neo-natal intensive care unit) team was not part of our insurance network although they were the only doctors available in the hospital we had no choice but to go to.

"Because the doctors were out of network we paid 90 percent of all our bills after meeting our $1,200 hospital deductable. Five days after my daughter was born she had major surgery resulting in a $100,000 bill. We paid $90,000 of that despite paying $1,200 a month for insurance to cover everything."

There's only one way to achieve genuine universal healthcare, the approach taken by every other industrialized country with a national healthcare or single payer system. In the U.S. we have that opportunity with HR 676, a single-payer reform that would establish an expanded and improved form of Medicare for all.

Surely, Americans deserve better guaranteed healthcare, not just more insurance.