Post Passage of the HCR, how easy would it be to "indefinitely postpone" the mandate?

[Taverner]

Say, make it take place 100 years in the future or when insurnace companies grow a heart, whichever comes last?

[Fumesucker]

1. The mandate is the one thing that won't be postponed..

Count on it..

[Taverner]

4. And why not?

Why not support the bill, fight the mandate? After passage?

[Fumesucker]

6. Because the mandate is what the owners of our politicians want..

All the other stuff is window dressing, what they really want is every sucker in America to forced to buy their shitty product.

[Taverner]

20. So?

By having it not take effect until 2014, this gives us a HUGE HUGE HUGE opportunity to kill it before it strikes

[Fumesucker]

24. I guess we'll see..

Every time I've been blindsided in my life it's been from being insufficiently cynical.

[Taverner]

27. True - but what say we blindside them for a change?

I don't think anyone in DC is expecting folks to push to keep the bill, kill the mandate

[cherokeeprogressive]

26. Why don't we just shoot a whole quiver of arrows straight up into the air as fast as we can?

Then we can take advantage of the HUGE HUGE opportunity we'll have to avoid them before they hit the ground!

[Taverner]

28. You must not have read the bill

The Insurance reform is good to mediocre but necessary.

[cherokeeprogressive]

30. I just think you're willing to take too big a chance by passing it now and thinking you can change

it before it takes effect. That seems like a strange way of doing things to me.

[Taverner]

31. No I am saying we NEED NEED NEED the insurance reform

And the poison pill of the mandate can be killed in the courts

[frazzled]

2. You know, get over it and be glad if you will be able to finally get some insurance

Millions of people want it and can't get it. If you don't want it, fine. Don't get it and pay the measly fine. And ten years from now, when you find yourself confronting gall stone surgery and you're doubled over in pain, you'll maybe rethink it.

The mandate is what makes this comprehensive reform work. Without it we won't have regulations on the insurers or cost controls on health care spending. You can't have the reform without the mandate. So be one of the 2.5% who refuse to get it. But leave the rest of us alone.

[Taverner]

3. Don't get me wrong, I support the shitty bill

I do - but the mandate seems like something that is doomed to failure from the beginning

[NightWatcher]

5. I dont think the mandate will survive a Supreme Court challenge

thus damning the rest of the bill as well.

It will have been a huge time (and political capital) waster

[Taverner]

21. Not really - getting rid of segregated washrooms didn't eliminate public washrooms

[Skinner]

7. Do opponents of the mandate actually understand the purpose of the mandate?

I know, I know: The purpose of the mandate is to enrich insurance companies.

Now that we have that out of the way, what are the other purposes for the mandate?

Purpose #1: So we can require insurance companies to provide insurance to people with pre-existing conditions. If you require insurance companies to cover people with pre-existing conditions, but get rid of the mandate, what would happen? It should be obvious: Healthy people would not buy insurance, because they would know they could wait to buy insurance when they need it (ie: when they get sick). If healthy people do not buy insurance, and only sick people buy insurance, then the premiums for insurance would be so high that nobody could possibly pay. Get rid of the mandate, and the requirement that insurance companies cover pre-existing conditions will almost certainly have to be ditched, too.

Purpose #2: So healthy people will buy insurance. I know, this is similar to what I said above. But it is important. One of the purposes of insurance is to spread the cost (and the risk) around to many people. In other words: The healthy people subsidize the sick people. Premiums for each individual person are kept lower because everyone is sharing the cost. If there is no mandate, then healthy people would wait until they are sick to buy insurance.

Purpose #3: To help keep premiums lower. Again, this is similar to what I said above. But it's important. (And it just goes to show how all of this stuff is interconnected.) By maximizing the number of healthy people purchasing insurance, the premiums for everyone can be kept lower. As I said above, the healthy people subsidize the sick people.

I don't like the government telling me what to do, either. But if you get rid of the mandate, the whole thing falls apart. (I don't know, maybe that's what people want.)

Instead of getting rid of the mandate, we should be focusing on making sure the subsidies are high enough so everyone who is forced to purchase insurance can afford to do so.

[laughingliberal]

8. I don't really have a problem with the mandate

All of your points are valid. The problem is the lack of competition from outside the industry and the failure to revoke the anti-trust exemption will = no decrease in premium prices.

I was glad to see the more generous subsidy in the House bill was adopted in the reconciliation package but there is still a huge problem with people of limited or average incomes having to come up with deductibles of $2000 (individual) or $4000 (family)and out of pocket expenses of $5000 (individual) or $11,900 (family). It is the point many are making. We will have millions more spending money to buy bronze policies (the policy which will be subsidized) but unable to afford the care. For many people this is not going to remove the danger of medical bankruptcies. The vast majority of medical bankruptcies now are people who have coverage, many with much better coverage than the bronze plans will provide.

The only way the mandate would have worked well for people is if we had gotten the elusive robust public option that would have provided the competition and incentive to keep premiums lower and service acceptable.

[MineralMan]

9. Your analysis makes sense, and I believe those reasons were

the stated ones from the beginning.

The interesting thing about all this is that a single-payer system would mandate the same thing, but the premiums would be collected through taxes. You might be able to opt out with a private insurance plan, but universal health care demands that everyone participate.

The benefit, of course, is a larger pool, encompassing the entire population, along with a non-profit system. But it would still be a mandate.

[Romulox]

12. "Premiums" collected by a government are called "taxes".

Corporations are so entwined with our government that this free and easy substitution of corporate and government actors might feel natural. But it isn't. :hi:

[MineralMan]

15. As I said in my reply,

" ...but the premiums would be collected through taxes. "

Further, that is not always the only way government collects premiums. In the case of Medicare Part B, they are collected by reducing the monthly Social Security payments. They are called premiums, not taxes, in that case.

[Romulox]

16. You've made the same mistake again. "Premiums" and "taxes" are not interchangeable. nt

[MineralMan]

18. Whatever you say...

[Romulox]

19. It goes to the heart of the discussion. You take corporatism as a foregone conclusion. I don't. n

[Romulox]

10. A mandate to purchase a product cannot "keep premiums lower"

Prices are set by supply and demand, not cost. A government mandated demand will necessarily lead to increased premiums, absent a concurrent increase in supply.

[Cleobulus]

13. In the short term, it may lower premiums and maybe control costs...

In the long term, it will have limited affect. For example, your Purpose #3, would only apply if it was ONE risk pool, ONE insurance company everyone has to participate in.

[leftstreet]

25. That's a very good point

would only apply if it was ONE risk pool, ONE insurance company everyone has to participate in.


Of course, that's the basis of Single Payer National healthcare

Which, apparently, we're not going to have
:cry:

[Hello_Kitty]

17. Yet MA, which has a mandate, has the highest premiums in the US.

http://www.boston.com/news/health/articles/2009/08/22/bay_state_health_insurance_premiums_highest_in_country/

MA accomplished some good things with their 2006 reform, including near universal coverage. But requiring everyone to have insurance has not led to any significant reduction in costs. I'm afraid proponents of the mandate have greatly overestimated the impact. You are absolutely right about risk pooling - having a large group of participants spreads the risk most effectively. That's the basis behind single payer. The problem is that we are not putting all those healthy, young people into the same big group. We are putting them into a pluralistic public/private hodgepodge of a system, which greatly dilutes their cost-reducing effect.

Instead of getting rid of the mandate, we should be focusing on making sure the subsidies are high enough so everyone who is forced to purchase insurance can afford to do so.

Agreed. Since getting rid of the mandate is out of the question, we need to look at the subsidies. Several threads recently have talked about the hypothetical single adult making $10 an hour and having to (somehow) come up with $100 a month for a premium. Basing subsidies off of FPL is ridiculous and indicative of how clueless the political professional class is of the reality of life for most low wage workers. I want to beat every single one of them over the head with my hardcover copy of Nickel and Dimed.

[Taverner]

29. Good reason to kill the mandate after it passes, but before 2014 IMO

Kill it in the courts, too - best chance of sucess

[mdmc]

11. that would work for me

but it would upset the corporate masters..

[Taverner]

22. Then we have to work 10x harder

Get it to the courts - I think the mandate can be effectively killed there

[Oregone]

14. The mandate is the reform. Everything else is window dressing

[Taverner]

23. The insurance reform is the only thing I support

But man, is it necesarry

Yes, too little too late, but better something than nothing

If we kept the bill but eliminated the mandate, we'd have some mediocre to good insurance reform