Hate to say it, but I agree with the judges who have ruled against Health Insurance Mandate

[Armstead]

I don't usually agree with right-wing judges who promote "markets uber ales."

But in tossing out the mandatory purchase of health insurance, I think they are correct.

now before you break out the pitchforks, let me make it very clear. I strongly believe in universal single-payer health coverage. On that I am firmly in the camo of Bernie Sanders and Dennis Kucinich.

Short of that, I believe the best second alternative is a "public option," preferably in the form of giving everyone an opportunity to pay into Medicare, or a similar version of public insurance.

IF there was such an alternative, which offered AFFORDABLE coverage based on income for anyone who chooses it, some form of mandate might make sense.

However, forcing people to buy private insurance -- an overpriced and inadequate form of extortion -- then the government has no right to compel people to buy such a commercial product. Especially when the government only has toothless regulations as the only safeguards of consumer protection.

The mandate is a form of collusion, intended to placate the insurance industry with a massive new pool of captive customers, in exchange for their promises to "be nice."

[liberal N proud]

1. That was a poison pill put in the bill to insure this exact action would take place

[The_Commonist]

7. I think you're right... poison pill.

And I don't like this mandate either.

[Proud Liberal Dem]

90. Chess playing?

:shrug:

[AngryAmish]

120. Who put it in? Pelosi?

She wanted to kill this?

Remember this bill was written with zero input from the Rethugs.

[TheKentuckian]

139. Votes? No. Influence? Affirmative. Well over a hundred TeaPubliKlan amendments were accepted.

Because we are that stupid and/or complicit.

[CaliforniaPeggy]

2. They need everyone to participate in order to make the pool

big enough to spread the risk around.

Good enough for me...

:shrug:

I do wish it had been set up otherwise, but it wasn't.

[Armstead]

5. I disagree. It is "blame the victim" regarding all those who...

Cannot afford the extortion.

In this case the "individual responsibility" is merely a way to allow private insurers to reap rewards while continuing to rip off the public. They will NOT use the increased I come to offset the expenses.

[woo me with science]

63. +1000000 nt

[golfguru]

72. +1000

[Lydia Leftcoast]

132. Yes, it's a millionaire Senator's idea of "affordable"

I actually looked up what would happen. The insurance I would have to buy would cost more and have no better coverage than the insane policy that I dropped last spring. (The premiums were preventing me from paying off uncovered medical bills.)

I am just over the income limit for subsidies, but even if I qualified, I would still be opposed, because it's nothing but corporate welfare.

When the mandate goes into effect, I will be pretty close to Medicare age, but others will not be so lucky.

It would have been easier and fairer just to lower the age of Medicare eligibility by five years every year until the whole nation was covered. Furthermore, adding younger, healthier people to the pool would have helped Medicare stabilize its finances.

The actual bill looks more like "Let's Pretend to Provide Universal Health Care While Providing Corporate Welfare to the Insurance Companies."

It is OUTRAGEOUS that Obama met with the insurance executives in closed-door sessions.

We all hated it when Cheney met in closed-door sessions with the energy company executives.

Why is it a "good thing" when Obama does it?

Besides, why do insurance companies get to WRITE the laws that control them? It's like an episode of the old BBC series Yes, Prime Minister.

[raccoon]

166. Great post. nt

[Bluenorthwest]

22. CP. You are too smart and honest to play that game.

If that is the goal, why is profit built in? Tell me how you 'need' that profit margin. Tell me how it can be alright to make more discrimination against families that are not approved by Rick Warren and Donnie McClurkin?
Every other nation that mandates the purchase of health insurance also makes it illegal to make a profit from providing mandated services.
To simply ignore that aspect is intellectually dishonest. It discriminates and is the first law on earth to demand that I as a private citizen contribute to the profit of another private citizen.
Easy for those who have all to be complacent. You will never even see the people who are harmed and mistreated so why should you care? You will not even spend a dime or a minute to seek equity for all in this process. You will post shrugging emoticons while my family is torn to bits to serve some 'adult children' of affluent people. The discrimination, the profit taking these were not necessary. They help no one but the bigots and the Insurance Industry.
I'm done with rationalizing this stuff. Done.

[woo me with science]

64. +100000 nt

[Dokkie]

91. exactly

You never see the people harmed by this bill. They say 20-27 would be able to stay on their parents insurance but what if your parents are dead or live in a different country? This bill would hurt more people that it helps. The job of the HCR should be

1. Reduce the cost of medical care in this country
2. Then provide a govt program to sell insurance

With this bill, the price of medical care is virtually going to remain the same and its just that now people would be forced to get a sign up for the high priced healthcare.

The whole bill should be redone

[golfguru]

104. +1,000,000

[slipslidingaway]

102. A reason for improved Medicare for All, not a reason to mandate purchase ...

or pay a fine, to buy insurance, not care, which is for profit.

If one wants to spread the risk, then leaving the seniors on Medicare while the healthiest segment is covered by the for profit companies makes no sense to me.

:shrug:

There is lots of talk about SS, but all those boomers will also be moving to Medicare which is the real problem IMHO. Dems should been honest with the people during the HC debate.

[swilton]

144. Mandatory health 'insurance'

Is windfall profits for the corporations that are profiting from a failed health care system....Where are the limits on what the health insurance industries can charge for their so-called care.

[phleshdef]

3. Your and their premise is incorrect. The law does not require anyone to buy health insurance.

[Armstead]

6. It does unless one wants to pay a penalty.

[phleshdef]

11. Yea. Unless, they want to pay the tax for not having it, which helps to subsidize uninsured ER care.

Its no different than if they had created an "uninsured emergency care" tax and then gave everyone a full or partial tax credit for having been covered for all or part of that year. Unfortunately, they should have structured the law in the way that I just stated and they would have been doing the exact same thing but it would have been an easier sell.

But my point stands. This law does not require anyone to carry health insurance. Its an absolute lie to say that it does. "Require" means that you don't have the option to not purchase it. You do have that option. But that also means you are a walking liability if you end up requiring emergency room care that you can't pay for. So you will have to directly contribute cash to covering that treatment if and when its needed. And if you can cover it, you can also report that on your tax return as uninsured medical expenses. If those expenses were really high, then you receive a write off which kind of balances out with the surtax you pay for not having coverage. That last part could probably be streamlined a little better, but the structure there exists to cover both of those situations.

[Armstead]

20. Why not just keep it simple and honest

Give everyone the choice of buying into Medicare (or a similar public coverage pool) as basic coverage, Instead all of this convoluted shell games?

Most people are not avoiding coverage because they don't want it.

They can't afford it, even if they work and are self supporting otherwise. They should have access to affordable basic coverage without having to go through all of those gyrations and the stigmas involved.

[phleshdef]

23. Yea, we all want a public option. But some people may not want to buy into that either.

Some people are going to not buy healthcare at all if they are convinced they don't need it.

In which event, they should at least pay a tax or something of that nature to faciliate paying for themselves as an emergency care liability. If they are too cash strapped to pay that, then they likely (should) qualify for medicaid anyway, in which case they would be exempt from the tax.

[Recursion]

25. Well, I absolutely don't want a public option

At least not one without a dedicated sacrosanct revenue source; without that it would just be like Medicaid only much worse.

[phleshdef]

30. I really don't get your argument. "If its not air tight from day 1, don't do any of it"

Thats basically what you are saying. If a social safety net program isn't being funded correctly. You don't trash the social safety net program, instead you work to change the funding mechanism to be more effective and more reliable. If we can get a public option established, I don't really care how we fund it as long as it doesn't involve something really horrible, like cutting social security to pay for it or something of that nature. You don't say no to something like that. You take it and wait for the next opportunity to improve it. As long as we still have a country, we will always have opportunities to fix it. We've been doing it for a few centuries now.

[Recursion]

33. In this case, yes

There has never to my knowledge been a case of a social program being funded out of general revenues that then is put on dedicated funding. If you know of one, then I'd really like to know about it too. History tells me that if you don't make a program with its own revenue source, it's not going to get one. And a public option absolutely needs its own revenue source or it will make Medicaid look good. Remember: the PO is what all the insurance companies are going to find a way to dump all of their sick people into. That's why insurance companies loved the idea. Hospitals and states hated it, because they deal with one of these (Medicaid) already, and this one would be even bigger.

[phleshdef]

43. Thats ridiculous thinking.

I'm not advocating that it shouldn't have a self substaining, purposed revenue source. But if they can pass the creation of one that isn't funded that way, it would be moronic to oppose it. Once the damn thing exists, its fully possible for the right congress to decide to change the funding mechanism to be more robust and reliable. To say that just because you can't find a historical example of this having happened doesn't mean a damn thing. History is important but the failures detailed in our history should in no way serve as a prediction to possible successes in the future. Thats just negative, cynical garbage.

[Recursion]

44. Yes, it does mean something that it has NEVER HAPPENED

It means it's almost certainly not going to happen now. If we don't have the wherewithal to fund the damn program, we don't have the wherewithal to pass it.

I think I do get where you're going: once it's there, people will have to fund it. Except that argument hasn't worked with Medicaid. It's just used as another punching bag for why the "Gub'mint shuld stay outta health care!!!"

[phleshdef]

45. But yet Medicaid exists and has in fact helped and saved many, many people.

And just because we haven't fixed it doesn't mean we can't or won't.

"Never happened" is a phrase that can be applied to every single event that has happened, albeit before said event happened. If it doesn't violate the laws of the universe, then it actually stands a fairly good chance of happening. Medicare and Social Security are things that "never happened" until they actually happened.

[Recursion]

47. And it's bankrupting both providers and states

Adding more to that fiasco is only going to make things worse. We'd be better off figuring out a way to lower provider costs.

[phleshdef]

48. Just because we need to figure that out takes nothing away from the lives Medicare has saved.

Thats the point you are missing.

[Recursion]

50. Medicaid, not Medicare

And of course it's saved lives. And it's unsustainable. And the point of this whole sturmunddrang was to make the way we pay for health care sustainable.

[phleshdef]

59. That was a typo on my part.

[Hello_Kitty]

71. Uh, you realize that the HCR adds about 15 million people to the Medicaid rolls don't you?

The people making 133% FPL or less that the private insurers don't want to touch.

[Recursion]

73. Yes; that's a huge worry for me (nt)

[Hello_Kitty]

69. But we have the wherewithal to subsidize private insurance premiums. eom

[Recursion]

76. Well, no, we really don't

It's just that doing that lets us forestall the day of reckoning for another decade or so.

[Hello_Kitty]

68. You mean "dedicated sacrosanct profit source for insurance companies".

There, fixed it for you.

[Recursion]

74. No, I'm talking about a public option

If it comes into being without a dedicated revenue source, I am firmly convinced it will make things worse.

[golfguru]

105. Name me one democrat who is not for public option

and I will show you a corporate shill.

[Lydia Leftcoast]

167. Yyyyyup.

And the fact that they couldn't get a measly public option passed with a majority in both houses and a Dem president shows that there are an awful lot of corporate shills.

[DrToast]

36. Because that system would collapse

Letting people buy into Medicare at their own discretion would have the same problems as non-manded health insurance.

People would buy it when they got sick and you'd end up with a risk pool of sick people.

Why do you think the existing Medicare is in such financial trouble? Because its "customers" consume a lot of health care.

[Lydia Leftcoast]

134. No, most people HATE being uninsured

(I just hated the insurance companies more and refused to be a victim of their useless, bloodsucking ways.)

[ClassWarrior]

115. That's like saying your Ginsu Knife is only $9.99...

...and putting the $14.99 s&h in small print.

NGU.

[dotymed]

124. The profit motive

has to be repealed. No other country in the world allows "for profit" health insurance.
IMO, yes, that was the "poison pill" to make sure that this bill was struck down.
We need to (our only hope) follow Egypt's lead and take to the streets (unarmed).

[formernaderite]

147. you can't penalize someone for inactivity

this is the error they made in constructing this bill. Commerce requires activity...

[Recursion]

19. I don't want to buy a house. So, I pay a tax penalty

You might as well say I'm mandated to buy a house since renters don't get the mortgage deduction.

[phleshdef]

40. I see nothing wrong with giving some tax relief to those that have additional financial burdens.

And as a home buyer who rented for years, I can definately tell you that buying and maintaining a home is a much bigger financial burden for me than renting was, at least to the short to mid-long term. Once I'm no longer dealing with that financial burden, that means my mortgage is paid off and I won't be getting that write off anymore.

Its the same with children. People who have children are responsible for the financial burden of raising that child. So they get a write off for it.

The difference here is that people who don't buy health insurance are creating a situation where they could be a liability to society if they don't pay something for care that they may need in a desperate situation. Because we mostly want to be a civil society, we require they be treated for emergencies regardless of whether they can pay for it. If we want to continue that kind of civility, we need to ensure that its something thats paid for in broad day light, which is exactly what the mandate/tax penalty (or tax credit for carrying insurance) accomplishes.

[Ozymanithrax]

4. The mandate is a method of getting universal or near universal health coverage.

The judges are arrogant right wing Conservative dicks.

[Armstead]

8. They may be dicks but this is not a valid form of universal coverage

Using the logic of this reform is like saying we will end homelessness and provide universal housing simply by forcing everyone to buy a house.

universal coverage is a great goal......Universal enforced rip off is not.

[Ozymanithrax]

9. It may not be the best method...

But it can work. It is also a great place to start.

[Armstead]

13. It's a bad place to start

Forcing people to buy a rotten and unaffordable product is a poison fruit that poisons all further "reform"

A good start would have been setting up the framework for a public coverage alternative. even if were initially limited, at least it would have set the machine moving I. The correct direction.

[ProSense]

From the OP: "The mandate is a form of collusion, intended to placate the insurance industry "

Then why are wingnuts, Republicans and AHIP trying to get rid of the law?

I mean, if it's so much better for the industry than the status quo, why are they trying to get rid of it?

[Armstead]

26. ever read the story of Brear Rabbit and the tar pit?

"please don't throw me into that briar patch."

In other words, while they would prefer to continue to operate I. A totally u controlled manner, health insurers see this as the form of reform that is best for them and offers a bonus....But, as former exec Wendell Potter noted, they also don't want to be seen as supporting it publicly.

[ProSense]

27. That makes no sense. n/t

[Armstead]

34. In other words, they did fight reform, but once something became inevitable....

they pushed for and got a version of pseudo reform that gives them a lot while requiring very little from them in return.

The Brear Rabbit aspect is that if they had publicly endorsed this, the public would likely have been a lot more skeptical.

[ProSense]

38. Still makes no sense.

"they pushed for and got a version of pseudo reform that gives them a lot while requiring very little from them in return."

Why are they trying to repeal it if it's so great?

You can't have it both ways.

[Armstead]

53. The Right Wing is trying to repeal it for ideological reasons

The health insurance industry did their fighting while it was being debated to get what they wanted.

And it is irrelevant whether or not the insurers oppose or support this.

What matters is whether it frees Americans from the grip of extortionary rates and policies designed to deny coverage whenever possible.

This version of "reform" only loosened the grip very slightly -- far from enough to make any real difference.

[ProSense]

56. "And it is irrelevant whether or not the insurers oppose or support this." Well,

there's a huge contradiction.

From the OP: "The mandate is a form of collusion, intended to placate the insurance industry "

[Armstead]

77. Not a contradiction at all

My point was that in terms of actual results for Americans, it is irrelevant whether or not it has the support or opposition of the insurance industry.
It is also irrelevant whether or not the results are beneficial for the industry.

What is relevant is whether or not all Americans have access to quality health care that is affordable for them. that is the bottom line.

In my opinion, the reforms that were done were the product of trying to placate the insurance industry to an extent that undermined the goal of affordable universal health care. What was done to satisfy their desires and interests was contrary to that goal.

[ProSense]

101. Well,

"In my opinion, the reforms that were done were the product of trying to placate the insurance industry to an extent that undermined the
goal of affordable universal health care. What was done to satisfy their desires and interests was contrary to that goal."


...that's an opinion and has nothing to do with the constitutionality of the mandate. Also, many people would disagree with you on affordability, including Krugman:

Guys, this is a major program to aid lower- and lower-middle-income families.

The full impact of the law will not be realized until the exchanges are up and running, but the provisions that have been implemented are making a difference.



Edited for clarity.

[phleshdef]

16. It does setup a framework for that. the only thing missing is a purely non-profit plan everyone....

...can buy.

What this law establishes is that the government is going to help people pay for coverage based on a progressive income scale. And the law also establishes the exchanges. People have to participate in the exchanges if they want the subsidies and insurance companies that want customers receiving subsidies will have to participate in the exchanges and will have to adhere to certain regulations to be qualified to receive customers from the exchanges. If a future law established a non-profit plan that anyone and everyone can buy into, regardless of income level, then the whole thing would be pretty much perfect.

[Recursion]

17. No, there are purely non-profit plans everyone can buy

They exist already. Most Blue Cross plans are.

[phleshdef]

21. Blue Cross is intertwined with all the private insurance companies.

Thats not what I'm talking about. I'm talking about basically a public option or something really close to it.

[Recursion]

24. Even Medicare does the actual provisioning through private for-profit companies

They aren't going away.

Pretty much unless a Blue Cross is Anthem or Regence, it's a non-profit organization running it. If profit motive is the problem, people on Blue Cross should have it made, right?

[Armstead]

37. Blue Cross has become indistinguishable from ;private for profit insurers

[Recursion]

41. Impossible. I keep reading that the problem is profit motive

A non-profit by definition doesn't have that.

[Armstead]

54. Read up on Blue Cross

It has become non-profit in name only

[Recursion]

57. CA Anthem and Regence, sure

Those are only non-profit by tricks of state law (and the non-CA Anthem isn't even that)

But Blue Cross Blue Shield of X is actually non-profit. So is mine, Tufts Medical Group. Why aren't they noticeably better than for-profit plans?

[Armstead]

32. It's chicken and eggs

It is a very big "if" to believe that this will be followed by a meaningful non-profit plan.

That should have been the first priority to give people an affordable alternative now. Then, if an affordable algternative were in place, they could do something to make the market for private insurance "kinder and gentler."

[phleshdef]

46. No, its not a big "if" at all. This philosophy that "they never improve it later" is insane...

...and it stands in the face of everything we have improved over our time as a country.

[Dawgs]

18. "great place to start"

Only in the mind of Democratic politician; or someone that will buy anything they are trying to sell.

[slipslidingaway]

103. Insurance does not equal coverage! n/t

[ProSense]

10. "I don't usually agree with right-wing judges who promote 'markets uber ales.'" But

in this case you're agreeing with two teabaggers when more than a dozen other sitting judges and hundreds of legal scholars have said their opinions are bogus?

[Name removed]

12. Deleted message

Sub-thread removed by moderator. Click here to review the message board rules.

[JTFrog]

151. +1

[swilton]

14. Totally Agree

Thanks for saying so!

[Recursion]

15. Do you disagree with all use of tax policy as a behavior incentive?

Or just this one?

[Armstead]

78. Depends...in this case I disagree with it

[Recursion]

125. Because someone, somewhere is making a profit? (nt)

[Armstead]

159. Because somewhetre someone is going to make an exorbitant profit at our expense

Also, when it comes to healthcare, the notion of tax incentives is an ineffective and counterproductive approach.

For people who do not pay much in taxes because their income is relativity low, a tax credit or break is meaningless when balanced against the high cost of private insurance.

[DrToast]

28. The government uses our tax dollars to buy all sorts of products from private companies

The only difference in this case is that they're not collecting it first.

Further, all of your reasons for being against the mandate are not legal reasons.

[Recursion]

29. Exactly. I'd much rather opt out of the JSF than health insurance

But, hey, if this means the Republicans have to actually be involved in what comes next, we might have a little less insanity.

[DrToast]

31. Are you against Medicare? Social Security? Those are mandated

Or are you only against this mandate because it involves private companies?

And if that's the case, do you think it's unconstitutional when the government buys jets from Lockheed Martin.

[Dawgs]

52. Federal government requiring INDIVIDUALS buy from private companies or be punished is the problem.

No precedent or example that even comes close.

[DrToast]

58. That point is meaningless

There is no effective difference between that and the government buying private goods with taxes.

The only difference is the mechanism by which it happens.

The attack on the mandate is a political one and not a legal one.

Where were all these clowns when Romney passed his law?

[Dawgs]

60. Agree that it is mostly political, but comparing government to individuals doesn't make sense.

The government is NOT buying private goods. They are requiring individuals do it.

I would also say that many, like me, are disappointed with the mandate because no public option or expanded Medicare is included; when it could have been.

[DrToast]

62. Again, that's a meaningless distinction

We ARE the government. Where do you think the government gets its money?

Instead of raising everyones taxes to buy insurance for people (which nobody would think was unconstitutional), we're simply requiring people to buy insurance. We're basically just eliminating the tax collection part of the equation.

[Dawgs]

66. "Instead of raising everyones taxes to buy insurance for people"

You just defined social security. Which no one has been able to argue is unconstitutional.

[lumberjack_jeff]

146. Well said. n/t

[Armstead]

80. Medicare and SS are a mandate service -- That's the difference

Those programs actually provide something as part of the mandate. It is similar to fire protection, which is mandated through property taxes.

That IS different that requiring people to buy a private product.

The comparison to defense spending is irrelevant. The government provides the service of defense. A contract for equipment is part of their expenses.

[formernaderite]

149. they are collected as taxes

remember Gore wanting a lock box for social security? why? because it's put in to the general fund...it's a tax. But the democrats were afraid of calling for a tax...although I believe the White House lawyers tried to argue it was essentially the same... unfortunately it's not. The commerce clause doesn't cover penalizing anyone for inactivity.

[golfguru]

107. LMAO the Medicare mandate is NOT from a private corporation

can you see the difference between mandating us to buy from a
for profit corporation and Medicare which is a single payer GOVERNMENT
run program?

I want a public option and not the mandate to guarantee a profit to
some private corporation.

[Lydia Leftcoast]

135. Social Security and Medicare are not profit-making businesses

Big difference.

[formernaderite]

148. medicare and social security are taxes

that are collected. That was the error in constructing this. You can't force a penalty on someone for inactivity, that's why the commerce clause doesn't protect this thing.

[treestar]

35. The public option or single payer could be unconstitutional also

Just because you didn't think it went far enough does not mean you have to jump on the right wing bandwagon for making it unconstitutional.

[Dawgs]

51. So you must think that Social Security is unconstitutional?

No? :shrug:

[treestar]

128. I said single payer or public option COULD be unconstitutional

:wtf:

[formernaderite]

150. social security is a tax

that goes into the general fund.

[golfguru]

108. Read the federal judge's decision again

The reason he said HCR is unconstitutional is because it mandates
every one to buy from a private corporation. In other words it forces
you to enrich the owners of a private corporation.

Whereas in Medicare, the revenues collected as taxes belong to all the
citizens of United States. Medicare is a NON_PROFIT outfit, run for the
benefit of all seniors with no exceptions.

[treestar]

129. Read the decision again

He said inactivity was not to be regulated under the commerce clause.

Other courts have said the opposite - or that the health care plan is valid as a regulation of interstate commerce.

So it will not be resolved until it gets to the Supreme Court.

Meanwhile, there's no reason to assume that its being constitutional or not makes it any more likely the public option would be.

[golfguru]

131. Best solution is Medicare for all

with genuine effort to REDUCE COSTS. The real problem is cost of health care,
not lack of it.

[MahatmaOlbermann]

39. I agree n/t

[muntrv]

42. The dems should have pursued a Medicare-For-All strategy.

[Recursion]

49. Too many moderates were concerned about stuff like how to pay for it

And every time somebody tries to work it out, the premiums for buying into Medicare become depressingly high.

[Armstead]

88. Not necessarily

I have seen other analysis and proposals based on calculations that are much more economically viable than our present system.

It a complicated situation and there are unfortunately no cheap or easy answers. But there is equal evidence that public social insurance can be much more efficient as well as more humane that the mess we currently have.
a

[karynnj]

55. There is an inconsistency in what you have said

If I am following you, you are saying that to mandate the purchase of single payer insurance (which I think would be the same as a tax) OR mandate the purchase of insurance IF there is a public option is ok - but it is not ok if there is no public option.

Now, we know the first case, single payer, would be legal as no one challenges the right of the government to tax. However, the other two are functionally the same. If there is the right to require someone to purchase a healthcare plan, both of these are legal. If not, neither are.

Not to mention, saying that people are required to purchase insurance is not what the law really says - they can purchase insurance or they are required to pay a fee. The government has a right to levy fees - and here the justification is easy. The government incurs the risk if someone without insurance ends up seriously ill or in an accident.

I am not a lawyer - so what I just wrote could be completely wrong.

[Armstead]

89. I'm not a lawyer either, but I see no contradiction there

My point was that, given the system as it is now, requiring people to buy insurance (or pay a penalty fee) is basically requiring them to buy a product.

If there were a public option, Medicare for all or whatever, that anyone could buy into based on their income, that is mandating a service, which government already does in other spheres. In such a case it is similar to, say, requiring that all young people attend school at least until they are 16 and that taxpayers fund public education. In that case, parents have the option of sending their children to private school to homeschool them, but that is a voluntary choice on their part and they always have the alternative of an educational "public option"

In other words, a mandate attached to a public service is one thing.--a mandate without a public service available in something different.

[karynnj]

109. I see what you are saying,

but it implies that the public option would be publicly funded. That was not what was proposed in 2009 as the public option. The public option was to be a government run, but not subsidized plan. (The entire plan does have subsidies in it, but they can be applied to whatever plan was chosen.

[Armstead]

113. A pay plan is not a bad thing -- as long as it is based on income

A commercial plan in which people are forced to pay $600 or more a month for private insurance that does everything possible to deny coverage is far different than a collective risk pool in which payments are based on ability to pay.

The cost of care does have to be covered and it is reasonable to expect people to pay something reasonable based on their ability to pay....However that is not forcing people to pay extortionist rates to enrich private insurance corporations.

[karynnj]

121. I agree completely with you - and think that what you describe is

the next best thing to single payer. (In fact, a version of single payer paid by taxes would essentially be that with less complication.) I also think a public option created a force that would have pushed the private companies to offer better packages at better prices - because if they didn't, everyone would select the public option.

If there were a greater number of companies or if barriers for new companies to enter were a lot lower, I would argue that competition would do the same thing. But, it is not a classic free market - I think it is an oligopoly, where they can tacitly agree to keep profits high without the need to actually illegally collude. Each company knows that there is no long term self interest in creating a lower cost/better benefit package that undercuts the others. To me, back when there was a debate, that is why I was for a public option - it was a necessary force to move everyone else.

[Armstead]

155. Exactly -- A Public Option would force the markets to be more affordable

Or, if it didn't drive dfown cost of private insurance, at least people would not be at their mercy.

[formernaderite]

153. you can't levy a fee on inactivity

It's not the same... they screwed up by not setting this up to be a tax on everyone...like social security. Maybe it's my age... but back in the old days we learned this stuff in school.

[vaberella]

61. You need to take a health economics class and understand what is going on.

On many points you're very short-sighted.

[Hello_Kitty]

67. Tell us how insurance industry profits fit into health economics.

Seriously, vaberella, what value do profits skimmed by insurance companies add to health care outcomes?

[Armstead]

85. In my work I have been "studying" this issue since the 1980's

you want to disagree with my conclusions? Fine.

Just don't assume anyone who disagrees with your opinions doesn't "understand" what is going on.

[woo me with science]

65. +1000000 nt

[damonm]

70. No, you don't "hate to say it"...you're turning handsprings.

Try being honest.

[Armstead]

83. I hate to say it because I would much rather be able to like the results...

....of health care reform.

And why don't you stick to analyzing your own motives, instead of making assumptions about those other people?

[BklnDem75]

75. So you're ok with partisan judgements

As long as it fits how you feel?

[Armstead]

82. No...I just agree with that particular conclusion...

[Yavin4]

79. Without the Mandate, Your Only Choice Will Be Unregulated Health Insurance

Some company will set up shop somewhere where the laws are lax, probably establish a home office in Marianas Islands and issue junk unregulated health insurance.

[Armstead]

81. Not the only choice

One would assume that we are still able to regulate companies that do business in the US.

[Yavin4]

84. Noooooopppeee

That's the Republican alternative. They want health insurance cos. to sell insurance across state lines and bypass state insurance regulations. They don't want any federal regulations either.

[Armstead]

87. Noooope...I don't recall saying I did not want state or federal regulations

Au contraire Pierre.

one of my problems with this version of health care reform is that there is NOT ENOUGH regulation of the health care industry.

[Yavin4]

95. I Didn't Say You....I Said Republicans Don't Want Federal Regulation

If the Republicans defeat the AACA and get their version of health care passed, then this is what will happen:

1) They will allow health insurance companies to sell policies across state lines, free and easy without any regulation.

2) Then we'll see health insurance companies set up shop in the least regulated u.s. territory that they can find and start selling virtually fraudulent policies to the public.

3) Employers will then be forced to buy this junk insurance in order to remain competitive.

In the end, we may see a total collapse of our entire health care system if the Republicans defeat this bill.

[Scruffy1]

86. Legally it's no different than the mortgage deduction

If you want the tax break you give the bank the mortgage. Morally its reprehensible.

[JoePhilly]

92. And the deduction for home mortgage interest forces one to buy a home

with a mortgage!!!!

[Orangepeel]

93. It's constitutional if it's not overpriced and not constitutional if it is?

Whether or not it's a good idea or a fair idea isn't really relevant to whether or not it is constitutional.

This is a tax. The administration just didn't want to call it a tax, so they called it a "mandate."

It's enforced by the IRS (to the extent that it's enforced). If you've got health insurance, you don't pay the tax. If you don't, you do. Constitutionally, it should be the same as a mortgage. If you've got one, you get a break. If you don't, you don't. That's also a lousy idea, in my opinion, but constitutional.

[Armstead]

97. A difference between a "break" and a charge

If you don't own a home, you pay what your tax is.

If you have to pay a surcharge if you don't have insurance it is a penalty.

Should people who don't own a home havevto pay a penalty?

Maybe that's a small difference, but since we're splitting hairs...

[Orangepeel]

100. I'm not splitting hairs. I'm saying it's two sides to the same hair.

:)

and a shitty idea can still be constitutional.

[Armstead]

98. A difference between a "break" and a charge

If you don't own a home, you pay what your tax is.

If you have to pay a surcharge if you don't have insurance it is a penalty.

Should people who don't own a home havevto pay a penalty?

Maybe that's a small difference, but since we're splitting hairs...

[Whisp]

94. sure you hate to say it.

:rofl:

[Armstead]

96. Yawn

[KansasVoter]

116. Please leave the DU! Thanks!

[Union Scribe]

119. Make him.

[Armstead]

160. Please don't read my posts if they annoy you.

[Citizen Worker]

99. Recently I've been wondering if the "reform" we ended up with isn't more a function of creating a

method for the insurance companies to recoup their investment losses in credit default swaps, collateralized debt obligations, etc.? Just wondering.

[Armstead]

110. Interesting thought....

[Lydia Leftcoast]

136. I wouldn't be surprised at all

Everything else seems to be set up to rescue the crooks and screw ordinary people.

[marlakay]

106. I would bet most of us agree with you

its not that people are against health care, they are against being forced into expensive health care they can't afford with jobs that barely pay rent and food.

[Armstead]

111. Exactly -- Nail on head

[LawnLover]

112. So do you think the car insurance mandate is wrong, too?

And don't give me the argument that "you don't HAVE to drive." That's a completely bogus argument.

[formernaderite]

154. car insurance is mandated by the state...but

not every state requires the same system. Some states allow for escrow accounts. So it's not really comparable on the federal level...

[Armstead]

161. It is not a bogus argument

1) Car insurance is to cover the expense that you might inflict on another vehicle or pedestrian. It is a protection for other people....

.If one chooses to take their chances and not have health insurance they are taking their own risk to themselves...(If you are concerned about passing along then costs to others, a law that put a firewall between coverage of the uninsured and everyone else is at least an alternative.)

2)You DON'T have to drive. Not a bogus argument, because you are accepting a mandate by choosing to drive....Having to purchase health insurance is a mandate on being born.

[Unvanguard]

114. Even if that were right--and it isn't--it only makes it a bad policy, not unconstitutional.

There's a difference.

[Skittles]

117. I AGREE

[quaker bill]

118. There is a simple way to solve this

that you would probably like even less. The government taxes everyone then goes out and buys group health insurance in the open market by bid. The only way to rule this approach "unconstitutional" would be to throw out the way government does nearly all of its business.

[Raine]

122. I agree

with you. I absolutely hate this bill, it's nothing but a give-away to insurance big phama. x(

[MasonJar]

123. Single payer is the answer. Obama would not even get near it.

This bill gives a gift to the insurance industry. Some people can't buy groceries. That said, much is good in the bill, like the part where insurance companies cannot turn someone down for prior illness.

[Proud Liberal Dem]

126. If repealing HCR was about replacing it with a single payer system

I wouldn't care but that's NOT the thrust of conservative activism and attempts to repeal it. As it stands, this is best we can do now and I'd rather see this succeed than be repealed.

[Lydia Leftcoast]

137. Here's a thought--if the Dems had had the courage to

make some changes that EVERYONE could see and benefit from NOW (not in 2014), would they have lost Congress?

If they had said, for example, that the age for Medicare will be 60 in 2011, 55 in 2012, 50 in 2013, etc. that would have been a BOLD initiative that everyone could understand. (It would also have brought younger, healthier people into the program. Your average 60-year-old is a lot healthier than your average 80-year-old, and it gets better and better as you add increasingly younger people.)

The biggest problem with the health care bill, bigger even than the mandate, is that it's too damned complicated, and the Dems were horrible at PR.

I actively LOOKED FOR executive summaries of the bill, and I had to dig deep. Even the executive summaries were complicated and full of pure pork, and I had a hell of a time trying to figure out how the law would affect me.

Meanwhile, the Republican Noise Machine went full throttle and got the Tea Party riled up with "death panels" and "government health care" and horror stories from the British tabloids.

Look, I can easily describe the Canadian, British, German, and Japanese systems in FIVE SENTENCES. That's what the Dems should have done: devised a system that they could describe to the public in five sentences that would make it immediately clear to everyone how the law would affect them.

And don't give me that nonsense about how the Dems didn't have enough votes. How about, "You vote for this, or you'll get the best-funded primary challenger who ever lived?"

[Honeycombe8]

127. I don't like it, but I dont know if "it" is illegal, which is what the Court said. Auto ins. - we

are forced to buy that.

We are forced to immunize our children against certain diseases.

We are forced to wear seat belts, for goodness sake. You can't just sit in your car...you have to put a contraption on, or you are in violation of the law.

We are forced to pay for registering our cars. And then we're forced to buy license plates and stickies on our windows.

We are forced to buy a food license in order to sell food to the public.

We are forced to do a lot of things, and buy things, by various governments. It is legal for them to make us do that. The legal reasoning is, I think, that there is a PUBLIC POLICY involved. That is, the public is affected detrimentally when you DON'T do that which we will now force you to do.

If you don't have health insurance, when you need medical care, the public will have to pay for it. Hospitals are forced to provide health care to people in life and death situations, even if they don't have ins. The public's taxes pay for that.

Most people have health insurance, anyway. Yes, millions do not. Still, most do. Of those that don't, millions are covered by Medicaid and do not fall within the "mandatory" provision. Still others WANT health insurance, but can't afford it; the fed will subsidize the cost of it.

I hate the mandatory provision. But I'm not sure it's illegal. There does seem to be a public policy involved. If the people without health care would agree to carry a card that says, "I have no health insurance. I, in no way, want any health care of any kind, should I become ill or injured in an accident. I waive all liability of care providers and others, relieving them of any responsibility of providing any health care to me. I accept the risk that I could die. I take full responsibility. I am of sound mind and over the age of majority."

But, you see, most people WANT health care, if they are injured or get sick. So....the mandatory provision. Without it, the whole health care system is in trouble. That has been part of the problem for years, now.

[Lydia Leftcoast]

138. But there is no mandate on the insurance companies to make the insurance

either affordable or useful. High deductibles and high premiums are still allowed (on the same policy).

Age discrimination is still allowed.

Some European countries do use private insurance. HOWEVER,

1. Premiums are based on income, not on age or state of health.

2. There NO DEDUCTIBLES, although some systems have co-pays.

3. If your co-pays exceed a certain percentage of your income, you get cash back from the government.

4. Insurance companies are required to pay within a short period of time, no questions asked, unless they can prove fraud.

5. Everyone is covered.

[Honeycombe8]

163. There is some sort of cap on the "high risk" policies.

I guess you missed that part.

And there is a subsidy, for those who meet the low income requirements. This is for the working poor....those with too much $ to qualify for Medicaid, but not enuf $ to afford insurance.

College kids can be added to their parents' group policies....so the cost for that is less than retail.

It sounds to me like everything's covered. Yes, I wish more cost controls had been put in. This is one of the things that can be amended in the future.

I just don't think it's a solution to expect ME, a single working woman, to pay for some guy's health care, because he didn't want to buy insurance. What makes people think that I can afford it any more than he can? And it's not even for my own insurance. I have my own medical bills and such. I pay my own way. It's a relief to know that there is some sort of assistance, if I lost my job and couldn't afford to buy ins. on my own (I don't think I'd qualify for the subsidy, though).

[Lydia Leftcoast]

165. Things are covered only in fantasyland (or political propagandaland)

The subsidy is artificially low. It cuts out in the high end of $40,000 for a single person, which is NOT rich unless you live in an impoverished part of the country.

Cost controls? Is that from the executive summary of the law or from administration propaganda or do you work for an insurance company that sends out color pamphlets telling their clients how wonderful and caring they are while raising premiums 10% a year "just because" and adding a few extra points for every five years of age?

Under the new law, as a person over 50, I would be paying TWICE as much in premiums as I did on the policy I dropped for being too expensive, and I'd still have a deductible and high copays (higher than I paid before). In other words, age discrimination is still legal. I don't have much time till I'm eligible for Medicare. I am self-employed with high debts from a slow period in my business, and you can bet that I'm going to pay off my own debts instead of enriching some insurance company executive.

Have you looked through the executive summary to figure out what your premiums would be?

How do you feel about outright corporate welfare in forcing us to buy the product of a private company with only laughable controls on those private companies?

College students are generally eligible for their college's low-cost plan. What about young people who have no parents and a low-paying job?

It sounds to me like everything's covered. Yes, I wish more cost controls had been put in. This is one of the things that can be amended in the future.

Do you really think that an administration that kissed insurance company ass (and maybe more in closed-door meetings) and wouldn't even meet with single-payer advocates--wouldn't even listen to them--is going to make improvements in this stinking heap of corporate welfare?

Of course not. Their corporate backers have everything they wanted: a captive market, no government negotiation for drugs, no public option to compete with their profits, a guaranteed medical loss ratio of 20% (Wendell Potter says they used to get by on 5%).

Their "opposition" was pure theater, a ploy to get more concessions for their blood-sucking ways.

Furthermore, the entire direction of the bill is wrong-headed. It's all about pampering the insurance companies.

The apologists say that a better bill was "politically unfeasible." No, the only reason for that was a large contingent of corrupt ConservaDems and a president who got into bed with the insurance companies and effectively "divorced" the people who supported him because he advocated a public option during the campaign.

At the very least, he should have vetoed any bill that didn't include some form of public option.

Wait till 2014 and see how you like the actual bill. If you have employer-provided insurance, you may not feel the effects. As an older self-employed person, I would be screwed.

[formernaderite]

156. you are confusing state and local issues with a federal process

of imposing a fee on NON activity. Not every state requires seat belts...on the federal level it's tied to highway funds. Immunization is also run by states... and you can certainly file various forms to NOT immunize. Car insurance requirements vary greatly. The list you gave...was all state not federal issues. The problem with this bill.... was they WERE NOT requiring everyone to buy insurance... but they were imposing a fee if you didn't. There is no precedent for penalizing NON activity via the commerce clause.

All of this could have been avoided by creating a tax and a universal system..like ss or medcare.

[Honeycombe8]

164. That's what I said. IF it's legal. It may or may not be. So far, courts have

disagreed on that.

Stop crying about not having a social or universal health care system. No country can abruptly change totally from one system to another in the matter of a few years. Just the logistics of it would be a nightmare, causing millions not to receive medical care, and care providers to leave the system in droves.

Such things have to be taken in steps. Not that we're headed that way, anyway. That remains to be seen. It's not like providing health care to a certain segment of people, the majority of whom didn't have healthcare and would have no prospects of getting it (being too ill or old to work) which was the situation with Medicare and Medicaid. Universal means providing care to tens of millions of people, most of whom already have health care. So I don't see a strong incentive there to go that way. But I DO see some cost controls in the future. Now that there's a healthcare bill, there is something to amend to add cost controls.

And getting that "cannot negotiate prices" out of the Medicare bill is high priority.

[Gravel Democrat]

162. RE: Your list-how many of those are federal mandates?

Answer: None

Auto ins: State
immunize our children against certain diseases: State
We are forced to wear seat belts: By the feds?
We are forced to pay for registering our cars: By the Federal Government?
We are forced to buy a food license in order to sell food to the public: Is there a Federal Food License that I'm not aware of?

In fact, there has never in the history of our country been a federal mandate to buy any product or service at all. Because that power is not amongst the enumerated powers listed in article 1 section 8 of the Constitution. And if the Supremes decide to allow this road to be opened up, do you really think the Republicans aren't going to mandate the purchase of something you don't want or need?

This is middle school civics stuff. I am shocked these "arguments" keep coming up.
Apparently the Constitution isn't very important to schools these days.

Obama was against mandates before he was for them:



Don't miss this clip!

http://www.eyeblast.tv/public/checker.aspx?v=hdqGnz6UqG

Candidate Obama speaking from Duncanville TX
...appeared on The Ellen DeGeneres Show. In the interview, Obama made the following distinction between his health care proposal and Hillary Clinton’s:

“Both of us want to provide health care to all Americans…. But, she mandates that everybody buy health care. She’d have the government force every individual to buy insurance and I don’t have such a mandate because I don’t think the problem is that people don’t want health insurance, it’s that they can’t afford it.

So, I focus more on lowering costs. This is a modest difference. But, it’s one that she’s tried to elevate, arguing that because I don’t force people to buy health care that I’m not insuring everybody. Well, if things were that easy, I could mandate everybody to buy a house, and that would solve the problem of homelessness. It doesn’t.”

—Senator Barack Obama, February 28, 2008, on The Ellen DeGeneres Show

[Phx_Dem]

130. The judges ruled along party lines so what does that make you?

The two Repubublicans said the mandate was unconstitutional and the two Democratic judges said it was not.

Do you think it's unconstitutional to require people to pay into SS even though there's a possibility they won't be able to collect anything (because Republicans want to change the rules and/or privatize it)? What about Medicare? You aren't required to use it, but you are required to pay for it so others can use it.

[Lydia Leftcoast]

133. Social Security and Medicare are not profit-making businesses

That's the difference.

[Gravel Democrat]

140. BINGO It shouldn't be that hard to see the difference but many have party blinders on

Who on this board would have supported John McCain if:

His wingman (the Max Raucous) had single payer advocates *arrested* at a *hearing*?

He made backdoor deals with insurance companies to keep single payer off the table?

He made deals to prevent the foreign sourcing of Pharma?

And then, to put the cherry on the cupcake--

MANDATED THE PURCHASE of "insurance" from for profit companies ***WITH NO public option***, after saying he would not sign such a bill?

Everyone.

Everyone that supports this "health insurance reform" (sic) foisted upon us all by the Democrats would equally support the exact same legislation if proposed by the Republicans. Even if only 40% of the public supported it.

Sure.

I believe that.


The Manipulators in DC keep doing what they've done because they can.

We affirm that every 2 years or so. At least so far.

And the more hate and division that is prepared and dished upon us, the harder it is to fight those that have stolen our treasure, commit us to foreign entanglements, whittle away our liberties, and sell our souls to corporations for the next campaign contribution.

After all, it's a lot easier to loot a populace that is fixated on the wrong balls.

[formernaderite]

158. No... they are taxes

that is the difference.. and as long as you are working, you have to pay into them.

[diane in sf]

141. I agree, and the ins. cos. won't be nice

[olegramps]

142. It is the Achilles Tendon that will bring the bill down.

What is so strange to me is this requirement is like the health care bill that Romney signed into law in Mass and he is considered to be a contender to run in 2012. I have difficulty in understanding just where Republicans stand on the issues except to be obstructionists.

[Lydia Leftcoast]

143. The "disagreements" between the Republicanites and the ConservaDems are ALL THEATER

They serve the same masters.

[lumberjack_jeff]

145. Your argument is that it's bad policy.

Judges aren't supposed to do that.

The government can mandate all sorts of things, and I don't see the merit of a distinction between mandating I buy a private product of my choice (HCR) vs a public product of their choice (OASDI).

[TheKentuckian]

152. It isn't a choice for most people. The vast majority will be forced to take what their work selects

That is a bridge too far, a dictate to purchase a "commodity" from the company store.

[Armstead]

157. A requirement to buy a product simply because you exist is unconstitutional

In most things (except obvious criminal acts like robbery, assault and murder) you do not have to buy into something simply because you happened to be born into this society at this time.

A parallel is often made with mandatory car insurance. However, at least people do have the option of not buying a car if they don't want to be forced to buy car insurance.

Likewise, even with taxes. You can control the amount of taxes you pay by the income you earn. If somehow, one chooses to live a bare-bones existence and not work, then they can avoid being taxed on their non-existant income (or determine what their income and thus control their taxes paid).

However, you can not choose whether to be born or not, and an obligatory purchase from a private company just because you exist is (IMO) unconstitutional.