More on the Politics of Healthcare Mandates

Apparently, I'm not the only one who thinks mandating the purchase of private health insurance is a political train wreck (not to mention overpriced and inefficient). Dave Johnson writes:

But Hillary says her plan will have a mandate to buy health insurance. FORCING people to give money to greedy, corrupt corporations? This is political suicide. Readers know how I feel about insurance companies. I will never vote for someone with the brilliant idea of forcing me to give my money to greedy corporations so their CEOs can buy bigger jets. This shows that Hillary now (correctly) feels it is safer politically to go up against the needs of the people than the wishes of the insurance companies.

Hillary's "mandates" plan proves that the only way we can have health insurance is with a Medicare-for-all system. Period. She may be trying to tell us that.

Actually, I think the reason she prefers mandates is because she's working under the Halliburton model: (barely) acceptable service for exorbitant prices. And, like most politicians in both parties, she's too chickenshit to take on health insurance corporations, even though they're probably less popular than many infectious diseases.

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Actually, this model can work quite well. It's what the Swiss do: everyone in Switzerland must have a basic level of coverage, and every insurance company must offer it. Further, the services are fixed by law, the price is capped, and the information the company can ask for is similarly limited (age and sex, basically -- maybe income, I can't remember). You can buy additional insurance from companies, but prices stay reasonable since it's fairly easy to start a competing business. For instance, I pay CHF80 (about $80) a month for my coverage from a small company that specializes in grad students and postdocs, and offers nothing but the basic service.

In the US, though, it would end up even more dysfunctional than now.

Mandating the purchase of private health insurance is as loony as mandating the purchase of private police insurance, highway insurance, street light insurance, food safety insurance, drug safety insurance, or invasion insurance.

By Ken Shabby (not verified) on 09 Feb 2008 #permalink

Mandating the purchase of private health insurance is as loony as mandating the purchase of private automobile and homeowner's insurance and public social security and medicare insurance...oh, wait, those are mandated.

Anybody want to speculate on what our auto and home premiums would be if they were not mandated, thus making the risk pool only a fraction of what is now? Or how small our Social Security and Medicare benefits would be?

I have no problem with mandates so long as the feature of Hillary's plan that requires insurance companies to insure all comers is adopted without exception. I also think -- not sure if this is part of Hillary's plan -- that buyers should also have the option of purchasing Medicare instead of private or Medicare + private supplemental (as I understand it, that's how Canadian healthcare operates).

Social Security and Medicare were only proven to work because the citizens were forced to participate in the programs through proof of concept. If the same mandates are not applied to healthcare, too many will opt out regardless of penalties and the opposition will always be able to argue that it is a failed policy based on the number of citizens that do not participate. And the dream of the universal healthcare enjoyed by the rest of the civilized world will never be realized.

But Constance, we don't wanna be like dem godless heathens in Europia. We don't need no increased risk pool - we got the blood uh Jaysus tuh heal our afflictions!