Why does it have to be mandatory?

Serious question. I really don't understand why everyone will be required to buy insurance. Why not let people who don't want insurance opt out entirely?

This is coming up in my debates with right wingers, and I don't have an answer. They see this as an affront to their freedom. Any help you can offer would be appreciated. Thanks!

It's more expensive for the sick. Any plan with mandatory coverage really depends on healthy people and people who rarely use their coverage to subsidize those who are in ill health. It helps to lower the cost.

Would it make sense to let the plan be more expensive and let the people opt out who want to? Some of them are never going to budge on this.

If only we could expand Medicare. They'd still be paying for it, but it wouldn't seem like an imposition.

...after their savings ran out, or b.) we'd let them die in the streets after their savings ran out

Oh, wait a second, we're Democrats. Scratch b.)

Many auto insurance companies didn't drop their rates when they lobbied state legislatures to require mandatory auto insurance for all drivers even though the risks were now spread out over a wider number of people and political ads were aired asserting rates would go down. The reality was much different.

The fear is there is going to be a repeat of that failure with health insurance.

...dear Brutus, is not in our stars, but in ourselves, that we are underlings.

Something like 200 million Europeans live in must-carry, must-issue regimes.

The degree to which insurance companies are regulated if we go that route is up to us. We act like we have no agency, and that's why it turns out to be the case.

Me, I'd go UK-style NHS, but then I'm a socialist. (See avatar).

There should be no profit-taking at all in the realm of health insurance.

The most one could do now with Congress is write clauses into federal bills allowing state legislatures to pass single-payer systems. Hopefully, states less influenced by corporate powers would be able to set up an example that people here in the US could study. California came closest if it weren't for the fact that Arnold, the idiot, vetoed the legislation. Since then, the bill has been pigeonholed indefinitely or at least until Arnold is gone out of office.

quasi-governmental. It's like having a Meddie Mac and a Fannie MD. And something like 80% of the French are covered by gap policies of one sort or another. Details on the French system here. Read it and you'll see why the French say 'A camel is a horse, designed by a committee'.

Public option might help at least I hope it does no doubt single payer would be the best and cheapest option,but I`m not holding my breath.

and doesn't qualify for Medicare or Medicaid, could otherwise afford the premiums, but decides not to spend the money, what is going to happen when - and it will happen eventually - that person either has an accident or falls ill and requires serious and perhaps extended medical care?

They can't be thrown out on the street, and maybe they'll end up in bankruptcy because they can't pay their medical bills.

And so the taxpayers end up footing his bill.

That doesn't seem fair, does it?

At least in my state it is illegal to drive without car insurance. Health insurance is more important,obviously.
Try that as an argument/analogy.

That's an interesting idea........................

...with garnishing of income, IRS style, for non-compliance.

If it's not mandatory, it's not universal, and it's not mandatory without some coercion.

Single payer and UK-style NHS-model plans are equally coercive, but the money is rolled up in your general tax obligation, so the tie to health provision is arms-length, and not obvious. And we know what happens when you don't pay your taxes.

(This is actually an argument in favor of either single-payer or NHS-style provisions, by the way.)

(Not a DUer, this was from a newspaper's forum.)

They said the penalty for being uninsured ($2500) was prohibitive, essentially making it illegal. I can sorta see where they're coming from.

Just trying to either justify the current plan or think of a better one...

...are, given the present realities of American politics, insuperable, and ironically, all the less coercive, profit-motive-free alternatives have all been made less likely by idiots like the town-hall disruptors.

The choices these people want, in order, are:

-- Someone else to pay for them when they tap out
-- The status quo
-- Anything else

The first two aren't really an option, and they've ruled out #3 in advance

But don't go looking for medical treatment.

The thing with mandatory auto insurance is that you might damage someone ELSE'S property or person by operating your car.

If you don't want health insurance, and you get sick, then what?

1. You are only required to have liability coverage by the government. That is, you are required to have protection against the damage you do to others' property and bodies, not your own.

2. All auto insurance is catastrophic. That means that it only comes into play when actual damage occurs. It does not cover routine maintenance in the way that health insurance does. Health insurance is more like a warranty. That's why it's not really accurate to say that mandatory health coverage will bring costs down considerably, since people who were previously uncovered will be getting more routine care once they are covered. When you factor in how that routine care will mitigate the higher costs of the acute care required by untreated conditions then, yes, there will be some savings but not as much as you might expect. The most generous estimates have the uninsured adding 8% to the average insurance premium. 8% is not insignificant but it's also not cause to think that mandates are a magical cure for high health care costs. What about the other 92%?

3. You don't have to drive. Therefore, there is nothing forcing you to purchase private auto insurance unless you want the convenience of a vehicle. OTOH, you don't have any choice over being alive. (Okay, you do have a choice but most people aren't inclined to explore that alternative.) Forcing people to purchase private insurance means forcing them to pay a fee to private corporations that are beholden to shareholders, not them. And unlike the government, you have no recourse if you don't like what they are doing. You can't "vote the bums out" unless you are a major stockholder. In essence, mandates to buy private insurance are taxation without representation.

...into submission, or to death -- the point of a public option -- if we wanted to.

Would we? "The fault, dear Brutus, is not in our stars, but in ourselves, that we are underlings."

And I mean regulation to the extent that you basically turn private insurers into non-profits.

You are quite right.The analogy doesn't hold.

Insurance is required to get a vehicle registered. Someone who wishes to drive only on private property does not have register the vehicle or get insurance.

We pay the ER costs of the uninsured. (Or by "footing his bill" did you mean all his other bills because of bankruptcy?)

I guess I don't understand why that safety net couldn't continue under a new plan.

in advance. It would be fair and leave people the freedom to opt out - but I don't think any of us want to condemn non-participants to death if they need medical help.

I haven't had health insurance most of my adult life. When I did and got sick, the hmo doctor left me to die anyway. I got help out of pocket from a pair of holistic practioners.

Frankly, at this point in my life, 20 years later, I really don't give much of a flying fuck.

Nobody ever wanted to marry me and make a family. I was supposed to be an illegal abortion; my favorite sibling told me she hates me decades ago. I haven't heard from her since (except the time she was in financial trouble...then suddenly she wondered how I was doing :eyes:)

Society made it clear to me that once I hit my late 40s, I had no added value. My 20 years of experience and training are not wanted anywhere. My friends all abandoned me when hi-tech crashed. (They abandoned each other too; it wasn't specific to me, lol.)

I'm healthy and I self-medicate with rest, otc and herbs. If I get seriously ill, I will go bankrupt and ultimately die. No different than when I had health insurance. Actually, the way things are going, I'll probably end up bankrupt and dying whether or not I get sick.

I honestly don't give a flying fuck any more. All I want is to be left the fuck alone. I don't want any doctors poking and prodding at me, or molesting me. Ever. Again.

So short of single-payer, I intend to opt out. Just like I learned to buy the cheapest health insurance that was forced on me by my employers back in the good old days.

...or it isn't universal.

The problem is the uninsured free rider who doesn't get insured ever, or until after they're injured or sick (Swiss/Dutch/HR 3200) or doesn't pay their taxes (Canada, UK, HR 676), and then gets sick or injured. They get the benefit of the system, whatever it is, without having participated in its cost.

he has no insurance and hate obamacare.

he just had a 2000 er bill for his hip. he was in too much pain to ignore it any longer..

i told him i'd rather pay a little more in taxes and have him get health care.
i told him neo-cons would rather see him die then pay more taxes.
he is jewish so i always get him to say "next, we go after the jews." after each of his right wing rants.

he just had a 2000 er bill for his hip. he was in too much pain to ignore it any longer..


Is this friend going to pay the bill, or stick you/me with the ER charges?

let them thrash his credit and we will pick up the bill..

Young & healthy people can and DO get sick, have accidents, have unexpected babies.

if you spread the cost over 300 million it's a LOT more affordable than when you only ask the sick people to pay..

if you're also going to let everybody wait until they're sick to apply for insurance. You'll bankrupt the companies.

I still wonder whether most people would wait until they're sick, or if a significant number of healthy people would buy insurance out of an abundance of caution -- enough to keep the systems solvent and the costs reasonable.

That would be easier to sell politically. You'd have a choice of plans, or no plan. It's like if the government said you had to pick a church, but you couldn't be an atheist. That would generate resistance. That's what I'm encountering -- people are feeling dictated to. I think this plan is going to be a hard sell unless Obama emphasizes our mutual dependence a little more, and stresses the need for reform, to outweigh such objections.

And what to me seems like the easiest sell of all, expanding Medicare, is not getting much play.

...either be lucky, or be in personal bankruptcy tout suite.

The only free care you'll get when your own money runs out is what the poor get today from the get-go -- must-treat for life-threatening emergencies, and for the rest charity, clinics, etc. and we know how thrilled the poor are with them.

Freedom (from the mandate) isn't free (paid for on my nickle).

Don't mess up my Medicare!! Plus you start getting the horror stories about Medicare not working.

These people will say whatever Fox News tells them to say.

They have no incentive to keep the costs down. A non-profit public option would at least force them to compete. With no public option there should be no mandate. If people aren't required to buy insurance the insurance companies, knowing that they now have to cover the sick, will jump through hoops to make their products attractive to the young and healthy.

And I really don't understand this notion that people won't get insurance until they are sick unless you make them. We don't have a mandate now and most people have insurance. The vast majority of people who are offered insurance through their jobs take it, because their portion of the premium is a lot less than they'd be paying on their own. Also, since most people get married and have kids they want insurance because they want coverage for when the babies are born and they want their kids to continue to have health care. Most healthy people who don't have insurance don't have it because they can't afford it (individual policies are ridiculously expensive and don't cover shit) and they make "too much" to qualify for state aid.

...until we provide, by legislation, incentives to keep costs down, or by competition via a public issuer force them to keep costs down -- hence the public option -- or both.

I don't think anyone on this board is suggesting mandates without a public option -- must carry without a real, affordable, must-issue. That's the pipe-dream of Baucus' posse.

But if there's no public option, plenty of them will still insist on mandates because they've bought into the myth sold by Clinton and Paul Krugman during the primaries that mandates are the key to reform. Remember, the big debate among Dems wasn't over the public option. It was over mandates. Mark my words, when the bill gets through Congress with no public option but individual mandates - just as I warned would happen for the past 2 years - there will be DUers defending the mandates.

The expansion of the risk pool that makes any universal system work actuarially is impossible without mandates.

And a mandates-bases system can be made to work even without a public option, although that's not the optimal way to go -- given sufficient political will.

I mean, seriously, if you owned a business wouldn't it be awesome to have people required by law to buy your product? And what if you happened to be in an industry that was the only one exempted from anti-trust laws? Oh yes. Health insurance companies are actually allowed to collude with each other to set rates and payments! Some competitive free market, huh? Basically, they're cartels, like OPEC. Honestly, if you want to see how private insurance mandates work you need look no farther than RomneyCare in MA. It has worked to a certain extent in that they have achieved a very high level of coverage. But after a few years some serious problems have emerged. The costs of health insurance to the state have gone up so high that they've been forced to do things like drop legal immigrants from the state health plans. From the individual side they recently had to exempt 10s of thousands of people from the mandate because the cost of coverage would exceed a cap of 12% of their income. For example, a 50 year old making $50k a year who would be out-of-pocket $7000 would be exempt. It seems that while the intention was good, the execution was poor. And the main reason is because the insurance cos. are out to make a profit over and above everything else. And there isn't the political will on the Dems side to stop them. I see one of two things happening. We get a plan with no public option and a mandate that will piss a lot of people off. Or the Republicans seize on the mandate issue and defeat it, coming out looking like populist heroes.

I'm one of those who supported Hillary's and John Edwards' plans against Obama's BECAUSE they called for mandates.

But along with the mandates was the understanding that there would also be AT LEAST a public option. Perhaps it wasn't spelled out, but that's the only way most of us would have bought into them (mandates that everybody is covered).

Mandates without a public option, or at least a workable non-profit one with plan massive firewalls against ever going the BC-BS route--DO amount to taxation without representation for the taxpayers. And extortion for anybody forced to subsidize one or another insurance company.

If it comes to that, lots of us may make common cause with the right-wingers who will fight it. Somehow there's something fascistic and unconstitutional about forcing people to individually subsize insurance companies.

They don't have insurance and they don't want to buy insurance. There are people on this board who are resisting buying for profit insurance.

I don't support the mandates, but I certainly wouldn't say that everybody would buy it if it were affordable. Most will, but there will be enough out there who won't who will mess it up for the rest.

It's probably for the same reason that people don't have health insurance - they can't afford to pay the premium. But they still need to drive to work.

There are people on this board who are resisting buying for profit insurance.

People have provided clear and legitimate explanations for why that is. I've yet to see anyone say, "I'm not getting insurance because I don't want it and I enjoy being a selfish dick who withholds money from the risk pool. I'll just wait until I get sick so I can stick you all with higher bills! Ha ha ha ha!!!" Honestly, the characterization of people without insurance on this board sometimes is sickening. They've truly been turned into the new Welfare Queens.

I don't support the mandates, but I certainly wouldn't say that everybody would buy it if it were affordable. Most will, but there will be enough out there who won't who will mess it up for the rest.

Okay, so you admit that most will. Which is probably the best we can ask for and it's entirely possible that implementing an enforcement mechanism to collect from the people who refuse will cost so much that it won't be worth it. "Affordable" is a highly subjective concept. Just because YOU think X amount should be "affordable" to someone making Y salary doesn't mean it will be to them. You don't know what their life is and what expenses they currently have. What this mandated private insurance is going to do is present yet another monthly bill to young working people who are barely scraping by as it is, often paying off massive college loans. And people like you will say, "Oh they're single and don't have families so they can easily afford it!" Those young people, when they go for a check-up or something, will be unpleasantly surprised to learn that the "subsidized" monthly premium they pay for the "government" private insurance doesn't cover everything! They still have to pay a $30 co-pay! There may be a deductible as well. Oh joy.

The current House version sets a cap of 12.5% of your income going to insurance costs at 400% FPL (which is about $42K) and sliding scale from 100% to 200%. So you may be thinking, "Wow, 42K a year is a lot of money! They should have no trouble at all paying a new bill of $437 a month." Right. And with a mandate, insurance companies will make sure they price those policies to be right at whatever the income limits are. Basically, this is more corporate welfare and yet another massive transfer of wealth from the working and middle class to the plutocrats. Then you have to realize that someday the Republicans will be back in power, at which point you can say adios to some of the subsidies and the private insurance cos. will get all kinds of lovely deregulation so they can deny people care. Oh, but the mandate will stay.

I've said that a cazillion times. It will be the issue with the public option too. Medicare Part B is $100 a month. Part D has the doughnut hole. Screaming single payer or public option does no more to fix health care problems for low income people than the right screaming free market and HSA.

The OP asked a question about why everyone needs to be mandated in the system. I would prefer a broad tax on gluttony of all sorts, and free health care for all. Or framing the mandate as extending health care to all. But for some reason a large number in this country responds to punitive measures more than give-aways.

Although, I suppose the argument could be made that mandating that everyone with a gas guzzler trade it in for a new fuel-efficient vehicle would produce a higher response. I definitely think the public reaction would be different, don't you?

We should be focused on making sure the subsidy is beneficial for everyone. I don't think a lot of people even understand there's going to be a subsidy.

I don't think a lot of people even understand there's going to be a subsidy.

I don't think you understand that if I don't have money in my pocket telling me I have to buy something and giving me a 50% coupon for it does not put money in my pocket to pay what the coupon doesn't cover.

...and just pay a la carte after we get invaded by Venezuela. Save me a bundle, it will, in the meantime.

http://www.ahip.org/content/pressrelease.aspx?docid=25068

Health Plans Propose Guaranteed Coverage for Pre-Existing Conditions and Individual Coverage Mandate

"Washington, DC – Health plans today proposed guaranteed coverage for people with pre-existing medical conditions in conjunction with an enforceable individual coverage mandate..."


AHIP & BCBSA support guaranteed issue and individual mandate

http://pnhp.org/blog/2008/11/20/ahip-bcbsa-support-guaranteed-issue-and-individual-mandate/

Posted by Don McCanne MD on Thursday, Nov 20, 2008

This entry is from Dr. McCanne's Quote of the Day, a daily health policy update on the single-payer health care reform movement. The QotD is archived on PNHP's website...


....The other problem is how are they going to pay for the high-risk individuals who now must be covered? Their solution is somewhat more cryptic. They are going to “ensure premium stability for those with existing coverage through a broadly funded reimbursement mechanism that spreads costs for the highest-risk individuals.” “Premium stability” means that other sources will be paying the higher costs of the higher-risk individuals. What other sources? They propose “Guarantee Access Plans” which are “loosely modeled on state high-risk pools.” Oops. The taxpayers – us – again.

Think about it. The private insurance industry has just the solution for us, but only if we agree to foot the bill for those who actually need health care, while they continue to collect large premiums to pay for their egregiously wasteful administrative excesses.

Their proposal is to shift the real costs of health care to the taxpayer. They are right. We need to establish a universal risk pool and fund it equitably based on ability to pay. The only sensible way to do that is through a single payer national health program. Why would we want to implant on our health care financing system the cancer of private health plans?"

the insurance companies were tightly regulated, particularly as to profits. I'm thinking along the line of the old public utilities model, where slim profits are guaranteed in exchange for providing necessary services even to unprofitable sectors.

If an individual drops out, they are reducing the size of the pool. Both the risk pool and money pool to pay claims of fellow citizens.

When you opt out, you are essentially denying every else their civil rights in a small but real way.

When enough people drop out, the pool collapses and then everyone is denied that right.

But opting out of paying blood money to the corporate parasites of the private insurance industry? Not the same thing.

Healthcare will be funded by all us even in a strict government only model.

The fine point you bring up is irrelevant to question at hand. The question is why should anyone be allowed to opt out.

My answer is you cannot opt out because you'll be denying someone else their civil right.

We can and should debate and make sure the delivery agent is honest. My vote is government.

But insurance company, or government, everyone must pay because its what everybody owes each other.

Then: "Don't worry about the mandate! There will be a public option that will force the insurance companies to compete! And there will be subsidies!"

Now: "Too bad about that public option! But everyone still has to participate or it won't work! Don't worry about the private insurance cartel getting a massive infusion of corporate welfare! And no competitive incentive to keep costs down! There will be subsidies to help you pay the premiums!"

Future: "Man, what a shame how the new Republican administration cut taxes on the wealthy and cut the subsidies! Still, we need to keep the mandate because everyone has to participate or it won't work! What do you mean, it's not working? Oh well! We still need you to be part of it so have you thought about getting a second job?"

when we are talking about the entire population, the idea of subsidies really loses its effectiveness. Who will fund the subsidies? Everyone. Who will benefit from the subsidies? Everyone. I support subsidies but we need to remember that there is a limit to what they can do.

No matter how we work this, its a zero-sum situation. The healthcare burden will be born by everyone in an equal and fair manner.

That's the problem we have now, its that its not born by everyone equally. The uninsured pay far more than the insurered due to insurance contracts with providers.

Essentially the uninsured are now subsidizing the insured which is simply an absurb condition.

Once Obama fixes this, we'll all pay about the same. It'll never be free (and its not free anywhere in the world) Its probably best to start thinking about health insurance premiums as a tax anyway, since it essentially the same...The amount of money that we owe to ourselves and to our neighbors.

Its highly likely that the IRS will be the enforcement agent in all this. If you fail to obtain insurance, you'll be subject to a special tax assessment. That doesn't please me in anyway, but its probably the most effective method of insuring fairness.

I'm so happy that Obama is working for us to fix this health care situation, but we must all understand that its not going to be manna from heaven with everything being upsides with no downside anywhere.

Without a doubt, many of us will have to make adjustments to our financial priorities to ensure that both you and your neighbors get what we are all entitled to. But that's what a society is all about - providing for each other.

So why should the Public Option be any different?

This assuming it's truly a Medicare type model with no private insurance hands in the till.

:shrug:

I would have problem with no mandate IF you sign a waiver indicating you are signing away all medicals services you don't have the ability to pay in full.
no insurance, no method to pay then no going to the ER on someone elses dime, you die in the street.
Ask the libertarians if they would be fine with that.

The problem is ER is extremely expensive. A single ER visit can cost more than a years worth of preventive care.
So someone says "I don't want insurance", and they don't get insurance. Then something happens and they use the health care paid by everyone else.
They don't pay into the system but they expect the system to take care of them.
Usually they have no means to pay and the $3000 - $10,000 ER visit gets absorbed by the hospital and thus raises the cost for everyone who is paying.

Now since in this country letting people who are too foolish to get insurance die in the street isn't politically viable then everyone gets insurance.


I got a similar solution for all those libertarians who say "the govt shouldn't be able to mandate me to get auto insurance". I say fine. You get in an accident and can't pay and have no insurance well you are an indentured servant with all wages going to the person you are indentured too until you pay off the damages you caused.

Most (not all) right wingers think they want to live in a world where the govt can't "tell them what to do" however what they really want is a world without responsibility where their mistakes and problems become someone elses burden.

Then something happens and they use the health care paid by everyone else.


Are you also willing to mandate that everyone pay the full cost of their insurance or face penalties/forfeitures?

for the poor, as per Medicaid today, yes. There is no universal coverage without coercion, either coercion via an existing tax, a new tax (VAT, eg.), or mandated insurance purchase. If there's no mandate, it's not universal.

(Me, I'm a socialist. I would prefer to simply nationalize the whole shooting match, as per the UK, but I don't expect to see that in my lifetime. Failing that, a single-payer system, as per Canada. But there are efficient, reasonably fair, compulsory-insurance-based systems that deliver universal, affordable health care to a couple hundred million people today.)

Lots to think about. It's late, and I'm off to bed, but I'll check back after I've slept on all this.

DU so fucking rocks.

Universal coverage for everyone.

Listen, it may peeve your ass to no end that you have to pay for kindergarten when you have no kids....

highways when you have no car ....

libraries when you are averse to reading ...


but the simple fact is, even without kids, a car, and intellectual curiosity, you benefit from all of those systems. Same with healthcare.

I love how people pretend we're talking about single payer or extending Medicare when what we're really talking about is a big old honkin' giveaway to the pigs of the private insurance industry.

Interesting you bring up the kids in kindergarten analogy. Do you support vouchers for private schools? You might as well because if you support forcing people to pay premiums to PRIVATE insurance companies and for tax dollars to subsidize those private companies then I guess you are totally okay with using tax dollars to fund private schools. Right?

We are not mandated to pay for private schools, driveways and corporate libraries.
If the system is 100% public, the mandate is OK.
If the system mandates insurance purchased from the current crop of private insurance hoodlums - no thanks.

Currently in this country it is a right, hospitals have to provide care. But it is only a right if it is an immediate situation, some situations like preventive care or expensive care are still a privilege.


If you think of health care as a privilege. A person who opts out and gets sick, you would have to just watch them die.

If you think it is a right, a person that gets sick, you help them even though they opted out of coverage so you pay for it anyway.

So if their health care will be paid for anyway, they could be required to pay a premium or a higher tax to pay for health care.

Also people with preventative care live more healthy lives so they cost the system less money.

However

Without a public option, mandatory health insurance is a tax paid to insurance companies, where a part of that tax is used for those companies to set social policy and pay salaries above what they earn. It reinforces the corporate system as a governance system, even including taxation into part of its skimming.

nothing more.

do?

I don't think so.

are not paying their bills adn it is falling on those of us that do.

is it going to be any more do able for those living paycheck to paycheck to have to have another bill for health insurance? of course many people will have a tough time getting it, even not be able to afford it, barely putting food on the table

but that has nothing to do with my statement. that holds.

too many people are not paying bills excalating costs

That's why the subsidy is what we really ought to be talking about.

as we all pay Social Security and Medicare. And if you don't want to use it when the time comes that's fine, but we all pay for everyone's benefit, and when we need it, it's there.

if I pay into a fund that guarantees that I get medical care whenever I need it w/o getting a huge bill, that's one thing. But mandating that I buy into one insurance scam or another, that's something altogether different.

those that arent insured and then need medical attention are in a pickle. a lot of those people dont pay their bills.

who pays?

those of us that are insured or can pay the bill

...by the For Profit Health Insurance Industry are the reason we don't have Single Payer Health Care in the US.

The People in every other Civilized Nation in the World have stood up against these predators.

are you thrilled to get in an accident with a person with no insurance? of ourse not. you know the mess. you know will probably cost you. do i empathize with people that chose car insurance or food on table.... damn straight.

or die without treatment. Making it mandatory prevents those who want to gamble from dying without treatment because they are not part of the medical system

economies of scale. Let the healthy people out and costs go up for everyone left.

Secondly, for the same reason we demand auto insurance. Those uninsured will cost everyone else money when they need something major.

around 25% in CA.. more than the number without health insurance. That mandate doesn't seem to be working, so what good is it?

people can choose not to drive. The idea that buying car insurance and buying health insurance are the same things is absurd.

This issue affects everyone.

Using tax money for the collective good is completely different from forcing people to purchase insurance. Telling people to purchase insurance or else is not health care reform. It's a bonanza for the insurance companies. Obama refuses to take on the insurance companies and is using this insane "mandate" so he can go, "see, 40 million people are now covered."

There is so much propaganda and so many congressmen in the pockets of the insurance industry. Couldn't the Public Option eventually lead to a single payer system?

If it is such a bonanza for the insurance companies, why are they fighting so hard against it? What I am hoping is that the public option will prove to be cheaper and more effective than private insurance. More and More people will switch, and eventually the insurance companies will go the way of the dinosaurs. The Public Option, as I understand will be based on a sliding scale and more affordable to lower income families/individuals. The real poor already have medicaid so wouldn't be affected by the requirement to get insurance. The public option isn't putting as nearly as much into administrative costs as private insurance (not paying billions to CEOs, executives and stockholder). I believe the public option will also receive finding other than from members. How can private insurance possibly compete with that, especially considering that they would not be able to exclude preexisting conditions, cancel the policies of people who get sick, and would have to limit out of pocket expenses?

big insurance leeches.

We should not be forced to buy products from faulty private producers. If it's your rightwing buddies objecting to mandates then finally, there is something we can agree on.

One of 2 things will happen:

1. A bill will pass with no public option and mandates. The President will sign it and people will be furious.

2. The GOP will fight the mandates and look like populist heroes. The insurance cos. will not accept a bill with no mandates if they can't exclude preexisting conditions. Health care reform will go down.

You can't tell me that "healthy" people are never in accidents.

I think that's what we'll have to do to get some of them to see it. Even people with HSA's are going to have to be made to see the expense of their health care when they try to save money by avoiding check-ups that would catch illnesses early.

Pray tell, do you actually know what kind of insurance is available on the individual market for people who don't get it through work? It's hideously expensive craptastic catastrophic coverage. IOW they gauge you for premiums and deductibles and don't cover shit. A young healthy person going without insurance is making a perfectly rational decision, since s/he is going to be out of pocket thousands of dollars if something happens either way. You really need to look into what's going on with insurance before you go around calling people names like freeloader. And yeah, I know: "But it'll be different when the plan passes! There will be subsidies!" Whatever. The point is that you, and others, are using vicious RW smears on people you don't know anything about right now.

Because I could never afford insurance on the open market and then ended up with pre-existing conditions so it costs over $1,000 a month.

I really wish people like you would understand that sometimes you are the one sitting there with the employer based insuranced policy and not understanding that those of us without that luxury understand the situation better than you. WE live it.

Once again, the OP says there are people who don't want to pay for insurance premiums. They object. Somebody needs to call them on it and if calling them freeloaders is what it takes, then call them that. If they then start telling the truth, that they can't afford it and are embarrassed to say so, maybe we'll get somewhere with reasonable subsidies and getting costs under control.

BECAUSE I DIDN'T FUCKING QUALIFY FOR SUBSIDIES!! I made "too much", according to the state. How many times do I need to repeat that before you get it through your head? I had $970 a month to live on. COBRA would have cost me $500 a month. Individual policies were pretty much out of the question. I applied for Medicaid, sandnsea. I was turned down. IOW, I was fucked. But I was a freeloader, according to you.

BTW, you do know that subsidies aren't conjured up by fairies, right? They come from somewhere. They come from taxes. The cost of subsidizing people to buy mandatory private insurance to pay the salaries of gazillionaire CEOs is going to be astronomical.

Most states don't have subsidies. In Oregon, you would likely be paying $26.00 a month - if we had full funding which we would if we could get something passed at the national level with everyone getting help who qualified. Anybody up to 400% of poverty would qualify, that means you.

I don't give a crap where the tax money goes. If Republicans want to give it to insurance CEO's, I don't care.

I have health care.

If you would stop thinking like an idealist and start thinking like a pragmatist - you would realize you don't need to give a crap that rich people's tax dollars go to other rich people. Fuck Them if they're that stupid. I don't care. Subsidize insurance so you and me can see the damn doctor. Get it?

$26.00 a month at 400% FPL? What bill is that in and please give me a page number so I can see it for myself. Because in the House version it says that you can be required to pay up to 11% of your income at 400% FPL. That's around $400 a month.

Edited because I looked up the House version and saw that it's 11%, not 12.5 like I initially thought.

How many times did I say that in this thread alone?

If you lived in Oregon, right now, you would be paying $26 when your slot came open. IF you lived in Oregon. IF you lived in Oregon. IF you lived in Oregon. I said that 3 times so you would hear it.

However, the subsidy that doesn't exist yet, even in the House bill, is on a sliding scale. 400% of poverty for a family of 4 is $82,000 a year. $9,000 is too much to pay which is why I keep saying this is where our focus should be - but it still isn't going to put that family out in the streets.

I believe a family at 150% of poverty, or thereabouts, would only be paying 1.5% of their income. It's on a sliding scale.

And one more time, this is where the debate should be. How much we pay and how much it costs to fund the subsidies, because that is going to determine the success of the program.

A broke-ass RW hellhole that doesn't do shit for its residents.

And one more time, this is where the debate should be. How much we pay and how much it costs to fund the subsidies, because that is going to determine the success of the program.

Yeah, how much are we going to subsidize the greedy ass parasites of the private health insurance industry? And unlike you, I don't subscribe to the belief that Republicans will never come back into power. Like I said, when they do, watch the subsidies go bye bye and watch insurance cos. get to deny people care. But still collect mandatory premiums.

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I'm talking about . .how do you respond to those who say that "people should be free to go without insurance if they want to"

way to miss the point

My son (an asthmatic) has just aged out of our family plan and hasn't found work yet. I am living in fear.

The "Welfare Queen" myth of the uninsured is bogus. The rich young uninsured freeloaders DON'T EXIST, contrary to popular belief. People don't have insurance for 2 reasons: 1. Because they are in crappy low-paying jobs that don't provide benefits and the state has decided they make "too much" for assistance. 2. They have pre-existing conditions that make them ineligible for insurance.

Stop blaming other uninsured people for the fact that your son is uninsured. They're in the same boat he's in. Really. There's not this vast reservoir of healthy young people with gobs of disposable income who could make everyone's premium go down to nothing.

The uninsured are adding 8% to your premium. How about asking where the other 92% is coming from?

Yeah, I was one of those freeloaders most of last year. I was unemployed and on UI, which was about $870 a month. That was "too much" to qualify for Medicaid, according to the state of Arizona so I went uninsured.

How about we try to stop with the RW memes demonizing people who don't have health insurance. KTHXBAI.

I decided to check into health insurance this weekend.
I earned $17K as an independent gardener in 2008.

Medicaid limit is $8,500, so I'm far too wealthy for that.
The Medicaid site directed us rich folks to Family Health NY.
The limit there was 10,500!
That site then directed me to Healthy NY, with a limit of $26K
Finally a program for me!

Except the premium totals $4,560 a year and the people I know who are on it say it is just a state- subsidized US Healthcare HMO garbage plan.

After business expenses I had $13K taxable, so this crap plan would eat up 35% of my taxable income. Not possible, unless I give up housing and food and give that money to US Healthcare.
(The CEO of United Health is paid $124 million a year.)

This system STINKS!

I really wish people would do some research into Romneycare in MA and see how it's working there. While it has done some good things it's turning out to be horribly expensive, for people whose income is above cut-offs for public aid and for the state as a whole.

Less than 2% of total doesn't really seem like BIG freeloading.

Even with mandatory insurance they're still going to be using the ER at the same rate, since they go for things like car accidents.

In economics, when a problem has to be fixed that's no one's responsibility to pay for, it's called a "social cost" (roads, cops, military, pollution, schools, meat inspection, labor law enforcement, street sweeping...). If you don't have insurance and you cut your finger off in a tragic jack ass type accident (and don't you try and tell me that wasn't you doing the keg stands on the abandoned roller coaster ride last Sunday night!), the city hospital they rush you to is gonna treat you anyway. You won't be able to pay, obviously, since you're about to lose your job as a Benihana chef for purely aesthetic reasons. Your lack of insurance just became a social cost.

You selfish twit.

If you want to force something on a group of people, it's useful to paint that group in an unsympathetic light. Thus was born the caricature of the uninsured as carefree irresponsible freeloaders, with gobs of disposable income that they wantonly and selfishly withhold from the insurance system, forcing Godly upright citizens such as yourself to pay for their numerous trips to the ER for their ski accidents and coke binges.

Oh yeah, I was a "selfish twit" with no insurance last year. I was living, if you could call it that, on $970 a month in UI. That was "too much" for state aid. My COBRA ran about $500 a month or I could have gotten some lousy individual catastrophic policy (assuming they'd even sign me since I was unemployed and they can reject you for that) that would have run me about $350 a month and had me out of pocket a few grand before the coverage kicked in. I chose to eat instead, selfish twit that I am.

You ignorant judgmental asshole.

:toast:

Some at DU are trying to revive Reagan's old "Welfare Cadillac" myth.

What's really fucked up is that they're doing it to carry water for the private health insurance industry.

As in very recent arrivals. Eventually they'll get it, but it will probably take personal experience, and that is coming very soon. :hug:

8% is not nothing but it's not cause to a) blame the uninsured for your high health care costs (what about the other 92%) and b) believe that mandates are a miracle cure of the ailing health system.

the mandate, that's their new income deal!

because even young and healthy people can get sick, or terribly injured and need drastic medical intervention. If you are not insured you have to depend on emergency rooms or county health facilities (in California) and that is the most expensive type of treatment you can get. Also, many medical facilities are not non profit anymore and they will turn away anyone who are not insured or who cannot pay a large cash deposit up front. People who are badly injured or sick enough die if they don't get treatment.

So there are two levels here. First of all we would rather make it mandatory to buy health insurance than to have people relying on a non existent or threadbare safety net. I understand what you paid would be based on your ability to do so. Not everyone would have to pay huge premiums like they do now.

In California it is mandatory to have car insurance. If you don't have proof of insurance you cannot register your car, and if the police stop you it is a big ticket which goes all the way up to impounding your vehicle if you do not bring yourself into compliance. Some people still try and duck it, but they will get caught and then they will pay more than if they bought the bare bones insurance that the law requires of them.

Is requiring someone to buy insurance to protect their bodies all the time any worse than making them buy it to protect their vehicles and themselves while riding in those vehicles? I don't think so. Also, it will ease the financial burden for others who do carry health insurance but have to have the costs for someone who does not added into their totals the way stores increase prices if they have a lot of spoilage and perishment. I hate comparing people to inanimate objects, but the Freepers tend to see people as inanimate objects anyway, not as flesh and blood entities who suffer, sicken and die without help and nourishment. The only people they are positively sure have righteous needs are themselves.

We need to see this as a way of looking after each other. Somewhere back in time our sense of community with each other and responsibility for each other got lost. We are never going to be whole in any sense of the word until we are able to bring it back. I would not suggest giving this as an argument to right wingers, though. The only community they would understand is one that offers murder for hire.

Would the government impose an unfunded mandate on people? Forgive me if that sounds like a stupid question, but I know a lot of people who cannot afford health insurance now. What good is a mandate if people still cannot afford even government provided health insurance?

Which will be on a sliding scale starting at 1-2% of income up to 11.5%. Making sure the subsidy is sufficient, whether it goes towards a public or private plan, is what we should be talking about.

Forcing people to purchase insurance isn't something the government should be doing. People can choose not to drive if they don't want to buy car insurance. That choice isn't available with health insurance. The mandate just funnels more money to the insurance companies. What are unemployed people suppose to do? Telling people "buy insurance or else" is not health care reform.

Obama was against the mandate during the 2008 campaign and he will likely lose my vote in 2012 if he signs a bill that includes it.

Fuck mandatory useless "insurance."

people to purchase private health insurance is wrong. If they mandated that everybody had to at least join a public tax payer funded plan, that would be different. But punishing somebody for not buying insurance from a private company to serve their profit margins is not only wrong, it is un-democratic, if not dictatorial. Single payer, public option, or nothing at all.