'Obama Health' without the mandates

is actually closer to what candidate Obama campaigned on. both during the primaries and the general election. Lack of an individual mandate (for adults) was the main (and bitter) difference Barak and Hillary, culminating in the 'Shame on You' event in Ohio.

Here's what Obama said in the January 31 '08 debate :

http://articles.cnn.com/2008-01-31/politics/dem.debate.transcript_1_hillary-clinton-debate-stake/

Perhaps ProSense can advise us once again on the elements of Health Care Acts. Some revenue/subsidy measures may survive:, as may some of the standards and structures, including the exchanges.

BTW, as far as a really competitive Public Option went, it was Edwards who emphasized this, more than Hillary or Obama. Obama stressed " a "government plan that would allow people who otherwise don't have health insurance because of a preexisting condition", although a more general public option was certainly part of his platform.

What does the Whitehouse.gov have to say? The Pre-Existing Condition Insurance Plan program makes it possible for people who may have previously been denied coverage to purchase health insurance. ... 50 States now offer options for people with pre-existing conditions"

The question remains, if the Supreme Court strikes down the mandates on individuals (but presumably not corporations), what lives on?

The Devil is in the details. A plan that still costs a prohibitive amount and covers next to nothing will still serve to bankrupt and punish the sick.

Please tell.

I don't know if it costs a prohibitive amount and covers next to nothing. That's why I asked the question. All I did was say that a plan that DID cost a prohibitive amount and DID cover next to nothing would still be devastating for a family with a sick child.

I have a 5 year old son that has spent upwards of 6 months at a time in hospitals and undergone 27 operations and sees at least a dozen specialists. So I know what our health care system is like and I see what it does to poor people and lower income people who can't afford good insurance. Hell, I've seen people with multiple insurance plans through employers still go almost bankrupt and have to sell their house because their "cadillac plans" didn't cover nearly enough of what was needed.

So that's why I asked. I'll ask again: "Does the pre-existing insurance plan referenced in that article cost a prohibitive amount and cover next to nothing?"

and there's a lot of details here, including what services are covered. I am so sorry about what you are going through.

If there is an affordable Government plan it may be buried away. It is certainly not being promoted. The subsidies are due to come in 2014, but may be technically tied to the mandates, in which case the private options fail, and an expensive Government program remains expensive.

Our insurance coverage is good. It covers a lot, and is more than fair and we have been able to get through a lot at minimal expense to my family. And my son will get better and eventually need less care. But I'm not someone who can't see what impact the system has on others who are not so fortunate either because they lack the insurance or because their children will never get better and are dealing with life long afflictions. What we have been able to get covered and save on, when we can afford to we try to donate to people who need it to help with their expenses, because we recognize how lucky we are and how but for small bits of fate and circumstance, it could be us in that situation. It could still be us some day.

But it is why I have such a vested interest in Health Care reform and why I want it to succeed and why I was so adamant during the process that it not be half assed and it not be easily struck down. What many were arguing in the abstract was and will always be a daily reality for my family.

The other piece as you said is that it "may be buried away". Which is why the government plans have to not only be good for them to be effective they have to be easy for people to understand. Between my wife and I we have 4 college degrees, speak multiple languages, and have a strong base of support and all the resources for research at our disposal. And at times it is suffocating navigating this system. Some of the families we know and work with and try to help do not have the education, do not have the language skills and do not have the time nor the resources to be able to dig deep to find out what is available to them and determine in what way they can make it work for them.

of this system I have a legal and medical background and I am still amazed at every turn. It's inexcusable that the system default is so often to shunt herd people onto a trap door, or towards a dead end.

Thank you for writing so eloquently.

Without the mandate or a single-payer-like backup system, I'm not sure if the rest of it can function like it's supposed to. Don't see a single-payer system getting through Congress anytime soon, certainly not now and probably not even in 2013 without some kind of massive public demand. :shrug:

or better still revisit the intenhsive 2008 debates about whether Obama's plan was workable right here in GDP.

...and it isn't now.

Whether funded by a mandate (PPACA, Switzerland, Netherlands), a hypothecated tax (Medicare), or general revenues (UK NHS), there is no 'universal' without 'compulsory. Employer, employee, citizen, someone's going to get a must-do.

Obama was being disingenuous then, and now he's seen the wheelhouse. There will be no return to that unworkable plan.

the question is, as a matter of legislation, how much survives?

Unless it's replaced with a tax.

The mandated insurance premiums surely go to the Health Insurers, not the Government.

There are some taxes in the bill. The mandates appear to raise no revenues in themselves.

...either via the tax code, or some other way, the free-rider problem makes it uneconomical to run a voluntary system.

I have a personal preference for Medicare for all, but I can also count votes. There is no way towards a more universal provision that is worse than the pre-2009 status quo, however.

One suggestion is private insurance plans that cover pre-exising conditions only after a waiting period of one year from taking out insurance. The pre-exising condition means diagnosed, not a category of illness. To bring coverage further for more urgent cases, pre-conditions would be covered in cases not discernible six months before taking out a premium. Those who don't know they have a pre-exsting condition are not free riders.

(Sorry I am so poor at comprehensible writing. I should be composing insurance contracts).

Non profit government regulated with a government plan, yes.

A mandate to buy private for profit ins. will fail.

and how they frame their decision.

Even if the supreme court rules the mandate is aok, it will fail. It is tied to for profit system that is not and will not be regulated effectively.

Non-profit is the only way a mandate works.

This "reform/mandate" is a bail out for insurance companies and the parasitic investor class who will be seeing a massive exodus of paying customers via baby boomers moving to medicaid.

If they were serious about covering everyone and saving money they would do what every other nation with a form of universal care does- insist on non profit ins. companies offering a government plan.
They are then allowed to make money selling the extras and luxury add ons the wealthier can afford.

This mandate is poison as long as it is tied to for profit ins.

"if the Supreme Court strikes down the mandates on individuals ... what lives on"

The reform is doomed to fail.

big insurance.

Both issues are now law. Only one is under attack.

why would anyone purchase insurance if they were healthy if the moment they got sick they could then sign up for insurance with virtually no penalty at all.

nt.

Once more healthy people drop out and more sick people sign up, the underlying costs become greater and the insurance companies will increase premiums. Once this happens it presents even more disincentive for healthy people to be insured, which makes the costs per person even greater, which makes premiums higher, etc., etc.

If you cant free ride six or three months, the moral hazard is manageable. Of course that means a three to six free ride to ER.

Anyone's guess. There was no severability clause in the legislation, but that doesn't mean the court WILL sever the rest of it. I'm given to understand that in the past severability has been observed when there was no severability clause.

if one part of the law is deemed unconstitutional the law must be re written and re voted.

is what OP #10 has suggested. I am not a constitutional lawyer. This case may be further complicated by the fact there is more than one Act.