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Universal Health Care is On Its Way

And it's going to be set up much like the Massachusetts plan with mandates. The use of a mandate in health care is just the latest in a long line of reversals Obama has made from his campaign. It was the very concept of a mandate that was the main difference between Obama's and Clinton's plans. Nonetheless, Ezra Klein has confirmed with several administration officials that the use of an individual mandate is the direction Obama is going:

Here's how it will work, according to the officials I've spoken to. The budget's health care section is not a detailed plan. Rather, it offers financing -- though not all -- and principles meant to guide the plan that Congress will author. The details will be decided by Congress in consultation with the administration.

One of those details is "universal" health care coverage.

That word is important: The Obama campaign's health care plan was not a universal health care plan. It was close to it. It subsidized coverage for millions of Americans and strengthened the employer-based system. The goal, as Obama described it, was to make coverage "affordable" and "available" to all Americans.

But it did not make coverage universal. Affordability can be achieved through subsidies. But without a mandate for individuals to purchase coverage or for the government to give it to them, there was no mechanism for universal coverage. It could get close, but estimates were that around 15 million Americans would remain uninsured. As Jon Cohn wrote at the time, "without a mandate, a substantial portion of Americans [will] remain uninsured."

What Cohn really means is that without a mandate, the healthy will refuse to buy health insurance, and since it's the premiums from those healthy Americans that will be needed to offset the costs of those who are unhealthy and who will cost more to treat, a mandate is necessary. We don't yet know what the consequences of not buying insurance will be yet. It will come in the form of fines, but we don't know how much.

The Cato Institute explained in a policy report in October 2007 that there are a number of problems with individual health insurance mandates. One big one is that mandates don't result in 100% coverage. For example, as Cato notes, those states that mandate auto insurance still have a fairly significant amount of their population uncovered. In California, 25% of drivers still don't auto insurance even though they are required to under law.

Another issue with the individual mandate that Cato discussed is the problem of defining minimum coverage. This is an easy issue with auto insurance, but it's a very complicated one with health insurance when you've got lobbyists from the various health care service organizations all vying to have their services covered. The more that services covered, the higher the premiums. The higher the premiums, the more people will ignore the mandate.

Tom McGuire writes about Obama's sudden interest in individual mandates after criticizing Hillary Clinton for promoting the same idea:

As a nostalgia piece here is a link to a lefty wondering why his party was so committed to forcing young, healthy members of the working class to subsidize the rest of us on health care; that seems like a good question but I am long resigned to not being smart enough to be a lefty.

And now it is on to mandates, which was always inevitable since lefties are never happier then when telling the rest of us what to do. As the great Warner Wolf might say, if you thought that during the campaign Obama was just tossing up a lot of happy horseshit about individual choice... YOU WIN!


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Comments (12)

Here's another important qu... (Below threshold)

Here's another important question: How do you enforce this draconian mandate?

They will also mandate that... (Below threshold)

They will also mandate that all physicians and providers accept participation. Its one way to nationalize the medical health industry.

Funny how "Universal" healt... (Below threshold)

Funny how "Universal" healthcare plans never include polititions.

Looks like the <a href="htt... (Below threshold)

Looks like the MASS model isn't working so well...

"The Massachusetts reform law is not providing universal access to care, even in a state with highly favorable circumstances, including previously high levels of spending on health care for the poor, high personal incomes, and low rates of uninsurance. It is not a model for the nation."
Seems to me like this is something we really don't need to be spending federal money on at this point...
If the idiots we keep elect... (Below threshold)
JC Hammer:

If the idiots we keep electing to Congress, no matter which party, can get excellent medical plans, why can't all Americans receive the same plan, as we as taxpayers are paying for the idiots, right? Does anyone have a compliant against that? If you do, why aren't you complaining about the idiots receiving it at our expense?

I think they ought to get t... (Below threshold)

I think they ought to get the average commercial care found in their particular districts, JC.

But they're special - don't they deserve more?

Alternatively, every job has its perks. The folks in Congress have (arguably) very important jobs and some pretty sweet benefits. I think they should get decent coverage - but the cost should come directly out of their pay.

Which it doesn't.

And it should - so they'll know what the REST of us who've got insurance that doesn't come off the government dime pay.

Well, if I have to particip... (Below threshold)

Well, if I have to participate, I'm going to specify that I want the Congressional Plan. And at the same price the congress is paying.

jc hammer - "Does anyon... (Below threshold)

jc hammer - "Does anyone have a compliant against that? If you do, why aren't you complaining about the idiots receiving it at our expense?"

You want a complaint? OK... screw them. They not only make enough to afford their own coverage they willy-nilly raise their own pay with ZERO consolation with those that hired them - the voters.

Screw them, strip their healthcare from their benefit list.

Lets get some definitions a... (Below threshold)

Lets get some definitions and language straight here. Americans, whether insured or not, have healthcare available to them that exceeds the quality and technology available to most of the people on this planet. What they don't have is universal payment for that care out of someone else's pocket. Not all healthcare providers will provide care for folks without insurance or means to pay, nor will all providers care for patients with certain forms of insurance. Once a third-party payor (someone other than the patient or provider) gets involved, they want a say in how the money is spent. This takes away from both the providers' and the patients' say in what kind of care is rendered. That does NOT help improve health care. It does not particularly "save" money, just changes whose hands it falls into.

Meaningful healthcare reform would put the onus for payment back on the patient, the onus for charging reasonable fees back on the provider (rather than be determined by the third-party payors "reasonable" rates) and monitor/regulate the quality and appropriateness of care and system function by an entity that had NO financial interest in the provider/patient relationship.

So far I see no one willing to address the issue that way.

If they want one healthcare... (Below threshold)

If they want one healthcare system, and they really want only one world government, why not go all the way?

One company.

Think how much more efficient it would be if we didn't waste all that effort on competition?

The one company would handle: television, health care, insurance, house construction, travel, medicines, education, computers, the internet, professional sports, communications, music, publishing, child care, groceries, and lawn mowing.

Wouldn't that be great?

Props to Tom McGuire and Wa... (Below threshold)

Props to Tom McGuire and Warner Wolf for getting it right: It was all horseshit coming out of Candidate Obama's mouth, and it's more of the same now for President Obama, earning him a Ph.D. (piled higher and deeper) as he bankrupts us all.

What are they going to do i... (Below threshold)
Tim in TX:

What are they going to do if I refuse to buy health insurance - throw me in jail? Seriously?






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