It seems to me that if the ACA hadn’t included that individual mandate, that it would be a healthcare law nearly twice as popular with perhaps only half as much opposition.
Politically, was the individual mandate really worth it? It was the cause of a lot of anti-ACA sentiment. Without that mandate, I think political opposition would have been less, although the Republicans still wouldn’t have supported the ACA.
Well, it doesn’t look like it’d work out financially without the individual mandate. The only other structure I could see working out financially would be a single payer system, which was less attainable politically.
So, I’d say that it was worth it politically.
It is not even a political issue.
Without a mandate, health reform that includes guaranteed issue (everyone can buy a policy) and community rating (every age group pays the same rate) will fail. Without all three items, there is no reform.
Washington State Republicans proved that over 20 years ago. They cancelled the mandate passed in 1993 and by 1999 it was impossible to buy coverage in Washington. All the insurance companies had stopped selling policies.
Repeal the mandate is a code word that simply means cancel reform.
Cancel this reform. There are other things you can do to reform healthcare insurance without making it compulsory for people to buy some shitty company’s product. For example, extending the same tax benefits offered to health-insurance-as-a-fringe-benefit to health insurance purchased individually would make it harder for a bad insurer to get away with screwing over their clients, because those clients would no longer face the substantial penalty for choosing a different insurer over the one their employer chooses for them.
Yes, totally worth it. Lives will be saved; that’s ALL that matters. Got something better? Bring it. So far all I’ve heard from the other side is chirping.
Except that most people seem to be paying more for insurance and getting less coverage. I wish the ACA worked but calling it “affordable” is kind of Ironic.
Key Study On Obamacare 2015 Premium Rates Is Out And You Won’t Believe What’s Going To Happen
Survey: Most Republicans Who Bought Obamacare Coverage Like Their Plans
http://www.politicususa.com/2014/11/14/republicans-devastated-poll-finds-americans-love-obamacare.html]Republicans Devastated As Poll Finds That Americans Love Their Obamacare
I don’t know anyone who would be happy, let alone Republicans, if they were paying more and getting less coverage. And there sure are a lot of very happy people in these polls, including Republicans.
Having gotten passed the SCOTUS, twice, ACA is no longer really an election issue.
Off to Great Debates.
Yes, let’s talk about mandates. Before the mandate, and still to this day, I have a mandate to pay for other people’s health care. Now, in theory, I don’t really mind doing this, but I’ll be damned if a bunch of mooching right-wing welfare queens are going to tell me I have to do this in the most expensive way possible. And that’s exactly what was going on prior to the passage of the ACA. I was mandated to pay for other people’s health care in the most expensive way possible.
The ACA includes a bunch of stuff that’s designed to bend the cost curve on government payouts for health care. It’s not ideal, and it’s not far enough, but it’s a much better system than we had before. So, I don’t really give a crap that someone might be mandated to buy government-subsidized health insurance. They certainly don’t give a crap that I have to spend an enormous amount of unnecessary money to save their asses when they show up at the emergency room.
Now, as to this specific mandate, a number of states have tried to set up health care exchanges without mandates, and they have all collapsed. There’s no way to make an exchange work without a mandate. I would have preferred Medicare-for-all, but that wasn’t on the table. What was on the table were exchanges. And if you want to do an exchange, and you don’t want exchange costs to spiral out of control until the exchange collapses, then you have to have a mandate.
You might as well ask if Apollo would have worked without leaving the Earth. Mandatory insurance is necessary for it to work and makes the cost to society minimal. Pay no heed to the horror stories that are manufactured about rates going up (we can’t stop that and they’re going up slower than they otherwise would). For many people, they’re getting insurance that they otherwise wouldn’t be able to get. For many, they’re getting better insurance to replace old crappy policies. For all, we’re getting the satisfaction of knowing that millions of our fellow citizens are much better off.
A system of depreciation …
First of all, I completely disagree with you that “lives will be saved”. Everybody will die, there’s no cheating mortality. One can either spend all their money jealously preserving their lives ten years longer as an invalid, or they can just let Death come when he will. On the other hand, we are rightfully appalled at the death rate of women during childbirth, and the frightening ways our children pass on. Queen Mary II of England watched all 17 of her children die in childhood.
(In the following, I will be using nice round numbers and straight-line depreciation. I think a 200% declining balance method using mid-year convention could be workable, but I’m sticking with the simplest case for debate purposes.)
First off, we include ALL children in Medicaid until their 21[sup]st[/sup] birthday, 100% coverage for everything, starting at conception. It doesn’t matter how expensive it is up front, these children will be tax-payers for 50 years thereafter, that’s more than enough to repay. This includes pregnant women because we need to keep that tax-payer-making machinery as healthy as possible. During an individual’s 21[sup]st[/sup] year, they still have 49 years to pay taxes, they get 98% coverage, at 22 they get 96%, etc etc etc … then at 69 they get 2% coverage and at 70 they have to pay all their own medical expenses. Whether out-of-pocket or through private insurance would be a decision they can make themselves. As an old people myself, I can assure you we are useless to society and do nothing more than consume at the expense of the young and post nastiness on otherwise great message boards.
This doesn’t throw the elderly to the wolves, the wolves have better tastes. What this does is relieve the young adults of an extremely expensive overhead of having to buy health insurance from private insurance companies, especially young parents. By the time an individual is in their 40’s, their health care costs begin to get outrageous, but they can better afford private insurance.
Instead of forcing the young to pay for the care of the elderly, we make the elderly pay for the care of the young.
Excellent post, BrightNShiny, glad to see someone being clearheaded about the subject.
That is, without a doubt, the most idiotic alternative I have ever heard. JUST when you hit the age where you’ll need health care the most, BOOM, we cut you off! Sorry, old people, sux to be you. Now please do the unselfish thing and just die already why don’t ya.
I don’t want to live in your world and thank goodness I don’t have to. ::walks away muttering:: People as commodities, cared for only because of their inherent tax value to society. Thought I’d heard it all. Sheesh.
I think it’s fairly safe to assert two premises:
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This healthcare reform would not work without the individual mandate.
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No other reform proposal that was politically plausible would have better policy outcomes.
So the question is really whether it was worth the political cost to do large-scale healthcare reform at all. I think the answer is obviously yes. What good is political capital if not to spend it on one of your party’s top priorities for decades.
Hey look on the bright side - he at least didn’t propose taking our money and putting us on ice floes.
Maybe because the ice floes are melting.
I think maybe the minds of the right are exploding because of the fact that all the lies the Pubbies in Congress have told about ACA are being proved to be false. Employment is growing, companies are thriving, costs are being held in check. And, worst of all, the poor are getting coverage and liking it. Oh, the horror.
Indeed. I’d ask the OP how he thinks the ACA could work without the IM. I wait until I get sick, and then buy “insurance” to pay for it.
As already well said by several others, the individual mandate is central to the success of health care reform. The law has to be shaped by what works, not by what is “popular” or “unpopular” especially when popularity, or lack thereof, is being shaped by delusions promoted by the insurance industry and far-right ideology.
One has to see it in the context of the eventual objective, that the only kind of health care system that works in the long run is one that is universal and based on a uniform rate structure. This doesn’t necessarily mean single-payer but it does necessarily mean a strong degree of government regulation of the insurance system. The objection to the mandate is based on delusional beliefs in precisely all the wrong things, all the things that don’t work and that have resulted in the fiasco that the ACA is a first step to fixing: belief in letting the free market solve everything, keeping the government out of health care, “danged if the gubbermint is gonna force me to buy something”, and “danged if the gubbermint is gonna force me to pay for someone else’s health care”.
I mean, really, what do these folks think is going to happen? That they can exercise their God-given freedom to not buy insurance until they’re seriously ill, and then any insurance company will be happy to sell it to them cheap, and will provide full coverage for all their treatments? These people claim to believe in free markets. They should spend half a second to think about how free markets actually work. Not only does insurance not work that way, but free markets fundamentally don’t work at all for health care, because it’s not a discretionary commodity. When you need it, you really need it, and no civilized society should deprive you of it.
Yeah, I heard that from the Republican camp during the 2012 election cycle as a replacement to the ACA … I want to say from the flat-taxes folks.
They are as likely to be as correct as the Flat-Earther folks.
Indeed. :eek:
I have nothing to say that would be appropriate for this forum. Let’s just say I wish I could study their brains and leave it at that.