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Mandates, Government and Liberty

James Joyner writes about the new GOP opposition to mandates that I posted about yesterday. He links to a blast from the 2008 primary past by Ron Chusid defending then candidate Obama's opposition to mandates:

Using mandates to achieve universal coverage seems like quite a cop out to me. Regardless of whether the plan is good or the plan stinks, universal coverage is achieved because the government forces you to join up. In contrast Obama takes on the challenge of offering a plan so good that virtually everyone will want to participate to receive health coverage. . . . In contrast, a self-proclaimed government junkie like Hillary Clinton just can not live with the fact that somewhere, someone decides they do not want her help. Clinton will help them whether they want her to or not.

. . . Some on the far left claim that Democrats lose when these alleged right wing frames about freedom are employed. They got it all wrong. Democrats lose when they concede traditional liberal values such as liberty to the right.

(Emphasis supplied.) Chusid's description of the difference between "liberals" and "progressives" is rather absurd, unless he is referring to 19th Century liberals. Liberals and progressives believe in a government that intervenes when it is good policy to do so. For example, a progressive income tax. Indeed, in Joyner's piece, he cites to a John Judis article that provides a much better and more coherent defense of Obama's campaign position:

Obama’s health care plan, which he announced last week, has been widely criticized by liberals for not making health insurance mandatory. Challenged by Edwards, Obama explained why a mandate is not a cure-all. “If you look at auto insurance, in California there’s mandatory auto insurance,” Obama explained. “Twenty-five percent of the folks don’t have it. The reason is because they can’t afford it. So John and I, we’re not that different in this sense; that I’m committed to starting the process. Everybody who wants it can buy it and it’s affordable.

(Emphasis supplied.) Obama argued for affordability as the lynchpin to health care reform. That is why he stressed a public insruance plan, NOT mandates. The argument contra to Obama's position was that affordability is most effectively achieved with a mandate/autoenrollment COUPLED WITH a robust public option.

Mandates without a robust public option, as you see in the BaucusCare proposal, does not address the affordability issue. It is instead merely a profits protection program for the health insurance industry.

Without a public option, mandates are a very bad idea. Indeed, an unacceptable idea. Because such a plan would not address the affordability issue. Mandates in such a scheme are merely a tax on the poor to enrich the health insurance industry. No "progressive" or "liberal" should support such a plan.

Speaking for me only

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  • Display: Sort:
    Bravo (5.00 / 4) (#1)
    by MO Blue on Wed Sep 23, 2009 at 10:01:26 AM EST
    Without a public option, mandates are a very bad idea. Indeed, an unacceptable idea. Because such a plan would not address the affordability issue. Mandates in such a scheme are merely a tax on the poor to enrich the health insurance industry. No "progressive" or "liberal" should support such a plan.

    For someone who claimed that health care was not your issue, you've come a long way.

    Well (5.00 / 3) (#2)
    by Big Tent Democrat on Wed Sep 23, 2009 at 10:04:47 AM EST
    In hindsight, I dropped the ball back then.

    Parent
    "Mandate fights" (5.00 / 2) (#3)
    by Stellaaa on Wed Sep 23, 2009 at 10:17:59 AM EST
    I remember that tense period during the primaries when the "Kreative Klass" collectively opposed mandates.   I was curious how this was going to play out.  

    Parent
    He didn't do this... (5.00 / 1) (#4)
    by masslib on Wed Sep 23, 2009 at 10:20:43 AM EST
    "That is why he stressed a public insurance plan, NOT mandates."

    Hillary and Edwards did this.  He wanted a public Exchange like Congress has.  He then added a public option pilot program to keep up with Hillary and Edwards, who both called for a massive Medicare-like public health insurance program, and not to "keep the insurers honest, but as Hillary said "because lots of people want it".

    He didn't want mandates or a big public insurance program.  Hillary nudged him into full on universal health care support.  He wanted universal health insurance access.

    Well (5.00 / 1) (#5)
    by Big Tent Democrat on Wed Sep 23, 2009 at 10:26:09 AM EST
    The campaign literature says he propsoed a public insurance program.

    Parent
    Well, the devil is in the details... (5.00 / 1) (#6)
    by masslib on Wed Sep 23, 2009 at 10:29:23 AM EST
    I suppose if one didn't read much of the analysis of the various plans, or listen closely to the proposals, they might have missed that.

    Parent
    but but but (5.00 / 1) (#12)
    by cawaltz on Wed Sep 23, 2009 at 03:13:16 PM EST
    they were all basically the same(tongue firmly in cheek).

    Parent
    Non-profits... (5.00 / 1) (#8)
    by DancingOpossum on Wed Sep 23, 2009 at 12:27:28 PM EST
    ...Doesn't necessarily mean they are better in any way, shape or form. They operate just like the for-profits or even worse:

    Here's a good debate on nonprofits and health cooperatives from different perspectives:

    http://blogs.reuters.com/great-debate/2009/07/30/experts-weigh-in-on-nonprofit-healthcare-cooperativ es/

    Exactly right (5.00 / 1) (#13)
    by s5 on Wed Sep 23, 2009 at 04:54:48 PM EST
    I've come around on mandates. I was against them but I've come to understand why they're a necessary ingredient. The health care system falls apart unless everyone is covered, and if we're not doing single payer (which I want but we're not getting) then a mandate is necessary.

    But without a public option, a mandate is a nightmare. Unlike auto insurance, you can't stop driving your body if you don't want health insurance. (Well, okay, you can, if you commit suicide.) So the thing you're mandated to have had better be affordable and provided as a public service.

    That, to me, is the correct left/centrist/right bargain. Okay, Blue Dogs, want a mandate? Fine. You only get it with a robust public option available on day 1. What's that? You don't want a public option? Fine. No mandate.

    Protect the profits? (none / 0) (#7)
    by me only on Wed Sep 23, 2009 at 11:54:47 AM EST
    My insurance is with a not for profit company.  Does anyone know what percentage of health insurance today is with not for profit companies?  Does anyone know what percentage of people are covered by "self insured" employers?

    Nonprofits (5.00 / 1) (#9)
    by TeresaInSnow2 on Wed Sep 23, 2009 at 12:37:06 PM EST
    make a profit, just keep it in reserve.  In our state, the insurers have huge monies in reserve, while still jacking up premiums.

    Some insurance companies transfer their non-profit money into for-profit subsidiaries.  

    Here's a link about what our "non-profit" insurance companies are doing in Washington state:

    Link

    Non-profit in the insurance industry is just a scam to avoid paying taxes.

    Parent

    Pardon me (5.00 / 1) (#10)
    by TeresaInSnow2 on Wed Sep 23, 2009 at 12:37:46 PM EST
    Non-profit INSURANCE companies make a profit, just keep it in reserve.

    Parent
    Are you sure this is something (none / 0) (#11)
    by me only on Wed Sep 23, 2009 at 02:55:19 PM EST
    unique to the health insurance industry?

    Parent