This is how Obama fights the GOP, not having mandates because of political concerns.

[rinsd]

Now, however, Mr. Obama is claiming that his plan’s weakness is actually a strength. What’s more, he’s doing the same thing in the health care debate he did when claiming that Social Security faces a “crisis” — attacking his rivals by echoing right-wing talking points.

The central question is whether there should be a health insurance “mandate” — a requirement that everyone sign up for health insurance, even if they don’t think they need it. The Edwards and Clinton plans have mandates; the Obama plan has one for children, but not for adults.

Why have a mandate? The whole point of a universal health insurance system is that everyone pays in, even if they’re currently healthy, and in return everyone has insurance coverage if and when they need it.

And it’s not just a matter of principle. As a practical matter, letting people opt out if they don’t feel like buying insurance would make insurance substantially more expensive for everyone else.

Here’s why: under the Obama plan, as it now stands, healthy people could choose not to buy insurance — then sign up for it if they developed health problems later. Insurance companies couldn’t turn them away, because Mr. Obama’s plan, like those of his rivals, requires that insurers offer the same policy to everyone.

As a result, people who did the right thing and bought insurance when they were healthy would end up subsidizing those who didn’t sign up for insurance until or unless they needed medical care.

In other words, when Mr. Obama declares that “the reason people don’t have health insurance isn’t because they don’t want it, it’s because they can’t afford it,” he’s saying something that is mostly true now — but wouldn’t be true under his plan.

The fundamental weakness of the Obama plan was apparent from the beginning. Still, as I said, advocates of health care reform were willing to cut Mr. Obama some slack.

But now Mr. Obama, who just two weeks ago was telling audiences that his plan was essentially identical to the Edwards and Clinton plans, is attacking his rivals and claiming that his plan is superior. It isn’t — and his attacks amount to cheap shots.

First, Mr. Obama claims that his plan does much more to control costs than his rivals’ plans. In fact, all three plans include impressive cost control measures.

Second, Mr. Obama claims that mandates won’t work, pointing out that many people don’t have car insurance despite state requirements that all drivers be insured. Um, is he saying that states shouldn’t require that drivers have insurance? If not, what’s his point?

Look, law enforcement is sometimes imperfect. That doesn’t mean we shouldn’t have laws.

Third, and most troubling, Mr. Obama accuses his rivals of not explaining how they would enforce mandates, and suggests that the mandate would require some kind of nasty, punitive enforcement: “Their essential argument,” he says, “is the only way to get everybody covered is if the government forces you to buy health insurance. If you don’t buy it, then you’ll be penalized in some way.”

http://www.nytimes.com/2007/11/30/opinion/30krugman.html

Obama thinks its ok for the childless to escape mandates.

I wonder if he thinks that way about public school funding.

[Barack_America]

1. How many times are you going to post this Krugman stuff?

Have you noticed that Hillary has been using Obama's non-mandate against him, claiming that millions will be left out under his plan?

Hardly sounds like leaving off the mandate was a politically advantageous move.

[rinsd]

4. Then why not include the mandate if he wasn't scared of how the GOP would paint it?

[Barack_America]

5. Maybe because he doesn't believe in forcing already financially strapped people...

to be forced to pay money they might not have?

[rinsd]

11. Neither does Hillary.

Those who cannot afford to purchase insurance will be enrolled beefed up Medicare & SCHIP programs.

The American Health Choices Plan will make health insurance more affordable for the millions of
Americans who want it. It includes a number of straightforward policies to achieve this end:
1) Ensuring Premium Affordability Through Refundable Tax Credits: Premiums have
skyrocketed over the last several years – nearly double since 2000. The American Health
Choices Plan helps working families afford coverage through refundable, income-related
tax credits to ensure that accessible, high-quality health coverage is affordable to all.
2) Limiting Premium Payments to a Percentage of Income: This credit will ensure that
securing quality health care is never a crushing burden for any working family. This
guarantee will be achieved through a premium affordability tax credit that ensures that
health premiums never rise above a certain percentage of family income. The tax credit will
be indexed over time, and designed to maintain consumer price consciousness in
choosing health plans, even for those who reach the percentage of income limit.
3) Promoting Shared Responsibility for Large Employers: Hillary Clinton’s comprehensive
agenda to lower costs and improve quality will substantially lower costs for employers,
making it easier for all firms to continue coverage or offer new health benefits to their
workers. In return, large employers will be expected to provide health insurance to their employees or make some contribution to the cost of coverage. This responsibility will take
into account firms’ size and average wages.
4) Creating Small Business Tax Credit: Small businesses are engines of job growth in our
economy. They account for 80 percent of net new jobs since 1990xvi and create jobs that
stay here in America. Yet, they also face the most acute challenges to providing health care
for their employees. Small businesses face higher premiums due to limited purchasing
power and tend to employ lower-income workers.xvii As a result, small employers cover far
fewer of their employees – and the proportion that offers coverage in the first place is less
than half that of large firms that offer health insurance. Coverage among small employers
is eroding. Since 2000, the share of these small firms offering coverage has fallen from 57
percent to 45 percent.xviii At a time when health care costs are increasingly undermining
the economic competitiveness of American business, Hillary Clinton’s plan seeks to make it
easier — not harder — for small businesses to create new jobs with health care for workers
here in the U.S. Specifically, small businesses that provide quality coverage (e.g., benefits
like what Members of Congress receive) and contribute most of the premiums for their
workers would qualify for a refundable tax credit. The tax credit could be structured as a
traditional policy (e.g., a credit equal to 50 percent of premiums for firms with fewer than
25 employees and less for medium-size employers). As President, Hillary Clinton would
work with the small business community and Congress to design the parameters of the
credit (e.g., protecting against subsidizing boutique high-income firms) as well as how the
credit might dovetail with the tax credit going to individuals and families to make
premiums affordable.
5) Strengthening Medicaid and the State Children’s Health Insurance Program to Serve
All Low-Income Individuals: These programs serve over 55 million Americans, and have
done so successfully through federal-state and private-public collaborations. The holes in
this safety net (e.g., lack of coverage of poor, childless adults) will be fixed to ensure that
the most vulnerable populations receive affordable, quality care. Similarly, the other part
of the safety net, like public hospitals and community health centers, will continue to
receive support to serve vulnerable populations.
6) Creating a Retiree Health Legacy Initiative: For major American employers with
workforces that face unusually high health care costs due to a high ratio of retirees, health
care costs can be a drag on competitiveness and job creation – particularly for our major
manufacturers. The American Health Choices Plan will provide a tax credit for qualifying
private and public retiree health plans to offset a significant portion of catastrophic
expenditures that exceed a certain threshold. Such reinsurance would be time-limited to
reflect the short-term demographic need of the aging baby boomers, and would be
devised in a manner that does not add to our long-term fiscal challenges. The policy will be
designed to make companies more competitive and assist workers – and not to take
pressure off the need for strong managerial leadership at the top. Participating companies
would also have to demonstrate that they are employing best health practices, including
chronic care management, information technology, and other modernization initiatives
that maximize value, quality, and accountability. Finally, employers will also have the
option of buying early retirees into the new Health Choices Menu

You keep claiming you have the plans but are semmingly ignorant of key facets.

That only works when able bodied and financially able people contribute to the poll of healtcare money.

Obama rather let those people gamble and make us pay more for their care when they need it.

[Cant trust em]

2. OTOH, poor people who are forced into buying plans

fall deeper into debt paying for something they couldn't afford in the first place.

[rinsd]

3. Here's how Hillary's plan will assist those unable to afford insurance.

The American Health Choices Plan will make health insurance more affordable for the millions of
Americans who want it. It includes a number of straightforward policies to achieve this end:
1) Ensuring Premium Affordability Through Refundable Tax Credits: Premiums have
skyrocketed over the last several years – nearly double since 2000. The American Health
Choices Plan helps working families afford coverage through refundable, income-related
tax credits to ensure that accessible, high-quality health coverage is affordable to all.
2) Limiting Premium Payments to a Percentage of Income: This credit will ensure that
securing quality health care is never a crushing burden for any working family. This
guarantee will be achieved through a premium affordability tax credit that ensures that
health premiums never rise above a certain percentage of family income. The tax credit will
be indexed over time, and designed to maintain consumer price consciousness in
choosing health plans, even for those who reach the percentage of income limit.
3) Promoting Shared Responsibility for Large Employers: Hillary Clinton’s comprehensive
agenda to lower costs and improve quality will substantially lower costs for employers,
making it easier for all firms to continue coverage or offer new health benefits to their
workers. In return, large employers will be expected to provide health insurance to their
employees or make some contribution to the cost of coverage. This responsibility will take
into account firms’ size and average wages.
4) Creating Small Business Tax Credit: Small businesses are engines of job growth in our
economy. They account for 80 percent of net new jobs since 1990xvi and create jobs that
stay here in America. Yet, they also face the most acute challenges to providing health care
for their employees. Small businesses face higher premiums due to limited purchasing
power and tend to employ lower-income workers.xvii As a result, small employers cover far
fewer of their employees – and the proportion that offers coverage in the first place is less
than half that of large firms that offer health insurance. Coverage among small employers
is eroding. Since 2000, the share of these small firms offering coverage has fallen from 57
percent to 45 percent.xviii At a time when health care costs are increasingly undermining
the economic competitiveness of American business, Hillary Clinton’s plan seeks to make it
easier — not harder — for small businesses to create new jobs with health care for workers
here in the U.S. Specifically, small businesses that provide quality coverage (e.g., benefits
like what Members of Congress receive) and contribute most of the premiums for their
workers would qualify for a refundable tax credit. The tax credit could be structured as a
traditional policy (e.g., a credit equal to 50 percent of premiums for firms with fewer than
25 employees and less for medium-size employers). As President, Hillary Clinton would
work with the small business community and Congress to design the parameters of the
credit (e.g., protecting against subsidizing boutique high-income firms) as well as how the
credit might dovetail with the tax credit going to individuals and families to make
premiums affordable.
5) Strengthening Medicaid and the State Children’s Health Insurance Program to Serve
All Low-Income Individuals: These programs serve over 55 million Americans, and have
done so successfully through federal-state and private-public collaborations. The holes in
this safety net (e.g., lack of coverage of poor, childless adults) will be fixed to ensure that
the most vulnerable populations receive affordable, quality care. Similarly, the other part
of the safety net, like public hospitals and community health centers, will continue to
receive support to serve vulnerable populations.
6) Creating a Retiree Health Legacy Initiative: For major American employers with
workforces that face unusually high health care costs due to a high ratio of retirees, health
care costs can be a drag on competitiveness and job creation – particularly for our major
manufacturers. The American Health Choices Plan will provide a tax credit for qualifying
private and public retiree health plans to offset a significant portion of catastrophic
expenditures that exceed a certain threshold. Such reinsurance would be time-limited to
reflect the short-term demographic need of the aging baby boomers, and would be
devised in a manner that does not add to our long-term fiscal challenges. The policy will be
designed to make companies more competitive and assist workers – and not to take
pressure off the need for strong managerial leadership at the top. Participating companies
would also have to demonstrate that they are employing best health practices, including
chronic care management, information technology, and other modernization initiatives
that maximize value, quality, and accountability. Finally, employers will also have the
option of buying early retirees into the new Health Choices Menu.

http://www.hillaryclinton.com/feature/healthcareplan/americanhealthchoicesplan.pdf

[Barack_America]

6. I still don't see how people who are already falling behind can afford this...n/t

[OzarkDem]

9. If their income is low enough they will get Medicaid coverage

Otherwise they can buy into govt health care like Medicare and get a tax credit to help pay premiums.

[Armstead]

12. She's doing what she did last time

Making a "plan" that is so complicated and goes out of its way to protect private insurers.

A mandated plan that relies on private insurance is the worse of both worlds.

1)It stirs up the conservatives and others who oppose universal coverage because they see it as intrusive.

2)It leaves the insurance companies in the drivers seat, and thus forces people into their arms.

3)It scares and screws the working poor more than it helps. There are already subsidized plans for people on the bottom. But people on the margins fall through the cracks, or they are stigmatized by having to apply for poor people's insurance.

4)It doesn't alleviate the burden on employers.

Why not just start out by advocating for a clean clear universal single payer plan based on excpansion of Medicare?

[OzarkDem]

7. Clinton's plan has caps on premiums, public insurance option

no more than a percentage of an individual or family's income.

The also have the option of buying into a government health care plan, like Medicare.

[bernicewilliams]

8. the mandate issue is not a big deal n/t

[IndianaGreen]

10. Mandates have turned out to be dismal failures in every state they have been tried

but don't take my word for it.

FOR IMMEDIATE RELEASE
January 31, 2008
11:32 AM

CONTACT: Physicians for a National Health Program (PNHP)

California’s Health Reform Failed Because Mandates Are Fundamentally Flawed as a Model for Reform

CHICAGO - January 31 - While Governor Schwarzenegger’s health reform plan crashed and burned this week on the legislative highway, it confirmed once again that using mandates to achieve universal coverage is a failed model for reform.

The take home lesson: America’s health insurance industry is the problem. Any reform based on a prominent role for the industry precludes success, because the private health insurance industry is simply too bureaucartic and expensive. The administrative overhead in the current private system approaches 30%.

As the members of the California Senate also learned, it is financially impossible to expand coverage to the uninsured without also controlling costs. This means taking on the politically challenging task of ousting the insurance industry profiteers.

The failure of the mandate model in the six states that have tried it (and currently in Massachusetts) can be directly attributed to the private insurance industry. Each of these state reform efforts promised cost savings, but none included real cost controls. As the cost of health care soared, legislators backed off from enforcing the mandates or from financing new coverage for the poor. Just last month, Massachusetts projected that its costs for subsidized coverage may run $147 million over budget.

The “mandate model” for reform rests on political surrender: avoid challenging insurance firms’ stranglehold on health care while coercing the uninsured to purchase costly insufficient insurance policies. But it is economic nonsense. The reliance on private insurers makes universal coverage unaffordable.

It is ironic that what started out as a “politically feasible” alternative to the single payer bill SB 840 that was approved by both houses and then vetoed by the Governor turned out to have little political support when it came under scrutiny in the Senate.

It failed the “politically feasible” test because its supporters surrendered to the insurance industry in advance on cost control and then gave them a blank check in the form of millions of new customers.

State budget experts testified that the bill was fatally underfunded and could leave the state billions of dollars in the red. Having been down that road with the hastily enacted energy deregulation fiasco, proponents could only muster one yes vote out of eleven committee members.

The wisdom of the California Senate’s rejection of the mandate model of reform jumpstarts the national movement for an entirely achievable single payer medicare for all system.

http://www.commondreams.org/news2008/0131-04.htm