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

[IndianaGreen]

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

[panader0]

1. "Any reform based on a prominent role for the industry precludes

success." That's the core of it ti me. The greedy middlemen.

[IndianaGreen]

3. It is also the reason why single payer is the only way to go

As Edwards used to say, you can't have the health industry that has abused and exploited patients sit at the negotiating table. It would be like inviting the Mafia to sit down at the same table as law enforcement.

[papau]

2. In Mass 300,000 of 400,000 uninsured mandated are now covered with 50,000 getting a pass

because of income (subsidy available was not felt to be large enough to say purchase was reasonable - so no penalty) - remaining 50,000 include 11% over 80,000 a year that prefer tax payers to pay for emergency treatment.

Looks like 12% not covered. Estimate was 70% would not be covered if no mandate.

Mandates work.

But the good doctors are correct that a single payer would be much better.

IndianaGreen, you did notice that they also reject a no-mandate version - the Obama plan.

These folks want single payer and correctly see mandated coverage as a week substitute. But Obama's no mandate variation is still the worse version of this weak concept.