If Private Health insurance is so good - YOU WOULDN'T NEED A MANDATE TO FORCE US TO BUY THE CRAP!

[grahamhgreen]

[havocmom]

1. May we pinch that line for sig lines and bumper stickers?

:applause:

[grahamhgreen]

2. absolutely!

[midnight]

126. Yes..... Perfect.....

[LWolf]

3. This is so obvious, it shouldn't need to be pointed out.

But, since too many seem blind to the obvious, thanks.

:thumbsup: :thumbsup:

[rfranklin]

22. The mandate would be great if...there were a public option...

I think everyone can also visualize that there would be people who would not get insurance if it was out there for ten dollars a month. The problem is not that everyone is required to have health insurance. The problem is that there are no controls or competition for the private insurers.

[LWolf]

24. The real problem is that insurance is not the same thing as care.

I already have insurance and don't get care. That's because the money I pony up for premiums doesn't get me care. It gets me access to care, for further cost. This bill doesn't do away with deductibles and co-pays. Forcing everyone to purchase premiums doesn't get them care.

[L. Coyote]

38. That's like saying practicing medicine and making money are not the same thing.

Oh wait, there NOT! (in other countries).

[salguine]

78. I thought I was the only one on this entire forum who grasped that fact. Thanks LWolf.

[LWolf]

140. You're welcome, of course. nt

:hi:

[Mimosa]

99. ^ Great post above! ^

Same here:

"the money I pony up for premiums doesn't get me care. It gets me access to care, for further cost."

Often, too often, I cannot afford the deductibles.

[WillYourVoteBCounted]

88. Roads, Police, Schools not mandated.. HealthCare should be a right

Everyone should be able to show a card and go to the doctor.
There should be no ins premiums.

Tax payer dollars spent on war could be used for health care instead.

[AusDem]

98. its a very simplistic statement to just

agree with flat out. there are lots of things that are good for people that they will not do. Its good for people to eat healthy food, but not everyone does it do they?

while making people purchase a product from a private insurer is not great, at least it will be from a heavily regulated private insurer. Also, if people can't afford it, they will receive subsidies to help them with it. so the end result is:

a) the service that they are getting will improve from the total crap the insurers offer now (insurance regulation)
b) more people will be able to avail themselves of this service as it will become more affordable
c) the service will become more affordable for one of two reasons:
1. A larger pool of people will buy into plans, which in theory should reduce costs across the board
2. The government will provide subsidies for those who can't

So yeah, the individual mandate without a matching public option or medicare buy-in is crappy, but its an improvement on the status quo, which is majorly crappy. its not the kind of reform you can believe in, but its some progress.

While this is primarily health INSURANCE reform, I feel that there will be some health CARE impacts as well. The first thing is the large increase in community health centers (thank you Mr. Sanders), but I think that the sudden increase in the number of people with insurance will mean a much higher demand for health services that people could not afford before.

All of this is before you take any political considerations into the mix (which I wont go into, because everyone here im sure knows the stakes).

[eridani]

103. There is NO regulation whatsoever!

All of the bullshit citations that people always post when someone points this out HAVE BEEN TRIED at the state level, and have FAILED abysmally. You think that it will be better at the federal level because why?

[MajorChode]

136. Do you have relevant examples?

The states I have seen that have the greatest health insurance regulation also have the greatest percentage of insured. I live in Texas where 25% of residents are uninsured and health insurance regulation is the least. Massachusetts, which has some of the toughest regulation has about a 7% uninsured rate.

I'm not sure how that can be counted as an abysmal failure, but perhaps you're using different metrics.

[eridani]

181. Who gives a flying fuck about "coverage"?

Having Health Insurance Does Not Mean Having Health Care

Statement of Rachel Nardin, MD., President, Massachusetts Chapter of Physicians for a National Health Program, neurologist at Beth Israel Deaconess Medical Center in Boston, and assistant professor of neurology at Harvard

In April 2006, Massachusetts enacted a health care reform law with the stated goal of providing near-universal coverage of the Massachusetts population. Nearly three years into the reform we know a lot about what has worked and what hasn't. Examining this data critically is vitally important as the Obama administration considers elements of the Massachusetts' plan as a model for national health care reform.

On Feb. 19 we released a new study on the Massachusetts reform. This study details many problems with the reform effort. We are also releasing a letter from nearly 500 Massachusetts physicians to Senator Kennedy asking him not to push for a Massachusetts-style reform nationally. My colleagues and I see the effects of the Massachusetts reform on patients every day and know that this is not a healthy model for the nation.

The Massachusetts reform is an example of an “incremental” reform. It tried to fill in gaps in coverage, while leaving undisturbed existing public and private health insurance programs. It did this by expanding Medicaid, and offering a new subsidized coverage program for the poor and near-poor. It also mandated that middle-income uninsured people either purchase private insurance or pay a substantial fine ($1068 in 2009).

The reform has reduced the numbers of uninsured, although our report shows that the state's claim is untrue. This claim is based on a phone survey that reached few non-English speaking households and few who lacked landline phones—two groups with high rates of uninsurance. Other data also calls this claim into question. For instance, both the Massachusetts Department of Revenue and the March 2008 U.S. Census Bureau survey indicate that at least 5 percent of people in Massachusetts remain uninsured. Moreover, the use of free care services in Massachusetts has fallen by only a third, suggesting that the numbers of uninsured in Massachusetts may well be even higher than 5 percent.

Despite the reform, coverage remains unaffordable for many in our state. As a result, despite the threat of a fine, some residents remain uninsured. Others have bought the required insurance but are suffering financially. For a middle income, 56-year-old man, the cheapest policy available under the reform costs $4,872 annually in premiums alone. Moreover, it carries a $2,000 deductible and 20 percent co-payments after that, up to a maximum of $3000 annually. Buying such coverage means laying out nearly $7000 before expenses before the insurance pays a single medical bill. It is not surprising that many of the state's uninsured have declined such coverage.

The study we released on Feb. 19 also reminds us that having health insurance is not the same thing as having health care. Despite having coverage, many Massachusetts residents cannot afford care. In some cases, patients are actually worse off under the reform than they were under the state's old system of free care because their new insurance has far higher co-pays for medications and care. According to a recent Boston Globe/Blue Cross Foundation survey, 13% of people with insurance in our state were unable to pay for some health services that they had received and 13% could not afford to fill necessary prescriptions. The reform does not appear to have reduced the numbers of people who were unable to get care that they needed because of the cost.

I will close with the story of one Massachusetts patient who has suffered as a result of the reform. Kathryn is a young diabetic who needs twelve prescriptions a month to stay healthy. She told us “Under Free Care I saw doctors at Mass. General and Brigham and Women's hospital. I had no co-payments for medications, appointments, lab tests or hospitalization. Under my Commonwealth Care Plan my routine monthly medical costs include the $110 premium, $200 for medications, a $10 appointment with my primary care doctor, and $20 for a specialist appointment. That's $340 per month, provided I stay well.” Now that she's “insured,” Kathryn's medical expenses consume almost one-quarter of her take home pay, and she wonders whether she'll be able to continue taking her life saving medications.

[daleanime]

113. You forgot the #3 reason....

The insurance company are not feel like giving out multi-million dollar salaries or generating excess amounts of profit.



Honestly, insurance companies have been very reliable. :sarcasm:

[LWolf]

139. I don't see your end results.

a. Those of us who already pay for an insurance policy now who get no care because paying for the policy doesn't guarantee care...will still be paying for policies that don't guarantee care. We may pay MORE for that lack of care.

b. I'm still not seeing how service is more affordable. Have co-pays and deductibles been outlawed? If not, then service is not going to be more affordable.

c. I doubt that subsidies will be available to the so-called "middle class," some of whom already can't afford to use the health care they've got.

I've seen nothing to indicate that costs will be reduced across the board.

[Echo In Light]

186. +1

[Nite Owl]

4. But we have to save the insurance

industry. They would go broke without a mandate if they had to cover sick people.
That's what it is all about and Obama came out and said it. It's not about us, it's about and for them.

[Morning Dew]

23. If we don't save them, who will?

It's not like they can go global... no one else wants those greedy bastards.

[glitch]

65. And it's not like they can save themselves

by repentence, redemption and reformation.

[Frances]

5. Then we don't need to mandate car insurance

The reason we mandate car insurance is so that if your car hits my car, I don't have to pay for the damage.

The reason we should mandate health insurance is so that if you get sick, I, as a taxpayer, don't have to pay for your ER care.

[Kalun D]

10. Big Difference

you are being mandated to buy insurance from private corps who take 30 percent profit off the top

in the entire rest of the developed world it's true non profit

you as a tax payer are paying for the health care of those who can't afford it, either way

the difference is do you want to pay a 30 percent profit to greed pigs or not?

[havocmom]

12. Nobody says you have to have a car. Health Insurance? Yeah, if you live

Not quite the same mandate now is it?

[Donnachaidh]

14. this talking point has been dispelled what, 10 thousand times?

But hey, when you've got nothing, roll out the old shit.....:eyes:

[rapturedbyrobots]

19. tired of this analogy

it is stupid

car insurance is only 'mandated' if you own or drive a car. you can choose not to do those things. so it isn't really a mandate.

[TorchTheWitch]

102. No, it's only if you OWN a car

Car DRIVERS don't have to have insurance - only car OWNERS do. Plenty of people drive and don't own the vehicles they drive. And it's only liability insurance - it doesn't cover the owner or the driver, it covers the people and property that the insured vehicle damages.

[grahamhgreen]

25. But, really, if private insurance was a good deal - everone would have bought it already - it's a

scam system that tries NOT to cover you when you go to the ER.

[grahamhgreen]

26. Also, if you go to ER - THEY STILL SEND YOU A BILL! It is only if you are truly indigent that you do

not pay.

And the truly indigent - WILL STILL NOT BE PAYING UNDER THIS BILL.

The middle class will still have to pay the subsidies, unless you go with the house bill which taxed the uber-rich, instead of the union HC plans.

[Lerkfish]

28. you can choose not to drive: you can't choose not to have a body.

you can't using public body transport or walk without legs or borrow your friend's heart and lungs.

[bvar22]

30. You are mandated to buy "Liability" Car Insurance to Protect Others...

...from your carelessness if you choose to use the Public Roads.

Not the same thing at all.

[Balbus]

34. Think before you post, please.

[girl gone mad]

66. You pay ER costs for insured people, too.

Hate to break it to you, but plenty of people with insurance still go bankrupt and/or have their claims denied.

Plenty of uninsured people pay their bills in full or get care outside of the system.

As a taxpayer, you will still be covering ER costs because of the subsidies and because many people will still choose to pay the smaller fines.

[rhett o rick]

80. The car insurance you are mandated is liability. So you can pay for the damage you do.

There is no equivalent health insurance to liability insurance.

[Occulus]

85. But we DON'T have a mandate to buy car insurance, EVEN IF you own a car.

You can provide a "surety" (at least here in MI) in lieu of insurance.

It's a false equivalency. Period.

[grahamhgreen]

179. Very good point!

[WillYourVoteBCounted]

87. car insurance doesn't pay for maintenance, prevention, diagnostics, or treatment

its inappropriate for our health care to depend on the whims of INS CO CEOS.

[liberation]

89. Wow... hold it there with them false dichotomies.

Driving is a privilege, not a right. And the action of driving is a voluntary one. So it makes sense private insurers take care of individual choices not considered a right.

Living however, is a right, not a privilege. Because, honestly, the conclusion one can draw from following your "logic" to its ultimate consequences, is that you consider life a privilege not a right... and is a rather sick position. Sorry.

Speaking of taxes, what about some of us who oppose this insane war and bailing out of Wall street? How come we still have to pick up the tab of stuff we're opposed to? Seems some of you are rather "selective" with your tax "concerns."

[pecwae]

105. Oh dear.

[Greyhound]

161. No we don't, you're right on that. Of course, just like we're going to see over the next few years,

the auto insurance industry wouldn't allow the people of California to get out from under their scam either.

They literally sued the state until the state could no longer afford to keep the trials going.

This is the industry that you advocate?

[Citizen Kang]

164. Thats the weakest arugement out there

Driving is a privilege, not a right. You need a license, you need to be able to afford a car, you need education to drive one.

Being alive on the other hand is a right. And being forced to buy a worthless product from these blood suckers simply because I exist, is unconstitutional.

[The Gunslinger]

6. Plain and simple +1

[stray cat]

7. its always easier to let someone else pay your bills - who volunteers to pay if they don't have to?

not if you can get some other sucker to buy it for you

[amborin]

13. the mandate cures the free rider issue; but is unfair w/o robust PO

[liberation]

90. Well, someone took the wrong turn on their way to the libertarian meetup....

[varelse]

8. Yep

it really is that simple.

[Commie Pinko Dirtbag]

9. From what I see here, the reason it's bad isn't the mandate.

It's the fact the system remains in the hands of protection rackets private insurers with little oversight.

[tridim]

15. "little oversight" is what we have today.

Starting Monday that all changes.

[enlightenment]

41. I don't suppose you've got any details on that?

What sort of oversight? How effective? Does it have any teeth?

[tridim]

43. If you haven't read the bill by now, there's really no hope for you.

All I can suggest is that you do so.

I'm not going to summarize the bill again for you or anyone else, it's been done hundreds of times already just on DU.

[leeroysphitz]

63. In other words it has no teeth. The few provisions that even come close to qualifying

As effective regulation are really just for show since many of them actually expire months aftergoing into effect.

[enlightenment]

70. You're a real piece of work, you know?

I don't want a summary - you've done that enough, using other peoples' efforts, generally. I wanted to see if you could actually cite something from the bill, which you obviously cannot do.

I've read it. I doubt very, very much that you have. You run from direct questions like your pants were on fire.

That makes your opinions worthless.

[eridani]

104. Every bullshit "oversight" method cited has been tried at the state level

Results? Total and complete failure.

[truedelphi]

75. Don't worry - be happy.

It is sure to be "fixed" real soon.

<sarcasm meant here>

[obxhead]

138. Most of the protection rackets will actually protect the businesses

they mandate to pay them. The insurance industry will not provide the same level of service once these mandates kick in.

[Donnachaidh]

11. Now don't you DARE piss in the punchbowl with LOGIC dude!

Koolaid's fine without it! :rofl:

[bamacrat]

16. That is true to an extent. Some people especially young bullet-proof people.....

don't think they need insurance because they don't get sick and they lack the foresight to realize something catastrophic may happen. Then they wind up in the ER.

[Bluenorthwest]

17. Candidate Obama made that exact point many times

Back when he opposed and mocked mandates. Back then, he said if it was affordable and had good benefits people would buy it without mandates. He ran commercials painting Clinton's support of mandates as a desire to reach into your bank account and take your money.
At least he was right before he was wrong.

[readmoreoften]

60. Oh that Candidate Obama truly was a man of the people. President Obama? Man of the Banks.

Best. Bait-and-Switch. Ever.

[salguine]

79. When I say stuff like that, my posts get deleted.

[Lorien]

157. You and me both.

[Beaverhausen]

18. You do know the mandate kicks in in 2014, when the large public "pool" also kicks in, right?

[robinblue]

21. and when pre-existing conditions kicks in for adults.

[enlightenment]

35. What large public 'pool'?

Citation, please.

[Greyhound]

163. The one they intent to drown sick people in once the insurance industry has performed

it's radical assetectomy.

[OmmmSweetOmmm]

123. and it kicks in after the 2012 election.

[CornerBar]

20. So obvious isn't it?

K&R

[frazzled]

27. If it were so bad, you would see the 80% of Americans who get it through their ...

employers electing not to take it. You don't see that, do you?

Poll after poll shows that most people are pretty happy with their insurance. It's mostly the people who have been kicked off it or denied it for a pre-existing condition or who have reached annual or lifetime caps who are angry. And this bill will prohibit all that.

[grahamhgreen]

29. You're making my point - if it's good, you do not need to force it on people.

[frazzled]

45. I used to think that

But over the last year, just seeing the many posts here from people who don't WANT to get insurance (for any number of reasons: claims they can't afford it, without taking subsidies into consideration; saying they don't want to get it from a corporation; or just plain thinking they don't need it), I've changed my mind.

We've always scraped together the money for health insurance and medical bills. Thank goodness we've never had anything too serious. (Though there were two hospital deliveries, the occasional $1,000 flu where the pediatrician insisted we take one or the other kid to the emergency room for alarming symptoms, and the time my husband ended up in ICU for a few days after a bicycling accident; other than that, pretty standard stuff). Paying the health insurance was always like a fact of life for us: like paying the electric or heating bill. I'd give up cable and cell phone before I stinted on insurance. But that doesn't seem to be the case for everyone. If car insurance weren't mandated, we'd have a whole lot of people who didn't buy that either (thinking they'd never had an accident yet). No, along with Obama, I've changed my mind: you have to make it the law. We are paying too much for the uninsured ... and they are risking their futures.

[eridani]

106. That's because what people know about their insurance is what they know about--

--their fire extinguishers. That is to say 100% total and complete ignorance. Medical bankruptcies are experienced by people who thought they had insurance.

[Codeine]

31. Mandates are what make the system fair for once.

Young, healthy folks will pay into the risk pool rather than opting out, making it financially sustainable. Everyone has to care the burden together.

[grahamhgreen]

36. Not true - the CEO's will simply pocket the windfall. Or are they motivated by altruism?

There is no reason for them put the money into the risk pool at all when they can just use creative accounting techniques to squirrel it away in offshore accounts.

Please don't tell me they would never do that - that is exactly how they have set a pattern and practice of corrupt behavior.

[Hansel]

58. There is no windfall. They are restricted as to what percentage

has to be used for paying for health care. Right now they are grabbing between 25 and 30 percent in profits and overhead. This bill mandates that they pay at least 85% of the premiums they bring in on health care bills for those covered by the policy.

So they won't be bringing in windfalls just by adding on 31 million people. They will be paying more out in claims, especially when they are required to pay for procedures that have been rejecting so far as too expensive and are forced to insure the sick. Although I haven't read every single detail in the bill, my understanding is that if they pay out less than that 85% thresh-hold the rest has to be refunded to whomever paid the premiums.

There are certain rules and regulations they have to follow in order to be a part of the exchange and they will follow them because they are not going to pick up a lot of clients outside of the exchange. I think the thresh-hold should be 90% and not 85, but that was a compromise made by some of the senators who are in bed with the insurance companies. It's still better than it is now.

It's not perfect because I don't think health care should be a for profit business and I don't believe they should be on the stock exchange at all.

[grahamhgreen]

73. What are the penalties for non-compliance?

Does anyone go to jail?

Do the fines exceed the profits?

Can the company lose it's charte and be pulled from the exchange?

Who audits the money flow? Remember we are talking trillions.

I think they will easily be able to use creative accounting techniques to squirrel away the cash.

I hope you're right, but I doubt there will be any effective oversight.

[eridani]

108. Those supposed stupid "regulations" have already been tried at the state level

15 states have tried regulating MLRs. Result? Total and complete failure.

[Nite Owl]

39. Fair for who?

The CEO's yeah, it does that. For us not so much. Without the mandate they would collapse, they need this bill to survive. No mandate would let capitalism do the work.

[eridani]

107. Mandates are fucking fascist bullshit

I want those useless shitstains LIQUIDATED, permanently. Corporate insurance is evil, vile and worthless, and I don't want it. I want to pay a tax in return for which I am guaranteed to get access to CARE.

[stillwaiting]

32. Failure to include the public option now means they get to do it in 20 years time.

They'll pass a MASSIVELY watered down public option in a decade or two that will allow the sickest patients off of the private insurance companies rolls. They'll transfer the costs associated with the sickest amongst us to the taxpayer and their profits will go up even more.

BIG win for the status quo in our for-profit, vampiric health "care" system.

I really doubt that I will see a system that is truly universal, fair, and just in my lifetime.

I can't believe they are going to get away with this mandate without a public option or pretty much any legitimate rate increase controls.

[nightrain]

33. knr. Nor subsidies to grease the pain of the rectal exam.

[grahamhgreen]

37. K&Y for humor!

[gulliver]

40. If cigarettes were so bad, no one would smoke.

If there were no mandate, many people would cheat and continue to choose the old "free option" of going to the emergency room and letting the rest of the public pay the bill. That would drag the system down with high cost and increase patient risk. For example, kids might have parents who would not get them insurance, either through negligence or in an unquestionably immoral attempt to gamble. Adults might choose to gamble with their own health by staying uninsured, knowing that they won't be allowed to die when they get sick.

We don't need these games. Just going to the emergency room under the current U.S. system is one thing. That is unavoidable for a lot of people. But once there is a good system in place, it should be used.

[eridani]

109. We don't need vile amoral profit-seekers as gatekeepers of our health care

Fuck insurance. We need CARE.

[ProSense]

42. Single payer systems are based on mandates. Why?

Mandatory Insurance Enrollment
Single-payer insurance systems in industrial countries typically have mandatory enrollment that include the entire population. Low- and middle-income countries, with a higher share of rural and agricultural workers and other workers outside the formal economy, may have difficulty assuring compliance with an insurance mandate for the entire population.

Adverse Selection
Adverse selection presents a long-term threat to the viability of microinsurance pools and any other multiple-payer insurance system without adequate safeguards. The health insurance system presents low- and middle-income countries with a difficult dilemma. There are two feasibility concerns to balance: insufficient financial and administrative capacity to establish a single insurance pool, and adverse selection concerns with multiple insurance pools. One general compromise that has been advanced is the formation of multiple insurance pools with an eye toward building the capacity needed for a future single-payer system (WHO 2000). For example, an insurance pool covering only public sector employees could later be expanded to include the entire population. This, however, could encounter practical difficulties. For example, the public sector benefits may have to be reduced in the future to make health insurance affordable for the entire population.

PDF

[Raineyb]

48. Single payer systems are funded by TAXES which everyone pays in proportion to what they make

And the insurance covers EVERYBODY regardless of present, future, or past conditions.

That is NOT what this bill does and you goddamn know it.

Do you EVER post anything that is true?

[grahamhgreen]

50. Thank you!

[ProSense]

53. Are the taxes mandatory?

Do you know what the hell you're talking about?

[Raineyb]

54. I know what the hell I'm talking about. Do you?

Taxes are compulsory in any society. And I might add, the countries with a single payers system leaves more disposable income for their citizens to spend elsewhere because they're not taking after tax income and forking it over to for profit insurance companies which is what the bill in question does. They are NOT the same thing by any stretch and for you to try to equate the two means that either you're a bloody idiot and you don't know what the fuck you're talking about or you're being disingenuous and are spinning like a top.

Either way what you've posted is pure bullshit.

[ProSense]

55. "Taxes are compulsory "

You mean mandatory?

A mandate is a mandate.

[Raineyb]

71. Taxes are not the same as compulsory payments to a for profit private company

And you goddamn know that. And if you don't you're a fucking moron in which case this conversation is done.

[SandWalker1984]

133. Many countries actually make insurance companies NOT FOR PROFIT

Many countries that have universal coverage still have insurance companies in place -- but the insurance companies are highly regulated and are not allowed to make profits.

Health insurance mandates is not the health care reform that Orahama promised us.

Right now, our health care costs twice as much as Canada's does, threre times as much as France's and nearly 4 times as much as Great Britain's. Some estimates are saying that this Senate bill will add another trillion dollars to our nation's health care costs. The business owners & politicians are always justifying moving our jobs to other countries to stay "globally competitive" and one of the reasons they give is cost of health care here. How is making our health care costs higher (as the bill does not address cost reductions) going to make our businesses more competitive globally?

This corporate welfare bill that the House is about to pass is about to make history, but not in a good way. It's about to make every American enslaved to a corporate group. You have no other option but to buy their product or pay fines. If you refuse to pay in protest you can go to jail. It is also the beginning of privatization of Medicare -- a huge goal of insurance.

The socialization racket of privatization marches on.

[grahamhgreen]

49. The senate bill is not a single payer system, and we are disallowed from buying into Medicare

With a private mandate , the money will fund corporate jets and gold plated china.

You statement fails to address the central tenent of my argument.

[eridani]

110. Single payer mandates are paying a tax for a service

Mandates to be customers of bloodsuckers who sell shitty products is fascism.

[GreenArrow]

44. Because you are, at the most basic level,

a consumer, not a citizen, so the bill must be oriented around that reality.

[gravity]

46. 85% of the population has insurance without a mandate

and I bet more people would buy it if it was more affordable. Most Americans want insurance, they just want it to be more affordable and more secure.

The mandate is really there to stop people taking advantage of the pre-existing condition clause.

[Vinca]

47. Actually, 50% of the population is covered by government-sponsored

programs so 85% do not have private insurance. The right wing talking point is 85% of all Americans are happy with their insurance. So if 50% have government coverage and 15% have no coverage, that leaves 35% of which 85% are, according to them, happy.

[ProSense]

51. Nonsense.

Government programs directly cover 27.8% of the population

[Vinca]

56. That's Medicare and Medicaid. Also included under "government"

health care is active and retired military services.

[Hansel]

59. And indigents who are not on Medicaid who are treated in ERs. nt

[Skittles]

82. and a great many of them are "happy" because

they've never REALLY had to USE it

[grahamhgreen]

52. No, the mandate is there to funnel trillions to big insurance. We can pass a PRE-existing

Condition clause with no mandate.

if we find it unfair - WE CAN FIX IT LATER!

[MajorChode]

57. I'm going to go against the grain

First, I don't understand this logic at all. Would the alternative you're suggesting be a 100% public health insurance? If so, how would that NOT be mandated as well vis a vis tax dollars and universal coverage?

I'm not saying I'm a big fan of private insurance, but your post displays a fundamental misunderstanding of how any insurance (public or private) works. The more people you have in the insurance pool, the cheaper it is to cover everyone. Insurance works because the majority of the insured are paying more than they are collecting. There's no other way it can work whether you're talking about a public or private plan. As it's optional now, those who are young and healthy opt out while those who are older and/or less healthy can't buy a non-group plan that's worth anything. That's why insurance is broke and will remain broke for millions of Americans unless progressive changes are made.

Now certainly I'd rather see a 100% public single-payer system as would many here, but the fact is that millions of Americans have private group insurance plans they are quite happy with. The reason is because they are part of a group that is large enough to offer them lower premiums. That's why you have millions of tea baggers who have absolutely no concept or care of the moral hazard they choose to perpetuate.

[eridani]

111. Happy = being a complete fucking ignoramus who has never actually USED

--her/his insurance.

[MajorChode]

119. or needed it

[eridani]

182. 85% of the population will never be expensively sick

5% of the population accounts for half of all costs, and 15% accounts for 85% of costs. The 85% mostly healthy majority accounts for 15% of costs.

[grahamhgreen]

146. A mandate and a tax are two different things.

First of all, what I see your saying is that the reason private insurance does not work is that people are not mandated to buy it, if they were mandated, it would bring down cost.

I just don't see this as a logical progression.

As the pattern and practice has shown - the CEO's will simply use creative accounting techniques to squirrel away the money regardless of regulatins.

The other logical issue I have is that there are many reason that private insurance is failing (mostly greed by the CEO's and boards, IMHO), to say that they are failing and the mandate alone will save them is taking a leap of faith and failing to address their central problem - that they operate on a for profit basis.

ANY business could claim that they would be in better shape is we were forced to buy their product!

Also (re-posting this):

Single-Payer is paid through taxes and guarantees care, not mandates to private companies that deny

claims to increase profits so that their CEO's can eat off gold-plated china and fly to DC to lobby our congress in private jets.

Note that taxes go directly to the government from where the funds are dispersed, as opposed to a mandate where you are forced to give the funds directly to the private company, thereby removing the funding mechanism from oversight government entity.

By having the money go into a central government pool, the funds can be with-held in the case of a crapsurance companies failure to deliver care or any other violation. Companies running scams can be eliminated. ie - the people have more control in a system, the funds are dispersed form a central authority with oversight.

No - the mandate is not a tax, and does not guarantee care either universally for all Americans, or individually if the company decides to dump you.

mandate
n. 1) any mandatory order or requirement under statute, regulation, or by a public agency. 2) order of an appeals court to a lower court (usually the original trial court in the case) to comply with an appeals court's ruling, such as holding a new trial, dismissing the case or releasing a prisoner whose conviction has been overturned. 3) same as the writ of mandamus, which orders a public official or public body to comply with the law.

tax
n. a governmental assessment (charge) upon property value, transactions (transfers and sales), licenses granting a right and/or income. These include federal and state income taxes, county and city taxes on real property, state and/or local sales tax based on a percentage of each retail transaction, duties on imports from foreign countries, business licenses, federal tax (and some states' taxes) on the estates of persons who have died, taxes on large gifts and a state "use" tax in lieu of sales tax imposed on certain goods bought outside of the state.

[MajorChode]

162. True. Taxes actually have stronger mandates than the proposed premiums...

as jail time actually can result from the refusal to pay taxes, but that's beside the point I was making.

I'm not saying that's the only reason why private insurance doesn't work. I'm saying that's why it doesn't work for everyone. Private insurance does work in some instances, and there's plenty of examples of this. The reason why it works is because the insurance pool is sufficiently large enough.

You want to get hung up on semantics and I'm just explaining the financial aspects. All insurance works because you spread the risk out among a group of people. The bigger the group, the lower average risk to the individual. This is actuary theory at its most basic. The single-payer definition you offered (which is not exactly correct) still mandates that people join the group whether they want to or not. If the reasoning of your original statement were sound, one could just as easily substitute the word "PUBLIC" for "PRIVATE" and many have already done so. I would take issue with that just as strongly.

[leeroysphitz]

61. Kick for great justice. n/t

[Motown_Johnny]

62. if seatbelts saved lives YOU WOULDN"T NEED TO TICKET US TO WEAR THEM

[havocmom]

64. Lots (if not most) of us wore seat belts as soon as they were put in cars

and long before it became an offense to go beltless.

[SemiCharmedQuark]

67. Most people already have insurance.

:shrug:

[liberation]

91. Please tell me I missed the sarcasm...

[Lorien]

158. You've never paid for your own basic insurance plan, have you?

I can assure you; it won't save lives because those plans fight EVERY claim that filed!

[Maraya1969]

68. It is so you don't become a financial burden to the country by using the emergency

room as your doctor. And to stop the government from having to pick up the bill if you end up in the ICU and then need serious and expensive care.

It is not all about you.

[grahamhgreen]

74. This is a straw man - you always get the bill if you go to the ER.

You only don't pay if you are indigent.

We will still be paying tax dollars for idigent care under this plan.

[Maraya1969]

76. The mandated insurance will cover the price of the indigent. It is cheaper

for the government to subsidize the indigence's insurance than for the government to pay directly for every visit to the emergency room for routine illnesses and procedures. It is also better provide tests so that illness can be cause and stemmed off. Like a simple blood pressure test. It is better to give everyone these tests and treat all the high blood cases with a pill than it is for someone to have a heart attack and and up in ICU for days.

[liberation]

95. But you know what is better...

... to actually provide a justification for your claims. And no, your personal opinion does not count as a fact. Sorry.

For example, since when has it been "cheaper" to add a middle man to any transaction you can do directly?

Let me paint a simple picture:

Single-payer: Government gives $$ ---> Drs Office/Hospital/Clinic get $$

Stupid dumbass subsidized system: Government gives $$$ ---> Private Health insurance takes $ just for the fuck of it ----> Drs. Office/Hospital/Clinic get $$


In order for your claim to be true: the government has to give out less $$$, which mean the health care professionals get less money since the private insurance companies take their fee from an already reduced payment. So it basically shafts the medical professional, while the only value added it provides is allow a few parasitic insurance companies to exist just to be a middle man between public funds and the medical professionals/institutions actually providing the care.


Good grief, is that so freaking hard to comprehend? Is common sense such a foreign concept to large portions of our population?

[liberation]

92. You are right, it is not about us... it is about you.

How nice of you...

[LibDemAlways]

69. Can anyone think of another instance of the US government

mandating that citizens buy the product of a private corporation under penalty of law? (Don't mention car insurance - apples and oranges) Have any of the proponents of this bill bothered to stop and think about what the reaction of the American public is going to be when they find out their bank accounts will be drained by the likes of Cigna and there isn't anything they can do about it except pay a yearly fine for failure to comply? I think this is going to piss people off - and not just "tea bagger whack-os." I'm talking about ordinary people who don't pay much attention to politics but who are aware that the Dems are working on health care "reform." This sure as hell isn't what they voted for, and those on this site who are cheerleading for this POS are going to be in for a rude awakening when Obama and the Congressional Dems' approval ratings go into the toilet - helped by the R's, who will waste no opportunity to point out who did this to them.

It's not that the bill doesn't attempt to do some good. But it doesn't do what people were promised by Obama - provide affordable health care and a robust public option. What it does is make a bunch of insurance company crooks even richer. Sorry to rain on the parade of a lot of people here who think this is some kind of great achievement. It's a piss poor excuse for "health care reform" and the Dems will pay a hefty price for the broken promises.

[truedelphi]

77. The only instance I can think of is that back in the days of the draft

You had to eat the C rations provided, and use the crap equipment, regardless if you'd lose your life because of inadequate equipment.

But of course, you weren't really "buying" anything - you were being forced to fight in a war, whether or not you wanted to. People who were drafted were actually indentured servants.

And now we have whole new class - indentured consumers.

[liberation]

96. The main problem with the mandate, it is that it implies that lack of health coverage is a choice

and that is a very dangerous implication for a government to make about its citizens. If the mandate does not include a public option, it will in no other terms send a very powerful signal regarding the corporatization of our government. That is a very dangerous path, when a government sees its role as a mere arbitrer between corporations, rather than the representative and enabler of its citizens. And that reeks of corporatism, which we all know what that is Italian for...

In the best of cases, it also means that the government thinks people go sans health coverage as a pure personal choice, when it is purely an economic one forced on our citizens. That means that DC is so utterly and embarrassingly so out of touch with the reality of its citizens. That we can make a very good case for wether or not the average American citizen is being taxed without representation.


In other words, it is not good under any intellectually honest analysis.

[LibDemAlways]

115. Not for the benefit of the people, for certain. And, more than likely,

unconstitutional. Of course the current SCOTUS considers corporations to be persons, so it's not a slam dunk that that provision would be struck down. It will be interesting to see how this plays out, but you're right. Many citizens will be no closer to having health care coverage than they did before, only now they'll be forced to pay a fine for their inability to pony up.

[Nay]

122. You got it, Lib. Once the financial effects are felt and the coverage

STILL sucks, and the ins companies still act like Hitler, the shit will indeed hit the fan. And that will be that.

[New Dawn]

72. K&R - FUCK the Fascist "Individual Mandate"!

[Skittles]

81. this so-called "reform" is utter garbage

[johnaries]

83. Yes, you would. Even if the PO was available some people

wouldn't buy it.

Even if we had single-payer that was paid for with taxes, many people would complain about paying those taxes.

Anyone who would make a statement like this obviously doesn't understand human nature very well.

[SlipperySlope]

84. Unfortunately, it is our party that will be forcing us to buy the crap.

Where are the good guys? How did this reform go so terribly astray? Is this what we wanted or expected?

[Richard Steele]

86. K&R

[depakid]

93. Actually you would, because the young and healthy wouldn't buy into the system otherwise

the trouble is that it's being done inefficiently, without appropriate cost controls or public competition and without effective regulation or individual remedies for insurer abuses.

[bos1]

94. You are spreading ignorance. The mandate comes with measures to make it affordable.

It wasn't affordable before. New regulations and measures in the HCR aim to make it affordable now. If under the new regulations, a person still can't afford it, there are subsidies and other measures to make it possible. That's the difference.

[icee]

100. And in your mind you actually think these alternative methods

will work? You apparently live in a different world than I.

[bos1]

121. "in your mind"? This isn't subjective. What evidence do you have that they won't work?

again, it just sounds like ignorance of the bill and its measures.

[icee]

124. The subsidies are supposed to be administered by CHIP,

Medicaid, or a new administrative functionary that will be formed. All of these are government or proposed government entities. Medicaid is already not being accepted by certain physicians and pharmacies. This will spread almost immediately. So where in line will the people who need subsidies have to wait?

[bos1]

127. I will be under the mandate, most likely. And I approve because

the mandate is being phased in. The fine for not complying is negligible at first. In the meantime, we have time to find our subsidies, the gov't has time to fill any holes in the system for those of us who are having trouble finding insurance to fulfil the mandate.

I most likely will be one of those who will have to follow the mandate, and everything I see says this bill will make it much more affordable to do so than now.

[icee]

135. Look for billing from the IRS if you don't pay.

[bos1]

141. Yes, it is very small fine.

It will be phased in under this good plan

[icee]

142. Okay, bos1. Let's see who ends up right. Ridiculous to argue

about it.

[bos1]

143. According to the text of the bill, it is a small fine that gradually increases year by year.

During with time, according to the plan, the options will improve as various measures take effect (like the provision for increased competition among the insurance companies) so that it is affordable for everyone. Like car insurance is mandatory in many states.

[icee]

155. Whenever the government tries to solve any problem, they will

always create at least five more problems of equal or greater magnitude.

[bos1]

170. That's quite a sweeping generalization, not true. Plenty of public measures are very successful

all thru history. This sounds like the Libertarian argument, which I find to be Utopian and unproven. There are no model Libertarian societies, and in fact, plenty of examples of less government being a disaster. Brazil, for example. Something inbetween is the best.

[eridani]

112. Make it affordable by fucking over the non-poor non-rich.

Thanks for nothing. Who do you think is paying the taxes for the subsidies for worthless garbage "coverage."?

[bos1]

120. 1. Are you anti-tax? Like Repubs or something? 2. who says the coverage is garbage? cite or desist

[eridani]

183. No. I will cheerfully pay taxes for government funded CARE

The notion of paying taxes to support mass murdering unnecessary intermediaries makes me want to vomit.

[Mithreal]

149. Subsidize the profits of greed care and make pisspoor care more affordable for some. Yay, team.

Gotta love the tiers and class based care.

[earth mom]

97. Word.

:thumbsup:

:applause:

[icee]

101. If you are including affordability in "good" then I would agree with

you; if not, I would not. People have to be mandated to buy it because they do not want to spend the money on it. They would rather eat meat a couple of times a week, or maybe buy Billy a new bike. This is the reason for the mandates. But, you are right about health care being crap. It is so bad that that my wife and I who are covered by insurance go to our doctor simply for presriptions and to have a doctor of record should we need advance medical care. If we get sick, we pull money out of savings and visit a real doctor. Our insurance doctor(s) almost killed my wife twice, and me once. Sometimes I have to fill medical forms myself that the doctor should be filling out to get certain meds paid for by the insurance company because the doctor's staff is not trained in filling them out. Some have trouble even writing English. So, anyway, you are right generally, but madates were created because of the money issue, not the quality one.

[NorthCarolina]

114. Didn't some Presidential candidate campaign AGAINST a public mandate in the primaries?

I think that same person also campaigned in favor of a public option. :think: In retrospect, we probably should have elected that candidate.

[Mithreal]

166. And I thought the years of irony were over.

[SlingBlade]

116. Its a Trillion Dollar Giveaway and a Party Killer

Guess who wins in the end ?

[uponit7771]

117. Good point

[Turbineguy]

118. It's the old insurance problem

Healthy people have to participate in the pool. That's what keeps the system running.

Because indigents use the emergency room for primary care, the costs to those who have insurance or pay is high. This is a case where all costs are born by sick people only. If you added healthy people to the system who pay but do not use the emergency room, the costs per person drop.

If you add to that a drop in emergency room visits because you provide health care, the overall costs drop as well.

In the short run health costs will rise because of the pent-up demand for care by those newly brought into the system. The repubs will not wait for those costs to go down before criticizing.

I think that passing the bill in spite of its obvious flaws puts us in a position to correct those flaws. A position we would otherwise not be in. Private insurance companies will be raking us over the coals in the short term and paying the price in regulation down the road.

The repubs consider health care as a cost without benefits other than profits. The civilized world considers a healthy population a good investment.

[berni_mccoy]

125. Millions can't buy it (PEC)

[bos1]

128. I will be under the mandate and I am glad.

This bill will make the insurance I am mandated to have be more affordable and more secure (no more pre-existing conditions worries or getting dumped when you get sick). I am glad.

[SandWalker1984]

134. You will pay 3 times as much for your insurance if you have a pre-existing condition

Being allowed to buy insurance and being able to PAY for the insurance are not the same thing.


From what I've read, the subsidies will not be more for those with pre-existing conditions OR over age 50 (who can also be charged 3x more), so you may not be able to afford a comprehensive insurance policy even with the subsidies. So, your option will be a very high deductible, almost useless policy. DON'T THINK THAT IS BY ACCIDENT. The insurance corporations don't want you. You're not a big enough profit margin for them.


THIS BILL IS ABOUT MANDATING PROFITS FOR THE INSURANCE CORPORATIONS, NOT QUALITY HEALTH CARE REFORM.

[AllyCat]

129. Well said! nt

[jpak]

130. We need a mandate so I won't have to PAY FOR HEALTH CARE that people should be buying themselves

yup

[jeff47]

131. Why a mandate is necessary:

Because if there was no mandate, there would be no healthy people buying insurance. The elimination of 'pre-existing conditions' means that we'd all just buy our insurance when we got to the hospital, and cancel it when we recovered.

Health insurance only works when healthy people are buying it too. Otherwise there's no cost sharing and no longer a reason to buy it.

So if we're going to have this Rube Goldberg bill that attempts to save the private insurance industry, it's going to have to have a mandate to have any prayer of working. Other countries that have gone down this route (ex. Switzerland) ended up with very heavy regulations in order to keep the insurance companies in check, and I suspect we'll blunder into that ourselves if we continue down the private insurance path. Much like mandated auto insurance resulted in heavier insurance regulations.

Is there something better? Sure. Medicare buy-in would keep the private insurers "honest". However, a far better system is using taxes to pay for single-payer. The cost of health insurance goes down the larger the pool of people insured. "Everyone in the US" is the largest possible pool.

[Mithreal]

152. unpersuasive hybrid argument, are you undecided?

Neither party is big into regulating or hadn't you noticed?

[jeff47]

184. It should be clear

It should be clear that I believe in single payer. Of course, that has a mandate too, in that you have to pay taxes.

My post only explained why the mandate was not pure, unadulterated evil.

As for regulation, it'll happen if the insurance companies abuse their position too much. Every time they release their annual profits and executive bonuses, they'll be making it that much easier to do.

[Mithreal]

132. Tax the poor and homeless out of existence too.

We regret they can sacrifice only one lifetime to the fabulously wealthy and the New Democratic Party.

[grantcart]

137. again showing an ignorance of the mandate that is spectacular

Following the same line of logic then single payers systems, in which every single system has a universal mandate, would also not need mandates.


Oh yeah I forgot to capitalize to show my uninformed indignation.

[Mithreal]

144. Or you have a losing argument. grantcart, for someone who seems to have it so together

you sure seem tone deaf on this one.

You are being disingenuous. If there was a SP or comprehensive quality PO type being offered, mandating some sort of healthcare tax would be more palatable.

People are not being offered anything close to "single payers systems" and you know it. Should I now consider you one of the propagandists? I will listen to what you have to say with an open mind because I usually appreciate the quality of your contributions but on this you are doing a disservice to this community. I can be persuaded I am wrong from time to time, but on this mandate, no. Admit that this is wrong. Obama did during the campaign. Or, is it a Party and President first thing? You buy into that whole Waterloo idea too, don'tcha? Just asking.

[grantcart]

154. You can continue to be outraged or you can learn something

The mandate is linked to removing the prohibition against pre-existing conditions.

This is 101 economics and is called "regulatory adverse selection". If you mandate that insurance companies must take everyone you must also mandate that everyone have insurance.

If you are against mandates then fine you support a private system that can pick and choose their clients.

If you are against the plan proposed (that now has the support of Sanders, Kucinich and every other progressive including Michael Moore) that too is fine.


But uninformed angry rants against the mandate are simply ignorant.

Here is the wikipedia article on 'adverse selection'

http://en.wikipedia.org/wiki/Adverse_selection

The term adverse selection was originally used in insurance. It describes a situation where an individual's demand for insurance (either the propensity to buy insurance, or the quantity purchased, or both) is positively correlated with the individual's risk of loss (e.g. higher risks buy more insurance), and the insurer is unable to allow for this correlation in the price of insurance<1>. This may be because of private information known only to the individual (information asymmetry), or because of regulations or social norms which prevent the insurer from using certain categories of known information to set prices (e.g. the insurer may be prohibited from using information such as gender or ethnic origin or genetic test results). The latter scenario is sometimes referred to as 'regulatory adverse selection'.<2>



. . .

Furthermore, if there is a range of increasing risk categories in the population, the increase in the insurance price due to adverse selection may lead the lowest remaining risks to cancel or not renew their insurance. This leads to a further increase in price, and hence the lowest remaining risks cancel their insurance, leading to a further increase in price, and so on.Eventually this 'adverse selection spiral' might in theory lead to the collapse of the insurance market.



Krugman and all economists share this basic understanding of insurance markets.

here is an unhysterical explanation of mandates

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=132&topic_id=8671777&mesg_id=8671777


You know have three alternatives

1) Remain blissfully ignorant of how individual mandates are price you pay for mandating insurance companies to take all customers and not charge extra if you have, say AIDs.

2) Hate mandates and also allow insurance companies to pick and choose who they want to insure.

3) Accept the reality of mandates and either be for the bill or against it on its merits.


During the campaign I too was against mandates. I was wrong. Obama was wrong. Krugman was right Senator Clinton was right.

But what is no longer acceptable is, having this issue discussed in length several times here is to post an emotional rant against mandates and assume that it is based on the reality of the economics of insurance or that it is an intellectually defensible position.

[Mithreal]

159. Who says I am outraged? You? And you just piled on more bullshit.

"If you mandate that insurance companies must take everyone you must also mandate that everyone have insurance."

That makes no sense. If you are supposed to be "the teacher," explain it better.

"that now has the support of Sanders, Kucinich and every other progressive including Michael Moore"

Appeals to authority and not representing nuanced positions are disingenuous at best.

So, using the logic favored by insurers leads to mandates? Really? I am shocked.

Listen, I get it, you don't like all that emotional stuff, well so the fuck what and who cares. And don't think I am outraged, I really am past that most of the time not that you would know it from the way I express myself but to each his or her own. You got nothing with those explanations, they are nonsensical. That you sold out your own position for one that you can't even explain simply is a damn shame. You are going to have to do better explaining this and please avoid the fallacies.

I mean it, please figure out a way to explain this in a more simple way. Otherwise, this next campaign season is going to get a little lonelier for the activists among us.

[grantcart]

168. This is the simplest explanation of the mandate that can be made

If there is no mandate for individuals but the insurance companies are required to take everyone and they have to provide health care without regard to their preexisting condition then


People would just wait until they got sick. Then they would buy the insurance. The insurance company would have to take them and treat them.


Then after people got well then they would quit and not pay for insurance until they got sick.


The basic principle of insurance (spreading risk among the largest pool of people so we all pay a little for the bad luck that afflicts the few) is gone.


You would end up with a permanent group of people with conditions that require insurance and others who would pick it up on an "as needed basis". This pool would not spread risk it would concentrate it and in order to cover the costs the premiums would be extremely high thereby creating more disincentive for healthy people to join.


For this reason the "high risk pools" that is being proposed as a temporary fix will have very high premiums, until the whole bill takes effect.


Be for the bill or against it.

Be for mandates or against it.

I couldn't care less.

But the reason for the mandate is that it is the other half of mandating insurance companies. You mandate them to take a person with AIDS and an Olympic athelete(edited to add)AT EXACTLY THE SAME RATE (except for age). Personally I like putting insurance companies under a mandate, having an individual mandate is the price you pay.

People who are against mandates should also be intellectually honest to say

"I am against mandates and I also oppose the government mandating insurance companies in taking all people regardless of their preexisting conditions". This however is the Republican position.

I am sure that you know this but for the record many who think that they can't afford it will be getting subsidies. Some that can't afford it and won't get subsidies can get waviers and finally the 'fine' for not getting it has been diluted and its implementation delayed.

[Mithreal]

171. That explanation is unpersuasive.

I can see what you wrote but let me say it back so you can see if I am having trouble processing or misunderstanding.

The insurance companies are concerned that if they must take everyone, even those with pre-existing conditions, then they want everyone, no exceptions. Part of it is to protect the bottom lines of the companies but also to keep people honest and from gaming the system.

Is that correct? I am going to assume it is for now, just for the sake of presenting my arguments.

First problem I have with this is the term pre-existing condition. If insurers are allowed to charge several times more for pre-existing conditions then where is the problem for the insurer? If you are talking about pre-existing conditions in general or very specific list of conditions matters as well. For someone with a chronic condition, I don't see how they can just quit their coverage once they become insured. There exist other potential workarounds like phone companies use for terminating policies prematurely. So, let's use an example of a potentially temporary pre-exiting condition, like a broken bone. Without health insurance, a broken arm might cost many thousands of dollars here. Would really like to know what that costs to treat in other countries but you know, specifics matter and we really can't compare our healthcare in terms of costs or quality because it almost never makes us look competitive in price or quality. The person comes in, buys insurance for the repair and then cancels. The system we are putting in place doesn't make everyone universally covered. If someone chooses not to participate, there are still emergency rooms. They can get the care they need and be expected to pay for it out of pocket. What I am saying is that you are using the term pre-existing condition very loosely. I am also saying that you are ignoring there are not other options that can also protect insurers' bottom line. Your argument is oversimplification and industry nonsense. They know what they are asking for, don't try and market us excuses when there are alternatives.

Second, your argument about those gaming the system is reminiscent of welfare queens. Something I have come to expect from those who put party before principles. Never focus on the actual worst offenders of the health care system, try to come up with scapegoated individual "bad" people. Everyone knows the corporation is motivated by only one thing, their purpose is to maximize profit and ignore troubling moral or ethical issues. The real gamers of the system are the insurance industry. Of course, they expect individuals to do the same.

Third, you are talking insurance and not health care. Nice. We must protect insurance interests and profits. Thank you for making it abundantly clear whose side you are on.

If I am wrong about any of this, come back and challenge it.

[grantcart]

172. The explanation given is not "mine"

It is the basic understanding of all economists, right, left, center.


If you mandate insurance companies to take everyone, and do not allow them to charge them different rates for different conditions then that creates the condition called, "adverse selection" or "regulatory adverse selection".

I am not going to discuss that anymore because it is basic black letter economics and you either have read the subject matter or not. Before reading it I too was against mandates.


Now here are the possible positions that you might take:


1) I am against individual mandates and I agree that insurance companies should be able to pick their clients and based on their preexisting conditions charge different rates for different classes of health conditions. People who have had several heart attacks should pay more for health care than people who have not.

2) I don't like individual mandates but I am willing to accept individual mandates because I want to also mandate that the insurance companies take all people without any regard to previous pre existing conditions and that the only factor on rates will be age. I like other parts of the bill, don't like some parts but accept it as a first step.

3) I accept the logic of individual mandates in 2) but having read the bill there are too many negative parts and am against the bill.


Any of these positions are intellectually defensible.

To continue to argue that mandating rules on insurance companies does not create 'adverse selection' that undermines the companies ability to have actuarial based rate structure is not. If you could prove the prospect that "legislative mandates does not create regulatory adverse selection" and prove it in a peer level publication you will certainly have invented new rules of economics and get the nobel award on economics.

[Mithreal]

174. Again with the appeals to authority and claim of "superior knowledge"

I get it, you can't be persuasive because your argument is based on the interests and appeals of insurance companies.

Nonsense.

Possible positions:
1. (-) mandates (+) discriminatory coverage and rates
2. (+/-) mandates (+) discriminatory coverage and rates (+) bill
3. (+) mandates (+) discriminatory coverage and rates (-) bill

You ignored my arguments that there are alternatives that also protect industry bottom lines. Your arguments are all pro-industry. How about I make a similar whiny comment, "I am not going to discuss that anymore." If you had a easily understood persuasive argument this would be game over and your position would overcome, but you don't have one and you know it.

Get out of your box, grantcart.

[grantcart]

178. Your 'arguments' are not based on the reality that is universally accepted

My box, no I was against mandates. Its Paul Krugman's box, oh and everyother economist on the subject.

The question here is very narrow. It has nothing to do with the bill for or against it.

The question is can you mandate regulations that force insurance companies to accept all people and not have rate differentials. The answer is no. Doing so creates adverse selection. It narrows the insurance pool.

If your against mandates then you cannot then legislation prohibition against countries to deny on the grounds of preexisting condition.

It is that simple and you have provided no authority or link to any credible source that disagrees with that, it doesn't exist.

[Mithreal]

180. grantcart, my arguments are my own. How novel is that?

I asked for an explanation that is not hiding behind terminology, you know, makes sense to the lay person. Even if you had a winner of an argument here, you can't explain it. And I post my reasons why I disagree and you just ignore them.

Please reread what you wrote.

"If your against mandates then you cannot then legislation prohibition against countries to deny on the grounds of preexisting condition."

I am doing my own thinking, please do the same and try to make sense. Thank you.

[grahamhgreen]

145. Single-Payer is paid through taxes and guarantees care, not mandates to private companies that deny

claims to increase profits so that their CEO's (sorry for the caps) can eat off gold-plated china and fly to DC to lobby our congress in private jets.

Note that taxes go directly to the government from where the funds are dispersed, as opposed to a mandate where you are forced to give the funds directly to the private company, thereby removing the funding mechanism from oversight government entity.

By having the money go into a central government pool, the funds can be with-held in the case of a crapsurance companies failure to deliver care or any other violation. Companies running scams can be eliminated. ie - the people have more control in a system, the funds are dispersed form a central authority with oversight.

No - the mandate is not a tax, and does not guarantee care either universally for all Americans, or individually if the company decides to dump you.

mandate
n. 1) any mandatory order or requirement under statute, regulation, or by a public agency. 2) order of an appeals court to a lower court (usually the original trial court in the case) to comply with an appeals court's ruling, such as holding a new trial, dismissing the case or releasing a prisoner whose conviction has been overturned. 3) same as the writ of mandamus, which orders a public official or public body to comply with the law.

tax
n. a governmental assessment (charge) upon property value, transactions (transfers and sales), licenses granting a right and/or income. These include federal and state income taxes, county and city taxes on real property, state and/or local sales tax based on a percentage of each retail transaction, duties on imports from foreign countries, business licenses, federal tax (and some states' taxes) on the estates of persons who have died, taxes on large gifts and a state "use" tax in lieu of sales tax imposed on certain goods bought outside of the state.

[Mithreal]

147. +1 well said

[grantcart]

156. all of which is irrelevent to the OP

mandates are the price you pay for mandating insurance companies to take all customers with preexisting conditions. For example taking an AIDS patient at the same rate as an Olympic athelete (assuming that they are the same age).


My referral to making single payer optional was simply taking the logic of the OP to its illogical conclusion.

If single payer systems were so popular (using the OP's logic) then you could have a "voluntary tax" and people would voluntary accept the additional cost.

For a more complete discussion on mandates please see up thread # 154

[Mithreal]

160. Nonsense and obfuscation. Please see my response as well, #159.

[treestar]

148. Logic flaw

There are people who do not do what is good for them. Even old ones.

Like not going to the doctor and getting checks, even if they have the money and a plan.

Or being young and figuring "I won't get sick, and if I do, I'll just go to the ER and declare bankruptcy." Whoever has to do that finds it no as simple as all that.

[Mithreal]

150. Thumbsup for truth in labeling.

And for those who don't see your flaw. The mandate is for your dollars, you know, not the care.

And :wtf: do you know about medical bankruptcies and people not having the spare cash even after the subsidies for shit care? You have got to do better if you want to prop up this bullshit.

[treestar]

151. Do you know any real humans?

Like the types who figure they can do without insurance?

What do you know about medical bankruptcies? They will affect your credit rating like any other.

The idea that something being mandated is therefore not desirable is logically flawed. Plenty of things that are perfectly good are mandated - not going through red lights is mandated - so that must be a thing people would not want done?

[Mithreal]

153. Typical obfuscation.

[Kalun D]

177. Do you know any facts?

""Like the types who figure they can do without insurance? ""

and those that cant' afford it?

""What do you know about medical bankruptcies? ""

enough to know that most of them have medical insurance during the entire process, IOW insurance did not help them

"The idea that something being mandated is therefore not desirable is logically flawed."

the idea that we would be forced to purchase something from a private for profit corporation is against the founding principles of democracy

and it doesn't equate to car insurance because you can choose not to drive, you can't choose not to live.

[Lorien]

165. Those of us that have lost our life savings to unpaid claims and 10-12k deductibles

know exactly what you are talking about, Mithreal. That's why we oppose this plan; we don't wish the same abuses to effect millions more. It means stress, bankruptcy, long term illness and sometimes death for those who can only afford "catastrophic" insurance. I wouldn't be so vehemently opposed to the idea of mandates if they:

1). Cap premium costs

2). Guarantee that at least a significant percentage of every claim was paid.

3). Make the deductibles affordable. How can someone who earns 24k a year pay a 10k deductible?

4). Cap CEO pay, since that's where a large percentage of the premiums are going. No one "needs" to make $120,000.00 per HOUR (as United Healthcare's CEO does).

5). Ban prescription drug advertising and pass on the savings to the consumers, OR allow importation of drugs.


Without these protections it really is nothing more than another wealth transfer from the bottom up.

[Mithreal]

167. +1 And some fellow DU'ers have been selling us snake oil for far too long.

[xultar]

169. It is a mandate to buy insurace period. NOT the insurace in the fucking bill.

[kenny blankenship]

173. And they wouldn't have needed to take the Democratic party HOSTAGE in order to pass the bill, either

if it was so good.

That's why this thing is passing. We're held hostage. Just listen to what supporters here say about it (aside from those who are in a sense, pro and spam the board by the hour) They say "Yes it stinks pretty bad, but if we don't pass something our party is toast."
"If we don't pass something, Obama's Presidency is a failure and his agenda will stall out."

The fact that we got to a bill that Presidential candidate Mitt Romney could well have authored and which would have attracted mainstream Republican support in 1993-4, and the fact that we are passing it under DURESS and being told if we don't swallow this shit sandwich we'll all go down with Obama is no mere coincidence. The only way to get a Democratic Congress to pass a Republican version of health care reform when Democrats hold the majority is to string the process out, shedding Democratic provisions and ideals along the way in a series of fake negotiations, then point to the clock and say we'll all be fired along with the Boss if we take any longer doing this. They strung you out and got you to grovel and plead for your chains. Well played.

Apparently it doesn't matter what gets passed as long as something gets passed and the shittiness of its provisions is staged over several years so people don't feel it all at once. Since that's the case, we could just have well passed any bill the Democratic majority wanted and rely the long interval before the legislation went into effect to soften any discontent. We might have, except our party leadership is in thrall to Reaganism and the corporate cash that underwrites it.

[laughingliberal]

175. +1000 nt

[Kalun D]

176. ^^^^+++++1,000,000

good post, hit the nail right on the head

the DLC is worse than the repugs, better at talking a good game, and better at hiding their crooked corruption.

[derby378]

185. KICK! (n/t)

:applause:

[CTyankee]

187. Breaking news: you are already "mandated" to pay for someone's health insurance.

All those folks who feel like they don't wanna pay for no stinkin' insurance and who get hit by a car...who do you think pays for their hospital bill? Yer taxes are mandated, dude...