CNN poll: Half favor repealing health care law. Which is why we should compromise and repeal the

[grahamhgreen]

mandate.

The real problem is with the mandate that shovels trillions into insurance company coffers that they will use to crush the good elements of the bill.

Here is the new poll - http://politicalticker.blogs.cnn.com/2011/01/18/cnn-poll-half-favor-repealing-health-care-law/


By coming out and fighting against the mandate (which has been ruled unconstitutional), we will get ourselves back on the side of the majority on this issue - and win over some independents and even a few tea baggers.

If we can succeed in eliminating the mandate, it will put Medicare for All or a public option back on the table, as we claw back big insurance profits.



Last months poll - "A CNN/Opinion Research poll showed that only 38 percent now favor language "requiring all Americans who do not have health insurance to get it." Support fell six points from August, when it was at 44 percent. Opposition to the provision has risen to 60 percent from 56 in August. Support for the individual mandate was at a high in November, when 49 percent said they backed it. " - 12/27/10

[bluestateguy]

1. No more polls

[Schema Thing]

2. The mandate is important to the overall bill

Public options are currently on the table, in the form of co-ops.

[leftstreet]

3. The mandate is ONLY important to for-profit insurance corporations

A mandate would only make sense in a single payer nonprofit system

[Schema Thing]

10. Not true

If I'm going to have to get my health insurance from a for profit, I damn sure want the risk spread out to include lots of uber healthy people like the person I've been for the last 47 years, while I went w/o insurance due to cost.


We ain't getting rid of the American system in one fell swoop. Not.gonna.happen.


So let's deal with reality.

[leftstreet]

17. "If I'm going to have to get my health insurance from a for profit..."

You lost me right there.

You don't have to. Demand Single Payer

[Schema Thing]

24. I didn't lose you. You are going to deal with the system we have

and you are going to have to deal with that fact.


The current HRC bill provides for some back door openings to non-profit co-operatives. Between those, and individual states experimenting, a form of single payer may take hold yet. I certainly hope so.


Meanwhile the bill passed last year makes HUGE improvements to the current system and mandates are an important part of that improvement.

[leftstreet]

48. You're basically right. The Democrats took Single Payer off the table

So until it's put back on....the for-profit system is all we have

And forcing citizens to line the pockets of Wall Street Executives is wrong.

Dump the Mandate

[dionysus]

103. they "took it off the table" because about 5 people in the senate caucus supported it.

according to bernie.

that doesn't make it right, it's just how it is. even the house's public option was watered down.

[leftstreet]

112. And they arrested the Single Payer advocates

That says plenty

[derby378]

67. Except that forcing people to buy a consumer product is unconstitutional

I didn't want a mandate to buy for-profit insurance as part of HCR. I opposed it in 1993, and I oppose it today. The only way you're going to pass Constitutional muster in terms of compulsory enrollment and personal responsibility is with single-payer or a robust public option that anyone can participate in.

[grahamhgreen]

70. Dealing with the system we have means preventing the repubs from repealing the whole bill,

a compromise by getting rid of the mandate is the best way to achieve this, otherwise, we may have obama compromise away parts of the bill that are good.

[dflprincess]

89. A form of single payer has taken hold - it's called Medicare

Mandating that we continue to buy the same old products from the same old crooks is no improvement at all, just a reenforcement of the status quo.

Obama once pretended that mandates wouldn't work without a public option to "keep them (the insurance companies) honest". So once upon a time even he was willing to admit they're crooks - but in the end he sold us out to them.

[Schema Thing]

99. oh please. You may as well be on Free Republic to say:

"the same old products".


That's just patently dishonest. Already *insurance* is not the same product it was 2 years ago. It's MUCH MUCH better and it's going to get even better.

MLRs
No lifetime limits
No annual limits
No rescission
No co-pay for checkups
and most importantly no such thing as pre-existing conditions.
etc etc.

[dflprincess]

105. I gather your employer has not moved to one of those delightful "Consumer Driven Health Plans"

The ones with the $1,200 - $1,500 deductibles (single coverage).

They pay for screenings and preventative medicine as well... Just hope that the screening test doesn't come back needing follow up because you'll be paying for that out of pocket until you hit the deductible. After that the insurance will kick in with a 80/20 or (if you're lucky) 90/10 payment.

Most the plans come with the offer of a Health Savings Account, usually administered by a Wall Street firm that does charge some fees for it. And, if you're healthy, don't tap into the HSA and manage to get at least $3,000 in the account you can then invest it in a mutual fund! Just hope you don't have a heart attack the day after the next market collapse.

Nothing in the Insurance bill does anything to stop premiums from continuing to rise. As they go up, more employers are moving to these CDHP scams.

And you know what? You're right! It's not the same product - they're getting worse.

[Schema Thing]

111. Oh I see... you've had the tastiest insurance through your employer

in the past, and now your employer has screwed you as much or even more than the insurance companies have, especially in the last two years when they had political cover.


It only makes sense to blame Obama.


I'm self employed. I can't afford those awesome 1200.00 deductible plans.

[dflprincess]

120. Obama and the alleged Democrats in Congress are the ones who have

tied us to a system of insurance with no guarantee of care.

Remember, the $1,200 deductible only applies to expenses the insurance company deems are "covered" - there's all sorts of other copays they come up with too. The insurance companies are actually pushing these scams despite the fact that growing evidence suggests that costs for people with chronic conditions will actually increase after the first 12-18 months of being on one of these. This is because people start putting off routine check ups (the ones that aren't covered when they are meant to monitor a problem, not prevent one) and stretching medications.

It isn't my employer who is screwing us - it's the insurance company that jacked its prices up higher than anyone can afford. Did I have better "coverage" before? I did - but still not as good or as cost efficient as what people in civilized countries have. But, in the U.S., even the party that claims it represents working people must first protect the corporations.

Yes, I blame Obama and the other "new" Democrats for not putting up a fight for actual reform and selling us out to their corporate buddies.

[dionysus]

104. obama did that singlehandedly huh? he could have strongarmed our entire caucus to make it so?

when even the house couldn't pass a strong public option?
really?

[dflprincess]

110. He could have vetoed the bill

He didn't have to have closed door meetings with the crooks & he didn't have to take single payer off the table from day one. You don't start bargaining from the point that should be the compromise.

[dionysus]

135. single payer never had the support to get out of committee. you can disbelieve simple facts if it

makes you loathe obama easier, though.

[PassingFair]

108. That's why the Public Option should have been included.

"Health" people could have opted into a lower
cost public option that could have lowered prices.
(Forgiveness of med school debts for service @
clinics, etc.)

You can't have the mandate without the public option.

[Hello_Kitty]

51. Well without a mandate the insurance companies would have to attract those clients

With a mandate (and a subsidized one at that) they can charge pretty much whatever they want to everyone.

And we currently have 85% of our population with some type of medical coverage, with no mandate, including 70% of 18 to 30 year olds. The young healthy adults who don't have insurance can't afford it and most of them still won't be able to afford to use their coverage after the mandate goes into effect, unless they're poor enough for Medicaid.

[Schema Thing]

97. Ins. co's get by quite well now w/o those clients

they won't be able to charge "whatever they want to everyone" because the MLR doesn't allow it. As well, forcing young healthy people into the system helps everyone else get more out of the MLR. And since we were all young once, we all deserve to have the benefit of young healthy people in the system.

there will be competition (and the cost are finally all lined up nicely on one web-site, so buying insurance is no longer the nightmare it once was) so companies will still have to attract those clients.

As far as "most of them still won't be able to afford to use their coverage after the mandate goes into effect"... they will be able to afford it to a MUCH greater extent than any insurance they could buy for the money currently.


Does it get the rich to pay their fair share and take enough burden off the poor? Not to the extent it should, no. But it is a HUGE improvement over what we've had.

[Hello_Kitty]

102. Those young people are going to be one of the most heavily subsidized groups

Given their typical earning power they're not bringing much to the table in terms of disposable income to contribute to the insurance system. Many will simply be going on Medicaid. Don't get me wrong, it's great that they'll have coverage but I think all this arguing over the mandate has led people to believe that it's a magic bullet that will make health care instantly affordable. It won't. As I said downthread. The mandate is to (some) Democrats what tort reform is to Republicans.

[grahamhgreen]

145. I couldn't agree more. The thougt that big insurance will

pass along their new mandated profits to the consumer by lowering premiums is laughable, IMHO.

[sabrina 1]

139. And how are those people who cannot afford it now,

going to be able to afford it then?

Mandates are a Republican idea, based on their mantra that 'why should I have to pay for the lazy, no-good, commies who refuse to pay their own way'?

The first time I heard Obama use a variation of that line, I knew we were not getting anything different to what we had already, just more money to the corrupt and criminally negligent middle-men who should have been prosecuted not rewarded for the number of people who actually had coverage, they allowed to die, for profit.

Most people I have ever known without insurance, were without it because they just could not afford it. Not one of them was happy about that.

It's so sad that the rightwing selfishness has been used to push for this rightwing idea and the further enriching of the Health Ins. Industry. If this had been Bush's bill, the left would have been screaming about it as they were over Romney's.

I've learned a lot about how people can change positions on important issues depending on which party is in power, and about how that very thing helps to maintain the status quo.

On the day that the people wake up and realize that it is not the Blue Team V The Red Team, it is those who have taken control of this government V both teams, then we will see some real change.

[vi5]

6. Co-ops

Maybe I misunderstand how these work or what they are. But I thought they were just groups of people banding together to get better group rates on insurance policies. But aren't they still subject to the free-market, private insurance company policies?

[Schema Thing]

12. As I understand it..

the co-ops will be groups of people banding together to actually form not-for-profit insurance companies.


From KFF.org implementation timeline:

quote:

Creates the Consumer Operated and Oriented Plan (CO-OP) to foster the creation of non-profit, member-run health insurance companies.

Implementation: CO-OPs established by July 1, 2013

[GinaMaria]

25. The 'not for profits' already exist and already have

their biz strategies to dominate the CO-OP. These are insurance companies without shareholders, but they do make a profit and plenty of it. Groups of people banding together will not stand a chance against some of these giants who are already well established in the marketplace.

[Schema Thing]

30. No. This is something completely different.

It's a new feature in the law and has nothing in common with the BCBS model.

But lovely cynicism you have going there. It's very helpful. Wait, no, it's not.

[GinaMaria]

34. Actually, it's BCBS that's working on it right now

PS. I work for them.

Does your denial require you to label other's post as cynical or can you manage it all on your own?

[bvar22]

79. We already had co-ops BEFORE the HCR bill.

We did NOT have to eat the MANDATES to get co-ops.
Co-ops have been around for a while.
I currently get my health care through one.

[TheKentuckian]

88. We have "co ops" now. They are not and have never been a "public option".

[Schema Thing]

101. Really? Could you give an example of a co-op

that will fall under the new law being implemented in 2013?

[subterranean]

4. Medicare for All? Public option??

We couldn't even get a watered-down public option passed when we had large Democratic majorities in the House and Senate. What makes you think it would have a chance now?

[grahamhgreen]

42. Assuming that eliminating the mandate would result

in a drastic loss of revenue for big insurance, then, they would lose their ability to lobby congress.

Then we can get what 70+% of the country wants. Medicare for All.

[kctim]

5. If you eliminate the mandate for this

how do you fight for the mandate needed for single-payer or public option?

[leftstreet]

8. If people understood it, you wouldn't have to fight for it

But the pols and the pundits keep corrupting phrases like 'universal healthcare' and 'healthcare for all'

Give people accurate information and they'll choose single payer

[kctim]

9. No matter how you spin the name

it is still a government mandate and would require a HUGE tax increase to implement and keep going.

I don't believe taking away choice and a paycut would be embraced by as many as some on here dream.

[GinaMaria]

27. What was passed already resulted in a pay cut for me

and others. I am looking at 10K out of pocket this year due to this 'reform' and that's a low estimate. Do you really think I would be taxed that much for access to a medicare for all option? We will lose our savings this year (what little we have) and accrue more debt to pay for healthcare. At some point we will fall out the bottom, live in a cardboard box and qualify for subsidies. Yay! :sarcasm:

[Schema Thing]

106. at BCBS?

[GinaMaria]

121. Yep. Due to the provision in HCR around MLR

the employees took a major hit. All employee compensation (salary, benefits) count toward that 15-20 cents of every dollar that the company can keep. Our deductibles are really high, co-pays were raised, % of service covered decreased and the % we pay of the premiums increased. We all just got poorer. The pay structure will likely change as well.

HCR actually encourages businesses to drop health insurance for employees and transfer the cost to the individual (without additional compensation). It's anticipated that individual health plans (the most expensive and most profitable because the risk is not spread) will grow rapidly over the next few years.

HCR gave insurance companies much more solid footing and moved us farther from a public choice. Many of us will be a lot poorer in the future.

Repealing HCR won't change some of this stuff. They've made the changes to their business model and found ways to make it work financially for them. The republicans won't really be able to undo anything except maybe subsidies, which will mean the aspects of HCR that hurt the middle class will remain and the parts that help lower income people will be abolished. We will have taken a hit for nothing.

[kctim]

131. We are talking of the government mandate

and why some believe it is not governments job to mandate such personal things. Most people always support mandates for things to be done how THEY want and most people almost always reject mandates when they are not.
When they do not, it is almost always about the loss of free choice, not money. And when you combine that with a HUGE tax increase, it only adds fuel to their opposition.

[GinaMaria]

132. "the loss of free choice, not money"

the less money you have, the fewer choices you have. They are linked. A combination of public and private options for people offer more options to choose from as they increase competition... that's a good thing for people who want more choice and are trying to avoid going broke.

The "Medicare for All" terminology is a misnomer. It should be medicare for anyone who wants it. It's not about eliminating the current system but adding more choice. This added choice will create competition and that will alter the current system's way of doing business or not in some cases.

The fight is for more options, more access to care for everyone and more cost effecient healthcare. We have a very long way to go to reaching these goals.

[kctim]

136. That is you're opinion

and understanding the 'other sides' opinion is key to getting something that works for all.

To a lot of people, individual rights and money are not linked. They would rather be poor and live how they choose, than have money and live how somebody else chooses for them.
That "Medicare for anyone who wants it" is spin because paying for a plan they do not want is NOT a choice, and being able to pay additional money for the plan they do want almost impossible.
That the fight is for government to stay out of their personal lives.

We cannot just dismiss their beliefs because we think it is what is best for them. Only they know what is best for themselves.

[GinaMaria]

166. Do you have a jump to conclusions mat?

Lots of assumptions in your post. Medicare for anyone who wants it is a buy in as well as an opt in. It would have much lower operating costs than traditional insurance plans and be more affordable for people. OTOH, it would likely be administered through private companies as medicare currently is, so this wouldn't be about removing the private companies we have now.

It is your opinion also what priority people place on money. They would rather be poor huh? I've never met anyone who has ever said anything close to that. I'm sure there are some who exist who believe that. I suspect that you are one of them. I've never made any assumptions that I know what's best for others or that I should make decisions for others. That is your assumption.

What I know is that competition is a good thing, especially competition that drives down cost. Freedom of choice actually requires that we have options. The more options the more choice, the more freedom.

I have not dismissed anyone. I, like you, have an opinion that I am free to express. Expressing that opinion does not dismiss someone else's opinion. It means we all don't agree and therefore we cannot have decisions made by consensus. My opinion isn't always with the majority. That's what we all must accept to live in a democracy. If you find, you never agree with the majority... Don't know what to tell you. You'll have to decide what you can do to cope with that. If you think we will ever find a solution that 'works for all' for any issue, you are living in an alternate reality.

[grahamhgreen]

146. There is no mandate for single payer

it is a tax, like the FICA tax.

Most of the country would like Medicare for All.

[NuclearDem]

7. Repeal the mandate...but as somone who HAS gotten insurance as a result of reform...

A big FUCK YOU to the Rethugs would want to repeal this.

[salin]

109. Glad to hear that you have benefitted... but your throwing under the bus the mandates

ensures that many people over the age of 30 probably will not - per the mandates (of ensuring a large risk pool) allows businesses to spread costs across a healthy and less healthy (due to aging) risk pool.

As more and more employers dump health insurance as part of their benefits (a growing trend in the past decade) more and more people are locked out of individual insurance due to "preexisting" conditions.

We either all support each other (rather than just what is good for me) or the whole reform is vulnerable.

Either we embrace our benefits from this law and recognize and support other provisions - or we create generational divides that lead to the end of all attempts at reform and we are left in an era with fewer employers offering health insurance as a benefit while at the same time there is an ever growing increased rate of denial of coverage to a whole lot of people, and a whole lot of other folks who do get coverage with only partial coverage (by denying any payment for treatment for "pre existing conditions".

[grahamhgreen]

148. Eliminating the mandate will not eliminate the other reforms in the bill.

[Still a Democrat]

11. How can you repeal the mandate and not the pre-existing condition change?

What would keep people from buying insurance only after they get sick?

[pnwmom]

14. Exactly. n/t

[grahamhgreen]

26. How? By compromising with the Republicans who claim

to hate the mandate.

The 6 month waiting period would keep them from buying insurance until after they get sick.

And the idea here is to bring big insurance to their knees, not prop them up with mandated purchasing of their crappy product that denies coverage to legitimate claims.

[Hello_Kitty]

53. What stops them now? 85% of the country has coverage, with no mandate.

Including 70% of young adults.

[markpkessinger]

58. Precisely!

Personally, I would have preferred to see a single-payer or "Medicare for all" type of system implemented, but for the time being, at least, it seems were stuck with the system of for-profit, private insurance companies. And since we are pretty much stuck with this system for the moment, then we must consider the business model that the current system operates under. The basic principle underlying all insurance is the concept of "pooled risk." The economics simply will not work if the system is set up in such a way that people only begin paying premiums when they find themselves seriously ill. At any given time, in order bee able to cover the medical expenses for those who are sick, insurance companies need to have a sufficient number of premium-paying customers who are healthy, and thus who are not a current drain on expenses. If we require insurance companies to cover those with pre-existing conditions, then we also have to make sure that the risk pool is large enough so that incoming premiums will enable the insurance company to both pay the medical expense of those who are receiving treatment at any given time and still realize a profit.

If there is any real criticism to be made of the so-called "individual mandate," it is that the proposed fine, or excise tax, imposed on those who fail to carry health insurance is far too small. I believe the proposed fine is the greater of $695 or 2.5% of annual income. Considering that an individual health insurance policy, at present, costs somewhere in the $3,500-$4,000 per year range, everyone whose income is below $139,000 will have a reverse incentive, i.e., to opt for the $695 fee rather than paying a $3,500-$4,000 annual premium, and buying insurance only once they are sick.

There is absolutely nothing unjust about the imposed fine, either, because at least that enables taxpayers collectively to recover at least some of the medical costs of those who selfishly refuse to carry health insurance.

[grahamhgreen]

68. Are you saying that without the mandate, big insurance will go bankrupt?

[dflprincess]

95. I'll say that but not for the same reasons

Without this bill the health insurance companies were bound to collapse of their own weight as fewer employers and individuals were able to afford coverage.

According to the CBO, even with the mandate, the number of uninsured will drop by 2014 but by 2019 be back up to 19 million and climbing & no one makes any estimates on how many will be underinsured (meaning they have "coverage" but can't afford care).

The mandate just buys the insurance companies a few more years before we find ourselves back in the same place we were before the scam was passed. And really, if we're going to wind up back at square one, the sooner we get there the better because maybe then we'll have a real shot at getting reform passed.

[girl gone mad]

62. The mandate doesn't prevent people from buying insurance only after they get sick.

Many will still choose to pay the fine if it is cheaper than buying health insurance. Unless the fine gets raised by several multiples of what it is set to now, it will still be cheaper for a significant number of people. There's a limit to how much the fine can be increased before Congress creates a new set of problems.

[Hello_Kitty]

66. The fine is just stupid for the low income people who qualify for subsidies

The government was willing to subsidize most of their premiums anyway. Why do they find it necessary to shake people just above poverty level down for $50 a month or impose a fine on them? The Medicaid eligibility should have been much higher.

[grahamhgreen]

69. Very good point!

[Still a Democrat]

91. But you'd be paying the fine indefinitely before you get sick and seek insurance

You could be dropping a significant amount of money into the pool for years. With no mandate or fine, you don't pay a penny until you get sick and look for insurance.

[treestar]

81. Right. People are just irrational about it.

They want the service without paying for it, plain and simple.

Like they don't want their taxes raised, but still want all the services, plus the budget balanced.

[grahamhgreen]

84. No, people don't want to be forced to pay for services that they never recieve from

insurers who have a pattern and practice of not paying for legitimate claims, that's all.

[treestar]

85. You know I've been through all this before when the law was being passed

It's just irrational to assume insurance never covers anything it claims it will cover.

[grahamhgreen]

87. It's not that the never cover anything, it's just that they

use underhanded practices to deny legitimate claims so that they can increase profits.

That's why we have the supposed 'end to rescission' and so forth in the bill.

They can not be trusted, if they could, there would be no reason for reform at all.

[BzaDem]

113. Have you read the portion of the bill that deals with insurers denying claims?

Or are you not educated about the very thing you are talking about?

[grahamhgreen]

142. Yes. They can still deny claims if they claim that the patient has committed

fraud, which is exactly what they do now.

In other words: say you took acne medication when you were 16. You failed to tell them. Now, they refuse to treat your skin cancer because buy failing to disclose this (you forgot all about it), you have committed fraud, and your insurance has been rescinded. If you disagree with this assessment, it will be you vs a team of overpaid industry lawyers.

They and their team of lawyers, fueled by trillions in mandated funds, will continue to deny claims, IMHO.

[pnwmom]

13. Repealing the mandate would be as silly as deciding no one

needed to pay into Medicare until they needed it.

The whole plan will collapse without the mandate because the rates will skyrocket if people can stay out of the program until they need it. It won't put Medicare for All back on the table. It will just destroy any chance of this plan working, and the Rethugs will say "we told you so."

[leftstreet]

15. (you changed your title) So, is Medicare a for-profit system?

The Capitalists have had plenty of time to prove to us their Free Marketz will save us.

They won't

[pnwmom]

16. And the socialists have had plenty of time to prove their plans

could get through Congress, and they didn't.

[leftstreet]

18. Yeah, they fought Congress for decades to get SS and Medicare

Jesus. They weren't even Socialists

[pnwmom]

20. Fine. Were they capitalists then? n/t

[leftstreet]

22. Actually, the Capitalists used FDR to push back against the Left

But that's a whole other story

Like, when there actually was a Left in the US

[grahamhgreen]

31. The "socialists" isn't that a far right meme?

[leftstreet]

46. Yes n/t

[pnwmom]

115. I like socialists. But I was responding to the previous post

about capitalists. Is there some other term I should have used to describe non-capitalists?

[grahamhgreen]

143. FDR Democrats, perhaps...

[pnwmom]

147. Weren't most of them socialists?

Just because the freepers use the term as a pejorative doesn't mean the rest of us should.

In my earlier comment I wasn't disparaging socialist philosophy -- just their effectiveness in Congress, no matter what label you give them. The numbers are far too small, even when you include garden-variety leftists-who-don't-call-themselves-socialists.

[Hello_Kitty]

57. What socialists would those be?

Are you just red-baiting or do you have particular people in mind? The only socialist I'm aware of in Congress is Bernie Sanders.

[pnwmom]

117. The previous post referred to capitalists. I suppose I could have

referred to non-capitalists, but who would that be?

[Hello_Kitty]

123. You should have gone full bore and accused them of being Communists!

[girl gone mad]

63. "socialists"

:wtf:

[bvar22]

83. Uh-Oh.

"Socialists"
.
.
.
.
My my.

[pnwmom]

19. No. And the mandate doesn't require anyone to buy insurance.

It only requires them to pay an excise tax which they won't have to pay if they can show they have insurance.

[leftstreet]

21. If you can prove you're already giving Insurance Execs money....

we'll go easy on ya

What a plan!

[girl gone mad]

64. You're not supposed to call it a tax..

because that would mean the President has broken his promise not to raise taxes on anyone making under $250K.

[grahamhgreen]

29. The plan will NOT collapse. The only

thing that might collapse are some for profit insurers, the same ones who deny benefits to legitimate claims, and will use their mandated trillions to destroy what little real reform is in the bill.

Once get rid of their lobbying dollars, it will be easy to instate Medicare for All, or a public option, like the rest of the civilized world.

[dionysus]

35. how the hell would the private insurers collapse? you really don't understand the issue i am afraid.

[grahamhgreen]

44. So you are saying that without a mandate, the insurers will be just fine? Then why have it?

[dionysus]

45. this has been spelled out many times. if you don't grasp the fact by now, you never will. sorry.

[grahamhgreen]

50. Nor does the rest of the civilized world. That's why for-profit basic insurance is illegal

in most countries.

[Hello_Kitty]

55. That's a very important distinction. Nowhere else has mandatory for-profit insurance

[dionysus]

59. i'm not advocating for private insurance over a govt run plan. no one here is.

in our country we're not going to get rid of private insurers in one fell swoop. it will never happen. the only way we'll get single payer is over time.

what you and i are debating is the concept of risk pools and mandates, which are you willfully refusing to grasp.

[grahamhgreen]

75. I understand what your saying, but this isn't about

risk pools and mandates.

It's about corrupt institutions that have gained control of our government.

If we give them more money by means of the mandate, they will use it to further entrench themselves into the system, and we may never get rid of them.

The Republicans dislike of the mandate gives us an opportunity to strike at the heart of the big insurers.

By siding with them on the mandate, and compromising on the bill by getting rid of it, the only ones who would possibly fail to benefit will be big insurance.

This most likely will translate into less profits, indeed, it may bankrupt some of the companies. With the companies unable to lobby congress, we can easily get Medicare for All or a public option passed is this is what 70+% of the country wants, IMHO.

[dionysus]

94. i'm stil not seeing where ins co's go bankrupt. they were screwing ppl and reaping obscene profits

before the health care bill.

nothing short of a single payer system (which i personally prefer) will do anything to the insurance companies.
and since we couldn't get single payer out of committee even when we had a large majority, how do you propose this be accomplished, exactly?

[grahamhgreen]

150. If big insurance will not go bankrupt,

then we really don't need the mandate.

To me, the thought that they would pass their mandated trillions on to the consumer in the form of reduced insurance premiums is just not credible, IMHO.

The danger with the mandate is that they will take these mandated trillions and continue to lobby congress to prevent reform, and to destroy the other reforms in the current bill.

By hitting them at their bottom line, it gives us a chance to continue to press for Single Payer, or at least a public option.

Also, the Repubs are going after HCR. By compromising with them on the mandate (which is the part of the bill their base hates the most), we may pick up some repub leaning independents.

[Selatius]

125. I do not believe health insurers will go into bankruptcy without the mandate.

Currently, there is no mandate, and many of these insurers are already monopolies in several states, and they are nowhere near approaching bankruptcy.

[grahamhgreen]

149. I agree. The mandate is unecessary, unpopular, and getting rid of it

is a good compromise, rather than having the Repubs to go after the entire bill, or the good portions of the bill.

[DonCoquixote]

78. OK

Considering that the mouth breathing scum (aka the american public) got dizzy at ther thought that their cough (hard earned tax dollars) cough might help one poor person live, what makes you think they will glaldy go to single payer once the GOP kills the HCR?

[grahamhgreen]

82. Just look at the polls - the majority of Americans do want SP or a PO, and

we are not talking about killing HCR, it's a compromise to save HCR, only the mandate and big insurance will suffer.

[Hello_Kitty]

56. Lots of people get Medicare who didn't pay into it.

It's not like SS where you have to pay in for 40 quarters.

[shimmergal]

168. NO, once you turn 65 and qualify for Medicare,

you pay into it, unless you're relying on another insurance plan rather than using Medicare.

[kirby]

23. How many supported paying for the uninsured?

Because that is what all of us, who pay for health insurance, do every single day.

[grahamhgreen]

33. Which is why Medicare for All works. The Repubs want a compromise - what part of the bill should we

compromise on.

Because we all know Obama will compromise on something in the bill, and most likely it will be something that is good for big insurance and bad for the people.

[dionysus]

37. why would medicare for all work? why, because it would be MANDATED.

until we can get a govt paid, mandated system, this is the best we can start out with...

oy vey.....

[grahamhgreen]

39. It is not a mandate, it is a tax. Big difference. The mandate is like allowing a private company

tax the people. Bad idea.

[dionysus]

43. taxes aren't optional.

[GinaMaria]

41. Medicare for all is a misnomer

Most people who support 'Medicare for all' really support Medicare for anyone who wants it. Which is what it should be called. It's an opt in, but not mandatory. Medicare for all caught on and it's doing a disservice to what people are really talking about. A choice between public and private options would be ideal.

[dflprincess]

92. Yes it would be mandated - we all know we're going to have to pay for health care somehow

but if we went to Medicare for All - we'd all be in the same pool which would drop costs and would be cheaper than mandated for profit insurance.

Other advantages would be that coverage would not be tied to employment, we'd actually have access to care and people would not face bankruptcy because of medical bills.

The Health Insurance Profit Protection Act still ties "coverage" to employment. It does not guarantee access to care - it only requires that we either continue to send money to a private company or that we pay a fine for not sending money to a private company. And it still allows out of pocket expenses (in addition to premiums) high enough to drive people to the poor house.

[dionysus]

100. i'm not disagreeing with you about medicare for all. what i'm saying is we didn't have

the votes for it, and i think our best option now is to make the bill we passed stronger.

we'll not get single payer passed through congress any time soon.

think about it. accordibng to Bernie, single payer had maybe 5 vote in the senate. the more liberal house, watered down it's own public option. and not even that made it into law.

[girl gone mad]

72. uncompensated care accounts for a tiny portion total health care expenses..

This has been covered countless times.

It doesn't make up even 5% of anyone's insurance bill, if that.

For all the hype, uncompensated care makes up a relatively small amount of the nation's total health expenses; in 2001, for example, Whitman notes that, at around $35 billion, it accounted for roughly 2.8 percent of total health care expenditures. Given that total health expenditures have risen since 2001, the Times' figure of $36 billion in uncompensated care almost certainly represents an even smaller piece of the total health-spending pie.

Whitman also notes that about a third of uncompensated care is actually doled out to the insured; a mandate probably won't make any difference for those who already have insurance. More generally, he takes issue with the idea that a mandate would actually "solve" the problem:

"To the extent that the public has to subsidize the formerly uninsured, the free-riding problem has not been solved — it has merely been shifted. It's wrong to say we "solve" the free-rider problem if all we're doing is paying for the free riders in a different way."

[Motown_Johnny]

28. ROFL @ The Mandate Being Ruled Unconstitutional

17 suits filed

14 thrown out of court

2 uphold the mandate

1 rules against the mandate





I wish we could get rid of the freaking mandate but it ain't gonna happen.

[grahamhgreen]

36. 1 is all it takes. The Repubs hate the mandate, let's pony up with them and

get rid of it at the expense of big insurance... why not?

[Motown_Johnny]

107. The Repubs LOVE the mandate. They will fight repealing only that provision

tooth and nail. They just lie about it because it makes a good bumper sticker.


You can't honestly believe that they will vote to repeal only that one provision (that will hurt their corporate masters) and leave the rest intact.




Also, it takes more than one court decision because it will be appealed.

[grahamhgreen]

156. Here is where getting the Dems to repeal the mandate becomes a political coup!

The corporate Repubs will be forced to show their hand if they don't vote for this.

Moderates and even some Repubs will flock to us in droves if they do.

We need to be smart and play hardball.

[dionysus]

32. mandated coverage is the only way to even out the risk pool. we've been over this a million times

[grahamhgreen]

38. That is only true in a non-profit scenario, otherwise the corporation

will take their mandated trillions and use it to destroy whatever reforms are in the bill, deny legitimate claims, and give more money to shareholders and management.

Besides, there is no proof to your claim, it has never been tried. Also, if this did result in a loss of revenue to big insurance - who cares? The sooner we are rid of them, the sooner we can institute a cost-effective system like the rest of the civilized world.

[Hello_Kitty]

49. It's a guaranteed costs plus contract.

Not only are people mandated to have private insurance but the government is subsidizing it!

[Hello_Kitty]

47. And it's been rebutted a million times.

85% of the country is covered now with no mandate, including 70% of 18 to 30 year olds. So there goes the "but young adults will never get insurance unless they are forced to" theory. And contrary to popular belief, uninsured people consume 1/2 as much health care services per annum as insured people. The uninsured are not driving up health care costs as they are constantly blamed for doing. Likewise, forcing a few million young adults into policies they can't afford to use will not make everyone's premiums and costs go down like magic.

[girl gone mad]

73. Precisely, but they will never address these issues.

The uninsured are not the cause of our exorbitant health care costs, though they make a very convenient scapegoat for the neolibs.

[Hello_Kitty]

86. Uninsured people have been turned into Welfare Queens.

Obvious from the way people talk about us here.

[BzaDem]

114. Just because someone rebuts it doesn't mean their rebuttal is accurate.

Republicans claim global warming has been rebutted many times. That doesn't mean it doesn't exist and isn't manmade.

The mandate is necessary if you are to prevent insurers from denying coverage for pre-existing conditions. Your argument to the contrary looks at how it is RIGHT NOW, when insurers are FREE to deny everyone. Of course people who don't have pre-existing conditions will be insured under the current system. That is IRRELEVANT to whether they would be able to cover pre-existing conditions without a mandate.

"Likewise, forcing a few million young adults into policies they can't afford to use will not make everyone's premiums and costs go down like magic."

It prevents people's costs from going so high that today's costs would be considered cheap. If insurance companies had to cover everyone's pre-existing conditions without a mandate, the price of the insurance would approach the price of the medical bills.

[grahamhgreen]

151. If I might

rebut your position that "The mandate is necessary if you are to prevent insurers from denying coverage for pre-existing conditions."

If we eliminate the mandate only, the rest of the bill will still be intact, so the pre-existing laws in the bill will still be in place!

[Riftaxe]

40. But if you repeal the mandate

your going to have a lot of grumpy lobbyist muttering about politicians not staying bought :)

Perhaps they can focus on providing health care in any compromise instead of the existing gift to the insurance companies as HCR exists now.

Even allowing the offering of a buy-in to the pathetic excuse of health care coverage we call Medicare would be better.

[Codeine]

52. So eager to buy into RW memes.

Unrec.

[Hello_Kitty]

54. I disagree. The mandate is to (some) Democrats what tort reform is to Republicans

It's not the magic health care cost decreasing bullet you think it is.

[dionysus]

60. it's not a magic bullet, but it is, in fact, one aspect of a rather lousy bill that will decrease

costs.

[grahamhgreen]

61. The mandate will not decrease costs, the profits will go into corporate profits, not to

customers.

That is obvious, is it not?

[dionysus]

65. you forgot the part ofthe bill that mandates a specific percentage of premiums is spent on treatment

i think it was 85% or something.

[grahamhgreen]

77. 80%

But this figure is malleable. There will be teams of industry lawyers - fat with mandated trillions - who will argue that everything is treatment.

That, and creative accounting methods will show that 80% of the money went to treatment, always - it will be the Eronization of medical insurance accounting, and they will have the money to develop complex schemes.

OTOH, the bill gives the private insurers 20% for overhead, whereas most countries health care operates at under 6% overhead, including Medicare.

[Hello_Kitty]

90. I don't care if it's 99%.

There are so many loopholes in the MLR requirement that allow all kinds of things to be considered direct medical expenses it's not even funny.

[dflprincess]

93. Actually it's 80-85% (depending on the group size) be spent on claims or

"other health related activities". That could very well include advertising that encourages people to exercise or eat right.

And that other 15-20% in admin costs? A lot will go to officer's salaries and commissions to sales reps.

Medicare's admin costs run 3%.

[dionysus]

96. i personally would like single payer. but we couldn't get that even with the dem majorities

we couldn't even get a public option.

the only way to move toward single payer is to get something small and build on it slowly, it'll never happen all at once in this country

[Doctor_J]

71. Half the people think their taxes went up

should we cater to their stupidity too?

[Swede]

74. Patient Protection and Affordable Care Act

http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act#Change_in_number_of_uninsured

[dflprincess]

98. This bill has as much to do with "affordable care"

as Bush's "Clear Skies Initiative" had to do with protecting the environment.

[rgbecker]

76. OK, let's see your count of votes in the house for no Mandate......

but Medicare for all or the Public option. You haven't got one Republican I'll wager, and probably couldn't hold the democrats together for even an introduction of the bill on the floor after the Dems win back the house in 2012.

[grahamhgreen]

80. What we're talking about here is saving the rest of the bill by giving away the mandate,

we will still have all of the good legislation - that will be untouched.

It's a great compromise.

By getting a claw-back from big insurance by eliminating the mandate, we are setting ourselves up a future run at Medicare for All, or a public option. Failure to do so will result in the mandated trillions being spent by big insurance to lobby congress to destroy the good reforms in the bill for the rest of history.

We should be able to get all of the repubs to vote against the mandate, and enough Dems.

[BzaDem]

116. If by being "saved," you mean making insurance cost thousands PER MONTH for everyone

then sure, it would be saved.

The problem is that under your "the bill is saved" scenario, the only people that could afford insurance would be the very rich.

"By getting a claw-back from big insurance by eliminating the mandate, we are setting ourselves up a future run at Medicare for All, or a public option."

Bullshit. By eliminating the mandate, we would be setting ourselves up for a removal of the regulation guaranteeing pre-existing conditions.

[Brilliantrocket]

118. I don't understand why I have to pay for something I don't want-

Why should the government be able to force all citizens to buy a product?

[BzaDem]

119. Because you are going to need healthcare at some point in your life, whether you want it or not. n/t

[girl gone mad]

122. You could say the same thing about food, water, shelter..

transportation, clothing, etc.

Where do you draw the line? Can the government force us to buy soup insurance from Campbell's, just in case?

[BzaDem]

124. The price of food/water/shelter does not go up when you don't pay for it.

With healthcare, if you ban discrimination on the basis of pre-existing conditions, there would be no reason to have insurance until you get a condition. This would raise the price of insurance to thousands a month or more, since the total pool would have to pay for more and more medical bills. No one would be able to afford insurance.

None of this applies to food and water and shelter or anything else. Insurance is the only event whose costs become catestrophic if people wait to buy it until they need it, and because we do not think it is right for people to pay more just because they are sick, everyone must pay into the system. There is a reason why every industrialized nation in the world has a MANDATE for health insurance (but not a mandate for food/shelter) -- even non-single-payer countries with no government health plan at all.

[grahamhgreen]

152. No, there is NO COUNTRY in the world that has a mandate to buy for-profit insurance

all of the civilized countries has non-profit base plans, nationalized health, or single payer.

[girl gone mad]

164. You're argument in support of the mandate is fairly twisted.

[Warren DeMontague]

129. Do you want to live in a country where emergency rooms let you bleed to death

if you can't prove you can pay, first?

Because what happens with people who don't have insurance and need serious, emergency medical treatment- they get treated. And if the person without insurance can't pay, someone pays. Know who pays? Me and you.

The government forces people to have liability insurance on their cars, so they can't smash someone else and stick them with the bill. Same deal.

My ideal is a Single Payer System, but that too, would be government (booga booga!) "forcing" you to pay for insurance through taxes.

The only other alternative is everyone for him-or-herself, which, in the case of health care expenses, would be utter insanity.

[Warren DeMontague]

127. Do you drive a car?

Just curious.

[Hello_Kitty]

137. Auto insurance analogy is flawed on many levels.

And has been debunked repeatedly. If you're to compare people to cars a slightly better analogy would be health insurance to an extended warranty.

[Warren DeMontague]

140. And when people who have no insurance turn up at emergency rooms, what happens?

and who pays?

[Hello_Kitty]

144. Last time my uninsured self went to the ER I paid for it.

All of it. You good godly upright responsible hardworking white Americans with insurance didn't have to subsidize one dime of it. And if I have a major ER situation I'll go to the county hospital and the taxpayers will pick up the tab. Just like they will when the HCR kicks in and I get put on Medicaid like I should have been in the first place. See, the thing is, most of the people in the country who are uninsured are also broke. Sure, a lot of them are young and healthy but they're not bringing much to the table, money-wise, to contribute to the system. Half the uninsured who will be covered under HCR will be going on Medicaid. The rest will be subsidized.

[Warren DeMontague]

155. I'm sort of hardworking, more responsible than I used to be, and I am white.

Good and Godly, probably and definitely not, respectively.

But stream-of-apparently-intended-insults aside, the fact remains that, like you say, taxpayers pick up the tab. Because Emergency Rooms don't check to make sure someone can pay before they save their life, as well they shouldn't.

Look, I support a SPHC system. But that, too, is a "mandate". As for the uninsured broke, part of the HCR bill was to broaden the income requirements for Medicaid. In a big way. Some, not all, of the people in question should be helped by that. Also included in the bill are subsidies for low income earners.

But "I refuse to have health insurance and if something terrible happens to me I'm going to run up huge bills and leave them for someone else to deal with" is not a mature approach to the issue.

[shimmergal]

169. A single payer system is NOT

a mandate, as long as the taxes used to support it are completely separate from one's health status or eligibility for health services. Unless you're cslling all taxes a mandate?

[Warren DeMontague]

171. A single payer system- which makes the most sense, IMHO- basically makes everyone one big ins. pool.

And yes, everyone would be paying for it, so it is a form of a mandate. So what precise mandated level of coverage under the HRC has costs tied specifically to health status or eligibility for health services? Got any specifics on that?

[Hello_Kitty]

170. I'm sure there may be people who have that approach but I think you're overestimating their numbers

"I refuse to have health insurance and if something terrible happens to me I'm going to run up huge bills and leave them for someone else to deal with." Like I've been saying, the uninsured are the new Welfare Queens. The fact is that the vast majority of people uninsured right now are not scofflaws gaming the system so they can stick you with the ER bill for their coke binges and snowboarding accidents. Really. Yet during the most heated mandate debates on DU I saw proponents trot out hoary stereotypes of uninsured people buying cellphones and flatscreens and bling instead of insurance while running to the ER for every sniffle and boo boo. And naturally running out on the bill. It's bullshit.

[Warren DeMontague]

172. And the choices remain: Do nothing, enact a single payer system, or have incremental change.

I think 1) is unacceptable, and unfortunately 2) won't happen any time soon, although I think now the way to get there is on a state-by-state basis.

I'm not interested in demonizing anyone, but the idea that somehow we're going to have universal health coverage without some form of mandate is just plain goofy.

[grahamhgreen]

158. The emergency room ALWAYS sends the patient a bill.

[Warren DeMontague]

163. And the patient always pays it?

To quote Fred Willard, I don't think so.

[grahamhgreen]

154. No.

[Warren DeMontague]

157. That's probably a good thing, if you also refuse to have health insurance.

Because while I'm sure you will never, ever, ever, ever, ever get sick (So why pay for it, Dude?) cars can be really dangerous.

[grahamhgreen]

159. I have Kaiser, from my employer.

I don't drive because I hate to pollute, and worse, hate to give money to my opposition.

Not to mention I love to bicycle.

OTOH, while in Australia in the 90's, my auto insurance AND registration were only $25/year!!!

Why? One reason is that when the country has single payer, you don't need to pay liability on your vehicle! Or your house, or your business!

[Warren DeMontague]

162. I agree 100% on Single Payer, sir.

I just happen to think that the only way we're going to get there, in this country-- hell, the only way we're even going to get close-- is not to ditch the law that was just passed and return to the way things were before, but instead to let the more progressive states experiment with their own Single Payer or Public plans, and let the savings and better coverage speak for themselves.

[grahamhgreen]

153. There is no mechanism in the bill that would

force the insurance companies to pass their mandated trillions on to the consumer in the form of reduced insurance costs.

With or without the mandate, the insurance companies will charge what they want.

WITH the mandate, we are forced to buy their crappy overpriced products. Without it, they are forced to compete by lowering their prices to what people CAN afford.

The ways out are: Medicare for All, Public Option, National Health.

[Warren DeMontague]

126. Oh, God, not this fight about the Mandate again.

You can't have guaranteed issue without a mandate. Eliminating the mandate isn't going to bring us Medicare for all, or a Public Option (and there would still be a mandate) or a true Single Payer system, which I support (and would still be a form of a mandate) ...eliminating the mandate is only going to mean that insurance companies can still kick people out or deny coverage for being sick. And put us right back where we were before, which is what the GOP and the Insurance Industry wants.

Half of the people demanding repeal think that the health insurance bill was written by satan for the express purpose of pulling the plug on granny. Angry about the mandate? They don't know WHAT they're angry about- but it sure isn't this bill. And like I said, if you remove the mandate, there is no bill- certainly no ending of denials of coverage for pre-existing conditions.

That would make the insurance industry happy, that would make the GOP happy.. I don't know if it would make the "Satan And Obama Want to pull the plug on Granny" crowd happy, I'm not sure who else it would make happy- maybe a small group of twentysomethings who are outraged that they have to pay for health insurance, because they're never gonna get sick, man.

I know people don't like the Insurance Industry- *I* don't like the Insurance Industry- but the mandate isn't the problem. The solution, now, as I see it, is to start building single payer systems on a statewide basis, and let the savings and increased efficiency speak for themselves.

[grahamhgreen]

160. Yes you can. You eliminate the mandate by

passing the law with repub support, and boom - the rest of the law still applies, including guaranteed issue.

The rest of what your saying makes little sense to me. THE BILL IS LAW. Repealing ONLY the mandate still leaves the rest of the bill intact.

No one here is suggesting repealing the entire bill - just the mandate.


BTW, a FICA style tax for Medicare for All is not a mandate to buy for-profit insurance.

[Warren DeMontague]

173. You say you work for Kaiser. Isn't Kaiser non-profit?

Isn't the mandate to buy insurance, like kaiser, which is insurance, and also non-profit?

Ergo, whatever the mandate is or isn't, it's not specifically a mandate to buy "for-profit" insurance.

[JVS]

128. Eliminating the mandate is a good way to appeal to moderate voters.

[Maru Kitteh]

133. And an EXCELLENT way to kill all possible progress/reform for yet another generation.

[grahamhgreen]

141. How and why would it kill any reform? All it would do is allow us to get a claw back from

big insurance.

The rest of the reform still stands, the only change is the mandate.

[Turbineguy]

130. Don't feed the hungry

you'll only encourage them to get hungry again.

[divine_truine]

134. POLLS SCHMOLLS!

screw cnn, fux, m$nbc, cbs, all of 'em!

[lumberjack_jeff]

138. "optional universal" health care is an oxymoron. nt

[grahamhgreen]

161. The bill does not provide universal health care.

[GSLevel9]

165. +1000

[Radical Activist]

167. Exactly how would repeal put Medicare for All or a public option back on the table?

I agree that the mandate should be repealed. I liked that Obama's original plan presented during the campaign didn't have one.

But I don't see any logic in thinking that it makes the public option more likely to happen. In fact, the perceived defeat would likely set back any progress on new reforms. Most of the public still doesn't know what the term single payer even means. Repealing part of the health care bill isn't going to make people wake up and suddenly demand something that they didn't know they wanted.