Q. That individual mandate really bugs me, why do we need that again?
A. Well, it minimizes adverse selection of the young and healthy out of the system and lowers average costs.
Q. Oh, so the way it works is that the young and healthy pay more in premiums than they get in care and the balance is distributed over the rest of the risk pool - less insurance company overhead and profits of course - right?
A. Exactly. That's the way that insurance coverage works.
Q. Interesting. So, a young and healthy person that has opted out of insurance to pay down debt, or try to save some money, is now required to subsidize the rest of the risk pool, right?
A. Well, yes.
Q. Just to confirm, because they're putting more into the system than they are taking out, these young and healthy individuals that opted out are actually worse off because of the mandate, agreed?
A. Well, yes, except they will now have insurance.
Q. We'll get back to that in a minute, but we agree that these young and healthy opt-outs, let's call them, voted overwhelmingly for Democrats in 2006 and 2008, right?
A. Certainly.
Q. And that, as Pew asserts "the overwhelming backing of younger voters was a critical factor in Obama's victory", agreed?
A. I do.
Q. Doesn't it seem like passing an individual mandate that requires these heavily Democratic voters to subsidize other less favorable demographic groups is politically kind of, well, stupid?
A. Keep in mind that these voters will now have health insurance, and Medicare and Social Security have the same sort of intergenerational transfer. I think these voters will understand the issue.
Q. Hey, I like Social Security and Medicare. So, I trust that like Social Security and Medicare, if someone subject to the mandate's income goes away entirely, that the premium obligation goes away, right?
A. Well, no.
Q. Wait, they still have to pay the premium?
A. Of course.
Q. Do they lose their insurance if they aren't able to?
A. Well, yes.
Q. What if because of the premium obligation, debt service, eating, etc. someone subject to the mandate can't afford the copays and deductibles associated with their insurance?
A. Well, then I guess they won't use it, but they're in the same position now without insurance. Plus, if things get really bad, they can just go on Medicaid.
Q. Except now, there's no requirement that they spend money on insurance that might be unusable, true?
A. I guess.
Q. Plus, with respect to Medicaid, can't they go on that right now if things get really bad?
A. I assume so.
Q. Hmmm...I really don't see how this is a political winner with the Democratic party's most supportive demographic. Can you explain it to me?