Mandatory Health Insurance: Major New Health Tax on Lower Income Americans?

Clinton and Edwards hold that mandatory health insurance this will lower health insurance premiums for all.

Obama says we can't mandate health insurance until everyone can afford it.

How to solve this chicken-and-egg problem???.....

The thing that suprises me is that Obama does not portray mandatory health insurance as a major new tax on those with low incomes, which it will be.

If somebody makes 12-15K a year, then a 1,200-2,000 dollar mandatory health insurance is really a major new tax of 10-20%, resulting in substantially lower disposable income for those who need that income most. Health care reform will be paid for by those with lower incomes.

Is that what Clinton and Edwards call fair?

Under Obama's system lower income people could opt out (see today's NYT Krugman column), save their premiums, then opt-in when they got really sick.  This would be seen as "cheating", but would actually be a way to get closer to a truly fair universal health system.

Simply raising the appropriate taxes to cover at least lower-income health costs would be much more logical and fair, but no one seems ready for that yet.

What do you think?

•  Facts help.

  "I want to say a quick word about health care because I've watched this sparring that's going on with Senator Obama and Senator Clinton. I don't want to get involved in that but I want people to know that there are real differences between us on this issue and what those substantive differences are.

  "I want to make sure caucus goers are aware that I was the first candidate to come out with a universal health care plan in February, and I'm proud that I lead on this issue. My plan is universal - I think that's a threshold requirement for health care reform in this country. That's why my proposal has a mandate that requires everyone to be covered.

  "Senator Obama's plan is not universal. He does not require that everyone be covered. As many as 15 million Americans will be left without coverage. And I've seen an estimate that up to 90,000 Iowans would be left without coverage. So there's a fundamental difference between us on the policy.

  "Senator Clinton's plan, which came out in September, is very similar to the plan I announced in February. But I haven't seen any specifics about how her mandate would work or how she would enforce the mandate.

  "I have laid out exactly how my mandate would work. The fundamental structure of my plan provides subsidies and the subsidies go up to about $100,000 of income. So for lower income families they'll be basically 100 percent subsidized, and the subsidy decreases for up to about $100,000 of income. The way we bring people into the system is anytime they have contact with the health care system or the government they can enroll - they go to the hospital to the emergency room, they sign their children up to school.

  "I think it's completely legitimate and fair for caucus goers to know where our policy differences are, and to the extent those differences continue to exist, I'll continue to make them clear. But I want to make certain that people know that I have a very strong positive agenda and I will remain focused on talking about what I want to do as president."

  Edwards Statement On How His Health Care Plan Differs From Those Of Obama And Clinton

  by TomP on Fri Nov 30, 2007 at 04:18:47 PM PDT

  •  better, though the number is high

    I would've thought a lower phase-out than $100k for the subsidy would make more sense. Surely people making $95k/year aren't exactly among the neediest Americans?

    by Delirium on Fri Nov 30, 2007 at 04:24:13 PM PDT

    •  They get a partial, not a full

      subsidy.

      by TomP on Fri Nov 30, 2007 at 04:27:45 PM PDT

    •  Depends on if you live in a high-rent area

      If you're making $100K, not getting any tax deductions because you don't own a house, paying half of your take-home in rent for a modest apartment, a quarter of your income in utiltiies, transportation, and food, you don't have much left over to pay for a mandatory health insurance policy. Especially if it's a junk policy that will take 10% of your income and still leave you with a $5000 deductible before benefits kick in.

      People without health insurance who make a lot of money by your standards but who live in high rent areas will be screwed by Clinton's health plan. I guess I should be thankful the limit goes that high at all.

      A word after a word after a word is power. -- Margaret Atwood

      by tmo on Fri Nov 30, 2007 at 04:36:37 PM PDT

      •  I'm not sure what your definition of modest is

        I live in the SF Bay Area, one of the highest-rent areas of the US, and I live pretty well on $30k/year. I have no idea what a "modest" apartment is that could cost half of take-home pay for someone making $100k, but it sure isn't my definition of "modest", nor that of most other people---the median family income of San Francisco is $68k.

        I'm frankly sick of upper-class yuppies complaining about how "oh high rents on ritzy condos and 4-bedroom houses make it hard to make ends meet with my poor 6-figure salary". Most of us can only imagine how much money it would be to make $100k/year, so don't have too much sympathy.

        by Delirium on Fri Nov 30, 2007 at 04:47:31 PM PDT

        •  People making 100K

          are not upper class.

          by denise b on Fri Nov 30, 2007 at 05:07:37 PM PDT

          •  sure they are

            For individuals, someone making $100k is in the top 7% of richest Americans. For households, they're in the top 17%. Any way you slice it, they're more privileged than the vast majority of Americans are. They aren't filthy rich with private yachts, of course, but just because there's a top 1% who's even richer doesn't mean being "only" in the top 7% makes you somehow middle class.

            by Delirium on Fri Nov 30, 2007 at 05:27:09 PM PDT

            •  All this tells you is wealth needed to what was

              once middle class.  100,000 with two kids does not provide what one income at 10,000 did in the 60s.

              I actually thought I would be rich making a 1000 a month at 25.  I just moved to San Francisco from San Antonio took me two years to close my open mouth.

              by yoduuuh do or do not on Fri Nov 30, 2007 at 06:04:22 PM PDT

            •  High income doesn't equal rich

              Rich people don't have to work for a living. They have assets. People making 100K may not, and almost certainly don't have enough to survive long without working, unless they're old enough to have socked away a lot.

              I made over 100K the past few years. I've been saving as much as I could for the past 15 years, but I've had high medical bills and periods of unemployment. Then I became disabled, and I will probably use up my entire lifetime's savings in the next few years. I'm most decidedly not rich.

              by denise b on Sat Dec 01, 2007 at 07:28:26 PM PDT

  •  Facts?

    by hollywood politcaljunkie on Fri Nov 30, 2007 at 04:34:17 PM PDT

  •  the reason your reasoning is wrong

    it skips the extra 'help' promised to lower income Americans with families and doesn't take into account what they already pay when someone gets sick but they have no insurance.  DId you read Krugman today?  I think we need to ask Senator Obama to fix his plan to include everyone, so that the healthy don't get to wait until they're sick to get insurance.  I like Obama, but he's sticking to his plan stubbornly and rather than back him up, i think we need to ask him to listen to Krugman and put forth a plan that covers everybody.  

    by anna shane on Fri Nov 30, 2007 at 04:46:46 PM PDT

  •  I stand corrected!

    Well, I do have egg on my face.

    Thanks for the info.  I stand corrected on Edwards, and will have to look more closely at Hillary's plan.

    Sorry for taking so long to get back - I was suddently called away.

    by Tom0063 on Fri Nov 30, 2007 at 07:43:02 PM PDT

  •  I stand corrected, but

    Why didn't HRC or Edwards manage to express this central feature of their plan when they were attacking Obama at the debate in Las Vegas?

    by Tom0063 on Sat Dec 01, 2007 at 02:17:26 PM PDT

•  Is someone advocating

  abolishing Medicaid, or not recognizing that low income/no income people will need assistance purchasing insurance?

  Wouldn't it make more sense to help people buy mandatory insurance then just say "Well, if you can't afford it - tough luck".

  by badger on Fri Nov 30, 2007 at 04:19:34 PM PDT

  •  Clinton includes and expands Medicaid.

    I cannot speak for Edwards on this - he may do this as well. Clinton expands Medicaid to also cover childess adults who are poor. Right now, if you're on Medicaid and your kid turns 18, you're booted right out of the system - regardless of how sick you are. Now, the state (or county) might find another way to cover you, but that's beside the point in a sense. In addition, her plan would provide more support to the county and state entities providing health care to ultra low income residents.

    by lorelynn on Fri Nov 30, 2007 at 04:28:14 PM PDT

  •  first, to paraphrase Shakespeare...

    kill all the health insurance executives.  (/half-snark)

    No way in hell that government has any right to force citizens to become customers of private companies.  This would be like passing a law that requires everyone to have a telephone or cable TV, and that didn't even exist in the days when the telcos and cablecos were tightly-regulated monopolies.  What's next, mandatory Christmas shopping to prevent recessions?

    The health insurance conglomerates are among the most evil, vicious, parasitic, predatory monsters this economy has produced.  IMHO they deserve to have their corporation chargers revoked and be dissolved.  

    Unlike car insurance, which only applies if you drive, these mandatory health insurance plans force you to have a private policy if you merely exist.  That's a tax by any other name.  If there has to be a tax, make it a real tax not a slightly-hidden or disguised tax, and then pay for health care directly from the tax: single payer, universal coverage, and no parasitic middlemen.  

    by G2geek on Fri Nov 30, 2007 at 05:41:03 PM PDT

    •  Interesting perspective!

      No way in hell that government has any right to force citizens to become customers of private companies.

      From a constitutional basis, I wonder if you have a point?? Can I/you/anyone think of a private company that citizens are now forced to deal with through government law?  How about trash collection paid through taxes but collected by private contractors?

      Come to think of it, if your scenario is carried to its fullest conclusions, then medical providers would have to work for government, so why not just salary them.  In your system, would providers be in private practice, and would that be forcing you to deal with private companies??

      Interesting.

      by truthbetold on Fri Nov 30, 2007 at 05:54:43 PM PDT

      •  You can generally be required to

        hook up to a sewer system if you are a homeowner.

        by SingleVoter on Fri Nov 30, 2007 at 08:03:19 PM PDT

•  Isn't is implied in all such plans

  that there will be subsidies based on income either directly or through tax credits to purchase the mandatory policies?  Lower income folks should not be paying for their policies under a proper working model of mandatory insurance purchasing!  Also with everyone in the pool for some defined policy requirements, only community rating allowed, and no pre-condition exclusions, such systems would be closed to a single payer end result in actuality.

  by truthbetold on Fri Nov 30, 2007 at 04:22:28 PM PDT

  •  It's stated directly in both Edwards' and

    Clinton's plan. Both provide subsidies and/or tax credits to lower income families.

    by lorelynn on Fri Nov 30, 2007 at 04:29:30 PM PDT

  •  Actually, Clinton's plan

    establishes an as yet undefined limit on the per cent of income that could go to health insurance premiums.

    Having some undefined features in a plan does not bother me.  Congress will have the final word on what is enacted.

    I must say that I am an Edwards supporter considering Clinton.

    by seeker on Fri Nov 30, 2007 at 04:32:41 PM PDT

  •  The Clinton plan caps the amount people

    would have to pay as a percentage of their income.

    by Partially Impartial on Fri Nov 30, 2007 at 04:33:50 PM PDT

    •  But they don't say what that percentage is

      That could make or break the plan for millions of people.

      A word after a word after a word is power. -- Margaret Atwood

      by tmo on Fri Nov 30, 2007 at 04:37:30 PM PDT

•  Everyone talks about mandates as a fix

  but how exactly are mandates enforced?  I mean, if someone doesn't buy health insurance do they get thrown in jail, do they get a ticket, do they get their wages garnished?  What's the enforcement mechansism?  I haven't seen this dicussed, which isn't to say it doesn't exist somewhere in someone's policy papers.  But my fear is that we equate the idea of mandate with full coverage, but the fact is even though car insurance is mandated in California, there are still plenty of people driving without insurance, or underinsured.

  by hollywood politcaljunkie on Fri Nov 30, 2007 at 04:37:16 PM PDT

  •  When you file your taxes,

    you either show you have a policy or you pay-sign-up-for or get your health polciy credit in the tax policy document.  Something like that!

    by truthbetold on Fri Nov 30, 2007 at 04:42:16 PM PDT

    •  Is that your idea or someone running for Prez?

      And again, if I don't show I have the policy, and don't sign up...what are you going to do to me to punish me and/or force me to comply with the law?

      by hollywood politcaljunkie on Fri Nov 30, 2007 at 04:43:42 PM PDT

      •  Yes

        Complying with the law is expected for everyone, and if you do not, you should expect adverse consequences!  Welcome to social living!

        by truthbetold on Fri Nov 30, 2007 at 04:54:18 PM PDT

        •  Again, that's not an answer

          It's fine to say there are consequences...but my point is are there actually any?  I mean, all these people are touting mandates as the solution, or the reason to support their plan.  But how do they enforce that?  Because I can tell you, we have mandates for car insurance here in Calif and not everyone has car insurance...so if mandates are your solution for containing costs...it might not work as expected.  

          And are we really goign to throw someone in jail for not having health insurance?  If not, what are we going to do?  Yes, there are consequences for not following the rules, but I think it's important for the candidates and people supporting these plans to talk about how a mandate is enforced so that it actually works.

          by hollywood politcaljunkie on Fri Nov 30, 2007 at 04:59:13 PM PDT

          •  Here

            This is the Krugman column. The point is, if there are criminals, does that mean we should stop having laws?

            http://www.nytimes.com/...

            by johnmorris on Fri Nov 30, 2007 at 05:06:12 PM PDT

            •  And Krugman doesn't get it either

              because that's not the point.

              The basic idea of mandates is to force everyone to have coverage so that the cost comes down, right?

              If a mandate isn't enforced, and everyone doesn't have coverage, how does the cost come down?

              Krugman, and everyone else, seems to gloss over this point.  And no one seems willing to go on record and say how they will enforce it.  That's not leadership.

              If you want mandates, fine, but tell me, how are you going to force every citizen to buy health insurance and how are you going to enforce that and how are you going to punish people for breaking the law.

              by hollywood politcaljunkie on Fri Nov 30, 2007 at 05:13:30 PM PDT

              •  Look, it is not that hard

                Use your imagination.  If you don't file a tax return, you go to jail. If you do file a return and have no policy, then based on your income, you are assigned a policy tied to your SS#.  If you qualify for a subsidy, that pays for all or part of it.  The rest is billed to you with the same consequences as not paying a tax.  

                BTW, in a single payer tax supported suystem, what happens to those who do not pay their taxes?? Samee dam thing really!

                by truthbetold on Fri Nov 30, 2007 at 05:20:08 PM PDT

                •  Sure, let's throw people in jail

                  I'd like everyone to start talking about that, and frankly I don't expect any of the candidates supporting mandates to come out in support of that plan...if they did, great.

                  by hollywood politcaljunkie on Fri Nov 30, 2007 at 05:23:21 PM PDT

                  •  What happens now if you

                    don't file a tax return??

                    by truthbetold on Fri Nov 30, 2007 at 05:26:52 PM PDT

                    •  Look, you're making this out like I'm arguing

                      with you, when I don't feel like I am.

                      My point was that no one seems to talk about this aspect of the mandate issue.  This isn't something I'm trying to win.  I'm looking for a discussion about it, because I don't see one either in the media, or by the candidates suggesting it as a policy.  And my sense is that's probably because the idea of punishing someone for not getting health insurance doesn't sell well.

                      So, to answer your question...yes, if you don't file taxes you may go to jail.  But that's not really my point.  I know that's your suggestion, and that's great.  But what exactly is HRC's and Edward's...because they are the ones fighting for this.  And if they aren't going to enforce it with teeth, than it's not really effective is it?

                      by hollywood politcaljunkie on Fri Nov 30, 2007 at 05:41:44 PM PDT

                      •  This is from a blog

                        If a person did not meet his or her monthly financial obligation for a set period of time (perhaps a year, perhaps longer) the Edwards plan would empower the federal government to garnish an individual's wages for purposes of collecting "back premiums with interest and collection costs."

                        The process, according to the Edwards campaign, would resemble the process used to collect money from Americans who are delinquent on federal student loans or child support payments.

                        http://blogs.abcnews.com/...

                        Note the use of the term Edwards campaign. I think this is a trial balloon.

                        Student loans can't be discharged in bankruptcy normally and people are thrown in jail for not paying child support.

                        by SingleVoter on Fri Nov 30, 2007 at 08:10:24 PM PDT

                •  many people are not required to file

                  returns with the IRS. Depends on income. If you have less than the standard deduction and exemption (IIRC) no need to file.

                  So what about them? Also what about adults who are still dependent on parents and on their forms?

                  sam

                  by samddobermann on Sat Dec 01, 2007 at 01:49:24 AM PDT

      •  That's part of

        the Edwards plan. When you file your taxes, you would have to prove health insurance just as, when you renew your drivers license or registration you are required to show proof of insurance. If you don't have it the (horrible) punishment is being signed up for health care.

        by johnmorris on Fri Nov 30, 2007 at 05:04:34 PM PDT

        •  So we are only giving health insurance to

          tax payers?  And even if you force someone to sign up, don't you think there will be plenty of people that simply end their coverage somehow, or don't pay.

          To me this mandate thing seems like a panacea people are latching onto....and it's the problem when we focus on health insurance rather than health care.

          by hollywood politcaljunkie on Fri Nov 30, 2007 at 05:17:43 PM PDT

          •  Politics

            is the art of the possible. The candidates, all of them, are assuming that an instant transition to universal, single payer health care would be politically impossible and economically disastrous. All of the plans are trying to get to that point by indirect means. Of the lot, Edwards's is the most direct, Hillary's follows closely and Obama's is a pretty bad compromise with the Republican tradition of lack of coverage. Coverage, in fact, is the issue and that's about insurance. We already have health care its just that not all of us can get it.

            by johnmorris on Sat Dec 01, 2007 at 09:59:35 AM PDT

      •  According to ABC News

        Edwards' idea is to enforce compliance by garnishing wages.

        If a person did not meet his or her monthly financial obligation for a set period of time (perhaps a year, perhaps longer) the Edwards plan would empower the federal government to garnish an individual's wages for purposes of collecting "back premiums with interest and collection costs."

        The process, according to the Edwards campaign, would resemble the process used to collect money from Americans who are delinquent on federal student loans or child support payments.

        The Edwards campaign has not put a dollar figure on the amount that would be garnished from wages because the cost of the lowest-priced plan in that region could vary and is not yet known.

        While raising the specter of wage garnishment could expose Edwards to the criticism that he favors a bigger, more intrusive government, he is hoping that Democrats will reward him for offering a plan that is bolder than Obama's and more candid than Clinton's.

        "To get fundamental change in our health care system, we need a fundamental change in our politics," said Edwards. "That starts with being clear and direct about what we are going to do and how we are going to do it."

        Gotta give Edwards credit for one thing -- that plan is bolder than Obama's and more candid than Clinton's.

        by moiv on Fri Nov 30, 2007 at 05:55:50 PM PDT

•  A dedicated tax stream is critical

  The worst part of Britain's NMG has traditionally been that it is paid for out of general revenue in the annual budget.  Thus it has been often underfunded, subject to the whims of partisan political strife.

  We must and should avoid this mistake in a national health care plan.  I think all the candidates' plans fall short by including subsidies for inefficient private insurers.  Far better and simpler to create a public-only health care plan, a "Medicare for All" approach.  A dedicated tax stream and an independent administrator, like the Social Security Administration, are needed to insulate the health care system from political meddling.

  Using a tax stream rather than "premiums" offers much more flexibility in deciding how to structure the revenue.  A progressive tax, imposed on all income above a floor (graduated or not) is a simple way to finance health care.  It is similar to, though higher than, the Medicare tax.  No ceiling on income would be advisable, to make sure lower- and middle-class Americans didn't feel the bite too heavily.

  by Dallasdoc on Fri Nov 30, 2007 at 04:41:41 PM PDT

  •  I agree BUT (there is always a but)

    is your idea politically feasible in the next 10 years???  

    A mandatory health insurance policy for all with the proper safeguards for consumers could well eventually lead to what you suggest because the insurance companies may well give up on health insurance business when it becomes clear to them that the gravy train is over. Not until that is made clear to them will they give up the cuurent status quo fight!

    by truthbetold on Fri Nov 30, 2007 at 04:47:03 PM PDT

    •  Not if it isn't tried

      The present insurance system is so deeply inefficient that we literally can't afford it.  We're already paying 50-100% more per capita on health care than other rich countries.  Cutting that cost is vital as we bring everyone into coverage.

      Only an all-public coverage system can cut costs enough to make universal coverage affordable.  Trying to do the "practical" thing will prove unaffordable, and this failure will be used by private interests to sabotage the entire reform.

      Splitting the baby is unlikely to work in health-care reform.  Perpetuating the problems of the current system won't lead to solutions.

      by Dallasdoc on Fri Nov 30, 2007 at 04:55:51 PM PDT

      •  Political reality

        must be paid attention to.  What you say will never happen in a single step realistically if insurance companies think they can thwart it.  A strong willed Congress could show to these powerful companies that the gravy train is over (but forcing into place enforceable and powerful consumer rules), and then the opposition to your idea may give up allowing it happen.  

        by truthbetold on Fri Nov 30, 2007 at 05:05:33 PM PDT

•  NOT a semantic difference

  I need health CARE not health insurance.

  by rincewind on Fri Nov 30, 2007 at 04:41:50 PM PDT

  •  Exactly, which is where all three of the top

    contenders fall short.  It's not about having insurance, it's about getting care.  In fact, I would argue insurance is the problem.

    That said, I have my doubts that we will ever have a truly, single payer national health care plan of the type we are talking about in this country...even though it makes the most sense.

    by hollywood politcaljunkie on Fri Nov 30, 2007 at 04:45:49 PM PDT

    •  What makes you believe

      that just becasue we have single payer will get you access to care on a timely basis??  I would imagine that if we don't do something about the healthcare provider infrastructure and scope of practice acts, that such single payer for all will result in huge rationing ques in short order as exist in Canada but faster and larger ones here!

      by truthbetold on Fri Nov 30, 2007 at 04:50:59 PM PDT

      •  Most people don't have access on a timely basis

        now.  When I was on HMO, it could take 2-3 months to get a doctor's appointment.  That's not timely.  In the UK doctors actually make house calls...I'll take my chances.  Yes, nothing is perfect...but our in perfect system now leaves 40+ million people uninsured while we continue to spend the most per capita on health insurance...so not only is it immorral, but it's just plain ineffecient.

        by hollywood politcaljunkie on Fri Nov 30, 2007 at 04:55:08 PM PDT

        •  This is somewhat true

          but just imagine if the 47 million were thrown into the equation on an equal footing to everyone there now?  

          Mind you I am not against this happening by any means, but I want to stress to you and others that just single payer will not magically get you access to timely care. If getting access to timely care is what you want from a healthcare system, then you need to look deeper-further than just the mantra of single payer rhetoric!

          by truthbetold on Fri Nov 30, 2007 at 04:59:02 PM PDT

          •  Not a mantra of rhetoric

            We have examples elsewhere in the world that single payer works. We're not inventing the wheel here. We also have a good example of what you get when you insist of preserving the private profit motive - Medicare Part D.

            by denise b on Fri Nov 30, 2007 at 05:14:20 PM PDT

            •  You will not get single payer

              until the majority of Americans are assured that long ques will not be in their future.  A smaller group of progressives may see the fairness in single payer, but that will not persuade a majority that are used to instant gratification.  A total system reform may work, but first you will have to convince the majority that they will be better off from an American perspective than they are now!

              by truthbetold on Fri Nov 30, 2007 at 05:24:41 PM PDT

      •  Have you, do you, live in Canada?

           Just curious,
              Heather

        by Chacounne on Fri Nov 30, 2007 at 05:08:08 PM PDT

        •  No

          but I have been involved in public health and public health policy in America on the federal and state level for 30 years.  I am pretty well aware of what some of the benefits and problems are in the Canadian system.  The biggest problem for America in trying to emulate the Canadian system, however, is that with America's much much larger population and the American history of getting many what they want almost immediately, it is going to be very difficult to get folks to wait in line!  Canadians have a much more social view of their lot in life and seem more inclined to put fairness and patiences ahead of individual greed.

          by truthbetold on Fri Nov 30, 2007 at 05:14:55 PM PDT

•  I frankly could care less what the Presidential

  candidates are talking about when it comes to National Health Care plans.

  What I want to happen with our National Health Care system will happen in the Congress and I'm not the least bit concerned that any of our Democratic candidates will veto single payer universal health care if it makes it through the congress.

  I'm more concerned with House and Senate seats than I am with the Presidency. Any of our Presidential candidates will be fine, because I'm not worried about them vetoing good legislation... I'm worried about good legislation not making it to the President's desk in the first place.

  We need to get rid of the repubs and bushdog dems in the House and the Senate more than we need to argue about the minute details of the Democratic Presidential candidate's health care proposals.

  by MichiganGirl on Fri Nov 30, 2007 at 04:47:41 PM PDT

•  Medicare for all

  It's quite simple, really.

  Medicare for All

  Medicare has lower administrative costs than any private plan on the market. It enjoys one of the highest approval ratings of any government program. But the most important reason Medicare is the best model for an expansion of healthcare benefits is that the program focuses on patients, not profits.

  by supak on Fri Nov 30, 2007 at 04:57:17 PM PDT

•  Ok....about subsidies.....

  What do you mean by subsidies, how would they work?

  The think I think alot of people don't GET is that many in the middle class are barely making it and any kind of health coverage is going to be expensive.

  I am fortunate that we have coverage through my spouse's employer but were the employer to drop the coverage, we aren't making enough to pay for anything else.  Currently the plan we get would cost over $1000 a month were we to have to pay for it on our own.

  by lrhoke on Fri Nov 30, 2007 at 05:01:21 PM PDT

•  Fuck INSURANCE. I want CARE. fire all the

  fucking insurance company people - they've had decades to prove how great they are compared to the horrible horrible government, and

  fuck them.

  rmm.

  by seabos84 on Fri Nov 30, 2007 at 05:11:55 PM PDT

•  Basic math

  Lower income people are already paying for their health care, through some of the most regressive taxes that there are.  

  Where do uninsured people go for medical care?  The county hospital.  Where does the county hospital get money to treat all of these people who don't pay?  From lots of places.

  - state and local taxes, like SALES TAXES and PROPERTY TAXES, regressive tax structures that are especially hard on the poor.

  - higher charges to people who do pay their medical bills, especially insurance companies, who pass those costs on to everyone including employers, who pass those costs on to...  Guess who?   Yep, everyone, including the poorest insured workers.

  - federal funds that go to states to fund hospitals, much of which comes from income taxes on the working poor.

  - charitable donations

  - I'll bet there's more that I'm not thinking of.

  Some of the uninsured get medicaid.  Guess who pays for that?   There's a cap on FICA taxes, so the poorest people pay more of their income to fund medicaid.

  Some of the uninsured get medical care from school clinics, paid for out of school district funds, paid for out of property taxes, not exactly the most progressive kind of tax.

  At the end of the day, it's a simple matter of mathematics that if we provide insurance for everyone, almost everyone is going to have to chip in to pay for it, some more than others.  Otherwise, where is the money going to come from?  The good news is that having health insurance will be a benefit to a person who has limited financial resources.  If they can get medicine when they are sick, they don't miss as much work and they have more energy to be productive at work and at home.  If they don't have to pay a huge bill for daring to see a doctor when they are sick, then they keep more of what they earn if they do get sick.  Otherwise, they get sick, miss work, don't get paid, then have a huge bill to pay to the doctor and pharmacy on top of everything else, plus fees on all the bills that didn't get paid on time or the bounced checks.  Health insurance will alleviate some of that load.  And, then there's the absence of fear.  Living without health insurance is living in constant fear.  If everyone is insured, then perhaps some of the pressure will come off state and local taxes, and some of the money may come back in the form of lower taxes.

  People have to buy mandatory liability insurance so they can drive to work.  We've adjusted to that.  If mandatory health insurance becomes a reality, then society will adjust to that, too.

  by DFWmom on Fri Nov 30, 2007 at 09:11:08 PM PDT

•  Mandatory Insurance is not the answer

  It gives the insurance companies, which have proven to be a disaster in providing healthcare, a guaranteed customer pool and thus no incentive to improve. It also provides these companies with an incentive to spend even more on marketing and PR because the only way they can grow (and improve share price) will be to lure away customers from other companies.  This is occurring with Medicare D now, where Medicare enrollees are forced to get the D coverage with penalties for not signing up from the start. Each year since its start the premiums have risen and more drugs have moved onto "prior authorization" list or off the formulary.  

  Also if you have any existing health problems in the family you will have problems choosing between plans with all their differing benefit packages. "Choice" can be a nightmare. Certainly it has been so with the mandated Medicare D.

  sam

  by samddobermann on Sat Dec 01, 2007 at 02:23:56 AM PDT