Watching Obama on Snuffleupagus today dodging around the question of whether individual mandates are a tax or not had me squirming in my seat.
The whole idea of a mandate seems to me like political suicide. Regardless of whether it is or not, wingnuts will jump on it (Snuffles took his cue and ran with it) as a huge new tax increase, and the media (as it always does) will dutifully "report" on mandates under the right wing framing. The "public option" story is now buried under the woodshed, and the new 24 hour focus will be on mandates.
I understand the theory behind the shared risk pool, but the argument seems to fly in the face of logic, especially when Obama clumsily tries to compare it to auto insurance, a "mandate" that can be simply avoided by not owning a car. You can't simply choose to not get sick.
People in this country rebel against the idea of being "required" to do anything, much less spend money, even if it is shown to be good for them. A mandate will be political suicide among the "independents", whose support Obama badly needs to get reform passed.
If you think the furor over the public option was bad, it will be a whisper compared to the coming outrage over the indiviudal mandate.
I was hoping that Obama was going to give public option-like tepid support to the idea.. "Look, a mandate is only a small part of the plan, it's not the whole plan.. only about 5% of people would even be subjected to a mandate", but no, he gave a full-throated defense of the idea.
By focusing his argument for mandates on the small percentage of people who allow "other people carrying your burdens for you" and those who've decided, "I just want to take my chances", Obama seems to be ignoring that the number one reason people don't have healthcare is that they cannot AFFORD to buy it. An insurance exchange without a public option does nothing but force people to buy high priced crappy insurance.
Even the much ballyhooed and equally undefined "public option" would not be free. People will still have to pay a premium, but at least the proft motive would be removed from the picture.
Obama seems to think that a single payer system would be "too disruptive" to the current healthcare status quo, but requiring 45 million people to buy something they cannot afford is not "disruptive"? Not evern thinking about how would such a mandate be enforced?
By many Physician accounts, Individual mandates based on a "buy your own" model in Massachussets is a failure. Here's just a couple
http://www.boston.com/...
http://www.boston.com/...
Costs in Massachussets under the private insurance based reform have continued to rise and are now the highest in the country
http://www.boston.com/...
Despite being dominated by not-for-profit health plans, Massachusetts had the highest family coverage premiums in the nation - an average of $13,788 - in 2008, the most recent year for which figures were available
Mandates without a public, government run option along the lines of Medicare will change nothing about the current system. You can still pass legislation to remove some of the more onerous insurance company abuses like pre-existing condition exclusions and rescission without subjecting the country to a massive private insurance industry subsidy, which is really all an individual mandate without a public option is.
The country is aching for a meaningful solution to the healthcare crisis, and there has never been more support for the generic idea of reform and specifically the option of a government run insurance program to compete with the private insurance market. It's maddening to watch the insurance lobby with the complicity of senatorial and congressional Democrats, along with a few loudmouth conservatives piss all that political capital away.