Top Ten Reason We Need Mandated Universal Health Care
(1) Precedent shows it's necessary.
Other industrialized country require participation in one or another health care program (see here and here). Often it's funded by taxes, but in many countries (e.g., Germany, France, Japan, Netherlands) it involves payment for social or private insurance. I am aware of no country in the world that has universal health care that allows people to not participate in a health care program, even if they are employed and can afford to. Indeed, the very notion of a universal system that is not mandatory is contradictory.
(2) It's for the public good.
If people are not insured, chances are they will eventually have health problems anyway, taxing emergency rooms and/or spreading disease to the rest of us. Indeed, under Obama's plan, there is little incentive for any healthy person to buy health insurance, because, once they become seriously ill they could buy it if they wanted to (remember, nobody can be denied, but nobody is obligated). Then people who did the right thing by buying insurance right away would have to support people who free-loaded off others. (Thanks to Paul Krugman for this argument.)
(3) It's easily enforced.
The Canadian way, adopted by John Edwards this week, involves automatic enrollment in a public plan as part of your income taxes if you fail to show evidence of insurance. Hillary Clinton prefers to work out the details of this with members of Congress, to achieve broad buy-in. The bottom line is that there are lots of ways that have been successfully put in place internationally. It ain't brain science.
(4) It's consistent, rather than half-baked.
Actually, Obama's plan does involve a mandate--for children. That thus destroys any argument that enforceability is a major obstacle, or that mandates are not needed because the only reason people don't buy health insurance is because they can't afford it (and that making it affordable will thus solve the problem). Is Obama suggesting that making it affordable will solve the problem for adults, but won't solve the problem for children (i.e., that people will be thoughtful enough to buy affordable insurance for themselves, without a mandate, but will require a mandate to buy insurance for their own children)? Sort of ridiculous, no?
(5) It's cost effective.
While we are talking about affordability, how does Obama plan to make health care affordable if the young and health are allowed to opt out? It's precisely by including a large pool of both the healthy and the unhealthy that we can make universal health care affordable to all.
(6) It's essential to reform.
We are demanding major concessions from insurance companies. They will be required to insure everybody, no matter what their preexisting conditions are. And they will be required to provide a certain level of coverage. Providing the "carrot" of a larger pool will make it much easier to achieve these substantive and major reforms we require.
(7) It has broad public appeal.
Even moderate Republicans, such as Schwarzenegger and Romney (back in the days when he was a moderate) have supported universal health programs with individual mandates. Our programs will be much better, because they will include tax credits to make them affordable to low-income Americans, as well as public options to compete with private insurance. But the principle of individual mandates has proven acceptable to everyone from the left to the center-right, and we can thus build a broad coalition for health care reform.
(8) It's the American way.
We already demand mandatory participation in social security insurance and workers' compensation. Anybody have any problems with that? Then why not in health insurance?
(9) Obama's own task force told him.
Obama likes to take credit for a state task force he helped create that urged universal health care. What he conveniently leaves out is that the report issued by the task force urged a plan where "all Illinois residentss will be required to obtain health care coverage" (see Chicago Sun-Times).
(10) It's the only way to achieve universality.
A broad range of experts agree that mandates are necessary to achieve universal coverage. For example, John Holahan, Principal Researcher at the Urban Institute, wrote, ""Implementing universal coverage requires an individual mandate, which may or may not be combined with an employer mandate. Implementing them would make insurance accessible and affordable, and reduce the number of uninsured by about one-third. Covering the remaining two-thirds is only achievable if health insurance is made mandatory."
The bottom line? If you care about universal health care -- as I believe most Kossacks do -- then please support one of the candidates that is calling for it. Don't support the candidate who would leave 15 million uninsured.
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