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Health Care

The dirty little secret about the health insurance mandate

Republicans have lately been denouncing mandatory health insurance as an unconstitutional assault on personal freedom.  However, in the 1990s many of them were actually touting mandatory private health insurance as a "free-market" alternative to government-run health care, as this article illustrates.  Even the Heritage Foundation was pushing it, and this partly explains why Obama publicly opposed it during his presidential campaign.  There are, of course, plenty of reasons to object to the recent legislation, but this demonstrates, once again, that the GOP is a weak reed on which to rely on matters of individual liberty.

Categories > Health Care

Discussions - 14 Comments

John - I probably have a tin ear here. Does the new threat to individual liberty come from the fact

1) that the mandate is coercive, like any tax? Say why this tax is peculiarly offensive. Should we repeal the income tax amendment?

2) that we are forced to join a risk pool for broader community rating? Is the offense that this is an especially harsh undermining of individual responsibility - and thus liberty?

3) that it is a federal, not a state mandate? Is this, then, an assault on federalism? But why would be allow a state to take away individual liberty?

All of the above?

How do you explain why Republicans were once for health insurance mandates?

Well, John, you just don't get it, do you. Now is NOT the time for obsessively pointing out hypocrisy on the Right (even when it clearly exists). Now is the time to circle the wagons and prepare for the next assault.

I've never understood hard-core libertarians. Such purist strategies can never ever win. Its unfortunate, but to beat the Left you have to become as ruthless and unprincipled as they are (at least, long enough to beat them). And yea, I know, then it's too late to change your spots,, yada yada yada.

Marquis of Queensberry is for losers, John. Best get over this self-righteous binge you're on.

Actually, one could make a case that in current circumstances it is not unreasonable to say that a responsible adult should have health insurance. But that same logic ONLY applies to catastrophic care insurance. The trouble with legal realism or positivism is that it discovers new needs without accepting that they are self-limiting.

In fairness to Mitt Romney, state governments have (on paper) general police power whereas the federal government has only delegated powers, so there is a distinction between the actions of the Massachusetts legislature (acceded to by the Governor) and the federal Congress.

The rest of the article refers only to trial balloons floated which were apparently well received by (unnamed) policy wonks. I fail to see how that is parallel to actually enacting a formal proposal of a sitting administration.

There is No Mandate....read the bill


This is a copy of the text as written in the bill:

2) SPECIAL RULES.—Notwithstanding any other provision of law—
‘‘(A) WAIVER OF CRIMINAL PENALTIES.— In the case of any failure by a taxpayer to timely pay any penalty imposed by this section, such taxpayer shall not be subject to any criminal prosecution or penalty with respect to such failure.
‘‘(B) LIMITATIONS ON LIENS AND LEVIES.—The Secretary shall not—
‘‘(i) file notice of lien with respect to any property of a taxpayer by reason of any failure to pay the penalty imposed by this section, or
‘‘(ii) levy on any such property with respect to such failure.

Yes. What Mike says appeared here: http://www.opencongress.org/articles/view/1766-Not-Much-of-a-Mandate

Dunno what to make of this.

Yow! Of course, in a bill of this size that nobody has read, I suspect we're going to get a lot of surprises like that in the weeks to come.

Read the bill? Where? I am grateful to whoever has time and picks out things like this from the law. Although, at the size, (how many pages did it end up being?) there may be some provision somewhere else in the bill that contradicts this bit, mightn't there? It seems to me that the real challenge of modern government is that whatever you do you are likely to be unlawful or breaking some regulation or statute -- always guilty.

I got this from CNN

"An adult who does not have health insurance by 2014 would be penalized $95 or 1 percent of income, whichever is greater, so long as the amount does not exceed the price tag of a basic health plan. But by 2016, the penalty increases to $695 for an uninsured adult, and up to $2,085 per household, or 2.5 percent of income, whichever is greater.

A person would also be penalized only if he or she went more than three months of the year without insurance.

Some people are exempt from the new law. If a person's income is below a certain level, or if the cheapest insurance would cost 8 percent of the person's income, no penalty would apply for lack of coverage."

And now I read there is no real penalty for not paying the fine, whoever you are? Who will buy health insurance? What will this do to our whole system? I mean aside from driving all private health insurance companies out of business.

What do you suppose our tax rates will have to be to pay for all of this?

Mike's comment does not prove the non-existence of the Mandate--it only restricts penalties for not having insurance.

Remember in the 1964 Civil Rights Act the clause about busing to achieve school integration not being mandated? Of course not mandated did not mean prohibited. Judges interpreted the Act to permit and even facilitate such busing, which undermined the transcendent purpose of the Act.

Of course, this is just another loony bit of the legislation stuck in to ameliorate some senator over The Mandate and probably subject to reform later when the whole process doesn't work on account of its toothlessness. It is just funny at the moment since it makes this law remind me of others, impossibles like the threatening tag that come on your mattress saying "Do not remove under penalty of law (blah, blah, blah)".

Most people will buy health insurance -- from some entity, public or private -- because they have been told they must. It's mandatory, but apparently so with an absurd arbitrariness that makes mockery of it.

What Mike cites refers to penalties imposed for not buying medical insurance -- it is not referring to the actual requirement to purchase said insurance. Moreover, are fines "criminal penalties?"

I think this is as clear as mud.

I first heard Heritage people pushing an individual mandate in the late 1980s. At the time, the bigwigs there made a calculation that pushing an individual mandate and preserving private insurance offered an alternative to single-payer or the messy ideas that eventually became HillaryCare.

It was a short-sighted, CYA move that has hurt Heritage's credibility on the free-market side of health care ever since.

Now is the best time to point out that the rebuplicans do not stand for the principles of their base. This the opportunity to end the false right left circle of death where we just keep getting worse and worse while one side pretends to be against the awful legislation that they have no power to stop and when they get power they will say its too hard to get rid of. It's easy for them to kick and screem for theatrics now when it matters not what they do, but I predict that if the country fills congress with corporate rebuplicans then the we get no better, loose more liberty, and the insurance companies and the banks continue to get their subsidies via our wealth.

"The individual mandate remains one of the murkiest bits of this legislation. During the 2008 primaries, Mr. Obama criticized rival Hillary Clinton for favoring such a mandate. He later changed his mind, for one big reason: There's no way to afford expensive provisions such as forcing insurance companies to cover people with, say, pre-existing conditions unless millions of healthy people who won't need insurance are forced to pay into the system. With the mandate, the government gets more healthy people into the risk pool—and with the penalty it gets their money whether they buy coverage or not."

That's Bill McGurn today in the WSJ. That was why some conservatives pushed the individual mandate in the 1980's. Once you have Medicare and Medicaid going where insurance companies fear to tread, wading right into a serious risk-pool, there has to be some way to cover that risk. Covering chronically sick people, which includes the aged, is expensive. Government takes up the slack -- how do you pay for it?

If conservatives were all ruthlessly free-market there would be only the political problem of appearing cold-hearted. Capitalism is not compassionate. Capitalists usually are, being human. Democrats calling for a more compassionate system miss the point. A system cannot be compassionate, only people can. Compassion is not always practical, but people must be practical about compassion.

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I think I may have been misunderstood in some of my recent posts calling Republicans to account for having favored health insurance mandates and the Medicare prescription drug benefit.  It's true that I don't believe that Republican politicians ar... Read More