Alternative to Individual Mandate is Socialized Medicine
Every health wonk--including conservative ones, as conservative as wonks in states like Utah--knows the alternative to the individual mandate is socialized medicine. There are no other possibilities. Ultimately, if the public demands healthcare as a public good (as opposed to insurance against catastrophe), the public as a whole must pay into it.
This is why conservatives invented the idea of a mandate in the first place, as a response against those who would nationalize and socialize healthcare. It's a battle we are losing, badly--Medicare and Medicaid are, for the most part, socialized medicine, and together they comprise nearly half of all health spending. And remember those free ER visits? Those often come out of the public purse, too.
We may win this battle, and SCOTUS may get rid of the mandate. But mark my words: in 2016, the debate will not be between proponents of the status quo and proponents of requiring American citizens pay for their own healthcare. It will be whether private insurance should be allowed at all, in our new, completely socialized, coldly rationed healthcare system.
And besides, the regulations and proto-rationing in ObamaCare are what we should really care about. The contraceptive mandate proves that! Do we really want politicized federal regulators saying which health services should be prioritized, and which should not? If you read the law, the sheer level of federal intrusion in the regulatory sphere is astounding. The mandate is the least of the law's problems. Unfortunately, the public seems to dislike it much more than they dislike regulations in general.
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Dec '10
Re: Alternative to Individual Mandate is Socialized Medicine
A free market in health care requires two things that we've not had during my lifetime:
The quality of health care should correlate with price, and
The quantity of health care should correlate with price.
If a free market is established with those two qualities, Obamacare's mandate and socialized medicine will be as useful and as welcome as chlamydia.
The HSA had a pretty good chance of establishing such a market, at least at the level of normal healthcare services.
Mar '11
Re: Alternative to Individual Mandate is Socialized Medicine
Another alternative might be for each State to come up with its own healthcare plan (States do not have enumerated powers, so could have a mandate, like Romneycare), while the Federal government stays out of it, and within its enumerated powers?
If nothing else, today highlights the difference between Romneycare and Obamacare. To be fair to Mr Romney, he has been saying this for some time.
Apr '11
Re: Alternative to Individual Mandate is Socialized Medicine
How about allowing people to buy insurance across state lines and decoupling insurance from employers? Those two steps alone would seem to solve most problems. People could get insurance for cheap when they are young and carry it with them so that there would be few cases of pre-existing conditions along with more choices. Amongst those choices could be simple catastrophic insurance which covers the cases that the Left freaks out the most against (i.e. getting cancer in your 20's).
Alas, it's my guess that the fear-mongering of the Left has people convinced none of these solutions would work, even though this is how most industries operate on the whole.
Jul '11
Re: Alternative to Individual Mandate is Socialized Medicine
Jerry Broaddus: A free market in health care requires two things that we've not had during my lifetime:
The quality of health care should correlate with price, and
The quantity of health care should correlate with price.
If a free market is established with those two qualities, Obamacare's mandate and socialized medicine will be as useful and as welcome as chlamydia.
The HSA had a pretty good chance of establishing such a market, at least at the level of normal healthcare services. · 8 minutes ago
One great post!
Mar '11
Re: Alternative to Individual Mandate is Socialized Medicine
Either way, if any health care provider starts making more money by providing better health care or more efficient delivery of care, the bureaucrats will perceive their success as ripping off the system and will look for ways to pull them down to the norm.
No one would argue that the high cost of health care is a problem, but making it a political problem takes away the incentive to find solutions and motivates the consumers to pig out at the buffet even if the food is very ordinary.
Re: Alternative to Individual Mandate is Socialized Medicine
Joseph, after reading your post, I find myself asking myself a question I have frequently found myself asking myself: "Why is it that conservatives are inclined to surrender before the fight even begins? Why are they so timid that they never even bother to articulate their argument?"
We got Obamacare because the Republicans surrendered. They did so when the Heritage Foundation proposed the individual mandate, Newt Gingrich sung its praises, and Mitt Romney implemented it in Massachusetts. This whole situation is the fault of the Republicans who dare almost never to attack the administrative entitlements state on the basis of principle.
Feb '11
Re: Alternative to Individual Mandate is Socialized Medicine
Forgive me if I'm rambling a bit off the topic. But I don't think you can explain the mess the US healthcare system has become without understanding that the left has done everything it can to make it fail with an end goal of a single payer system. Or worse.
That's why it never got fixed with any or all of the wonderful free market ideas that would have done away with the impulses for "health care reform" that we've suffered from since whenever. And that's why the left regards the plainly unworkable monstrosity of Obamacare as a great triumph. It's a great step to their end goal, whatever that is.
So to really fix US healthcare you need to defeat the left.
And now I think I'm just stating the obvious. So why do I get the impression that the GOP has never actually figured this out? And is still looking for that sweet "bipartisan" compromise that will make everyone, everyone at all, fabulously happy?
Am I wrong to think the GOP utterly fails to grasp the actual problem at hand?
Someone please tell me so.
Apr '11
Re: Alternative to Individual Mandate is Socialized Medicine
If the argument is "you (the individual) are in the market" can't that be argued for food, housing, energy, etc. as well as for health care?
Re: Alternative to Individual Mandate is Socialized Medicine
See FDR's Second Bill of Rights -- presented in his 1944 message to Congress. You are right on the money. This will never stop.
Sep '10
Re: Alternative to Individual Mandate is Socialized Medicine
Paul A. Rahe: "Why is it that conservatives are inclined to surrender before the fight even begins? Why are they so timid that they never even bother to articulate their argument?"
We got Obamacare because the Republicans surrendered. They did so when the Heritage Foundation proposed the individual mandate, Newt Gingrich sung its praises, and Mitt Romney implemented it in Massachusetts. This whole situation is the fault of the Republicans who dare almost never to attack the administrative entitlements state on the basis of principle. · 45 minutes ago
It shames me to admit it, but I think that argument on the basis of principle is unlikely to win over voters, which makes Republican timidity understandable. I'm afraid people have to be shown the actual bad effects of the superstate before they'll grasp the principle. What we need are people who are capable of drawing a vivid, believable picture of the practical problems endemic in utopia. They understand "death panels" and "waiting lines" and such, and we need to connect the dots between socialist promises and real-world privation in order to make the principles real in their minds.
May '10
Re: Alternative to Individual Mandate is Socialized Medicine
John Murdoch:
And I think you're also missing a few alternatives, including
Would you please explain this one?
Insurance is a gamble. How can a gamble be taxed? On which end do you intend to tax it — the buyer's or the provider's? Do you intend to wait until Sally needs an organ transplant and then tax the payment of that service? Or would you charge her for merely purchasing insurance? Or must an employer pay a penalty to provide insurance?
I'm completely lost on this idea.
Oct '10
Re: Alternative to Individual Mandate is Socialized Medicine
Aaron Miller
John Murdoch:
And I think you're also missing a few alternatives, including
Would you please explain this one?
I'm completely lost on this idea. · 20 minutes ago
It derives from the fact that during the post war years when Federal price controls were firmly in place over all industries, corporations were allowed to deduct health care premiums for employees as a business expense (i.e. paying these benfits in "pre tax" dollars). This allowed them to offer this "benefit" in lieu of a higher wage in order to attract a higher quality of labor. It is also why unions tend to have the richest insurance benefit packages.
Under current tax law individuals pay for insurance in "after tax" dollars. In order to level the playing field for the individual, either the employed person who recieves benefits from the employer is taxed as if the benefit was a wage, or the self-employed or employed without benefits person gets to deduct some portion of their insurance costs from their taxes.
Dec '10
Re: Alternative to Individual Mandate is Socialized Medicine
Justice Scalia asks if broccoli is deemed to be healthy, can the government can compel the citizenry to enter into the broccoli market? Justice Breyer says that if the government thinks a public interest is served by having burial insurance then it can compel the citizenry to purchase such. I wish one of the justices had ask the SG if it were determined that homosexual anal sex were a health risk can the government compel homosexuals to purchase condoms? And, if a gay man contracts a venereal disease via anal sex, can the government impose penalties? I just wonder what the four liberals on the court would think of that!
Mar '11
Re: Alternative to Individual Mandate is Socialized Medicine
Paul A. Rahe: "Why is it that conservatives are inclined to surrender before the fight even begins? Why are they so timid that they never even bother to articulate their argument?"
We got Obamacare because the Republicans surrendered. They did so when the Heritage Foundation proposed the individual mandate, Newt Gingrich sung its praises, and Mitt Romney implemented it in Massachusetts. This whole situation is the fault of the Republicans who dare almost never to attack the administrative entitlements state on the basis of principle. · 2 hours ago
Why have Republicans always been too scared to denounce state-subsidized healthcare? Perhaps because one of their largest contituencies is the main recipient of Medicare? Perhaps because any free market reform of healthcare will invariably require that certain services which were previously covered will now be too expensive for most? Because a politician who supports a bill which results in even a few lives being lost can never be reelected?
We have created an electoral environment in which any action that might result in some voters receiving less healthcare has become political suicide. I don't blame Republican politicians for following the incentives we have set for them.
Re: Alternative to Individual Mandate is Socialized Medicine
Good grief. Do you really think the only choices are socializing profit (socialism) or socializing demand (ObamaCare's fascism)? Has capitalism really not made itself known to you as a possibility?
What destroyed the free market was insurance companies being given a pass by the Justice Department Anti-Trust Unit, specifically with regard to illegal tying agreements.
Simply enforce the laws we have and demand insurers make available hospitalization and catastrophic insurance without tying that to policies that make you buy insurance to cover 10 cent aspirins. The market will bring prices down and availability to healthcare up.
Edited on March 28, 2012 at 8:05amOct '10
Re: Alternative to Individual Mandate is Socialized Medicine
Paul A. Rahe: Joseph, after reading your post, I find myself asking myself a question I have frequently found myself asking myself: "Why is it that conservatives are inclined to surrender before the fight even begins? Why are they so timid that they never even bother to articulate their argument?"
We got Obamacare because the Republicans surrendered. They did so when the Heritage Foundation proposed the individual mandate, Newt Gingrich sung its praises, and Mitt Romney implemented it in Massachusetts. This whole situation is the fault of the Republicans who dare almost never to attack the administrative entitlements state on the basis of principle. · 7 hours ago
It's hard to attack administrative entitlements when the voters love then so much. The advantage of Republicans "surrendering" early, is if we design these programs, we can privatize them, but if Democrats have a chance to implement their ideas first (as happened with Medicare and Social Security) ex-post reform becomes impossible.
Oct '10
Re: Alternative to Individual Mandate is Socialized Medicine
Tommy De Seno: Good grief. Do you really think the only choices are socializing profit (socialism) or socializing demand (ObamaCare's fascism)? Has capitalism really not made itself known to you as a possibility?
What destroyed the free market was insurance companies being given a pass by the Justice Department Anti-Trust Unit, specifically with regard to illegal tying agreements.
Simply enforce the laws we have and demand insurers make available hospitalization and catastrophic insurance without tying that to policies that make you buy insurance to cover 10 cent aspirins. The market will bring prices down and availability to healthcare up. · 3 hours ago
Edited 2 hours ago
I'm not so sure. The anti-trust exception is a problem, but not the whole problem. And while we may have theories of how a mandate-free healthcare market would work, there are no practical examples; most healthcare systems in the developed world use either the mandate, a public option with limited enrollment, or a single-payer model.
Oct '10
Re: Alternative to Individual Mandate is Socialized Medicine
Paul A. Rahe
See FDR's Second Bill of Rights -- presented in his 1944 message to Congress. You are right on the money. This will never stop. · 9 hours ago
I've always thought a negative version of those rights would be useful; so, for example, poor people could sue municipal governments that restrict housing with onerous zoning laws. Or employees could sue over regulatory policies that raise the structural level of unemployment.
Aug '10
Re: Alternative to Individual Mandate is Socialized Medicine
Joseph Eagar
...so, for example, poor people could sue municipal governments that restrict housing with onerous zoning laws. Or employees could sue over regulatory policies that raise the structural level of unemployment.
Uh-oh. Sovereign immunity. The government cannot be sued unless it specifically waives its rights to be sued or consents to the suit -- and how often's that gonna happen? Though municipal governments are an exception: they can be sued under federal law, since they're "enough" like a private corporation. So I suppose the zoning suit may be possible. (On the other hand, I don't suppose the saying "You can't fight City Hall" came about just by accident...)
Suing the sovereign over taxes is particularly verboten, and I would imagine suing over economic effects falls into roughly the same category.
I wonder... why is sovereign immunity such hot stuff?...
Edited on March 28, 2012 at 4:34pmRe: Alternative to Individual Mandate is Socialized Medicine
Joseph Eagar
Tommy De Seno: Good grief. Do you really think the only choices are socializing profit (socialism) or socializing demand (ObamaCare's fascism)? Has capitalism really not made itself known to you as a possibility?
What destroyed the free market was insurance companies being given a pass by the Justice Department Anti-Trust Unit, specifically with regard to illegal tying agreements.
Simply enforce the laws we have and demand insurers make available hospitalization and catastrophic insurance without tying that to policies that make you buy insurance to cover 10 cent aspirins. The market will bring prices down and availability to healthcare up. · 3 hours ago
Edited 2 hours ago
I'm not so sure. The anti-trust exception is a problem, but not the whole problem. And while we may have theories of how a mandate-free healthcare market would work, there are no practical examples; most healthcare systems in the developed world use either the mandate, a public option with limited enrollment, or a single-payer model.
We know exactly how it would work because it worked fine until the introduction of the HMO made us buy insurance for things we would spend less money paying for directly.
Edited on March 28, 2012 at 5:58pm