Jan 19th 2011

Why the Insurance "Mandate" is a Bogus Issue

by Robert Creamer

Robert Creamer is a long-time political organizer and strategist and author of the recent book: "Stand Up Straight: How Progressives Can Win," available on amazon.com.
Former Republican Majority Leader and FreedomWorks uberlobbyist, Dick Armey, who helped organize the original "Tea Party" opposition to health insurance reform, recently sent a memo to his followers detailing their plan to "repeal" the Affordable Care Act.

Armey understands that most of the specific provisions of the law - like banning insurance company discrimination based on pre-existing conditions, eliminating the ability of insurance companies to cut you off when you get sick, or assuring access to insurance to most Americans - are pretty popular. He argues that the point of vulnerability is the so-called "insurance mandate" - the requirement that every American has to either have private insurance, coverage at work, Medicare or Medicaid.
Armey's memo puts it this way:

Target the individual mandate. Like the Death Star, the health care "reform" law has one especially critical weakness: the individual mandate. Section 1501 of the Affordable Care Act requires all individuals to purchase government-approved health insurance.

The "mandate" is also the principal focus of the many lawsuits that right wing state attorneys general have filed against the law. Ironically, Armey and his ilk, use the unpopularity of the insurance companies (whose interests they actually represent) to gin up unhappiness at being forced to buy insurance from those very companies.

Armey argues that if they can kill the mandate, the rest of the new law will fall of its own weight, since if there is no mandate - but insurance companies can't discriminate based on pre-existing conditions -- then people who are not sick will wait to buy insurance until they are. And that, of course, is in fact a serious problem since it will drive up insurance premiums for everyone else.

What makes the right wing's assault on the mandate so disingenuous is that virtually everyone in America - from "Tea Party" adherents to supporters of Single Payer - agrees that no one should be denied health care when they need it. In fact, the two most effective attacks on the Health Care Reform bill were the bogus charge that it included "death panels" that would deny people medical care if that care were not "cost effective" and the equally false charge that the bill would cut Medicare by half a trillion dollars.

Both of these attacks had traction precisely because virtually every American agrees that when you need health care - you should get it. No one really believes that if you're in an accident and you don't have health insurance or can't afford care you should be left by the side of a road like "road kill." And you can bet none of the right wing voices who rail against the "insurance mandate" would volunteer to sign a waiver of their rights to medical care when and if they needed it if they had declined to purchase health insurance.

So if we all agree with that central premise, then the major question remaining is how we should pay for the health care system that provides that care. Of course once you assume that everyone who needs it should get health care, then it follows that everyone should - in all fairness - contribute to the system that provides it.

Personally, I believe that the most efficient way to make sure that everyone contributes their fair share to the health care system is through taxes that would support Medicare for everyone. That system has worked terrifically for seniors - and there is no reason people who are under 65 year old should be denied the advantages of a simple, efficient mechanism to contribute to and pay for their care. Medicare for all would not "socialize" the provision of health care, since most doctors, hospitals and others that provide care would continue to be in the private sector. But it would create a fair, efficient system that would eliminate the domination of huge private insurance companies - including their profits, and costs of armies of bureaucrats that spend their work lives denying claims rather than providing care.
The other alternative to assure that everyone contributes to support their own health care is the health insurance mandate included in the Affordable Care Act. If you don't have a mandate, then the costs of the people who refuse to buy insurance until they are sick are spread to the rest of us - either through higher premiums or higher payments to hospitals and doctors by the government to pay for "uncompensated" care.

The result would be similar to the current system where many people wait until they are really sick to seek treatment - massively increasing the costs to all of us. That, of course, results in large numbers of unnecessary deaths and disabilities that would not happen if everyone felt they could afford to get preventative care or were covered by insurance. The one difference would be that much of the costs for those who do not have insurance would be borne by those who do.

Armey and his corporate clients understand all of this. They intend to exploit fear of the "mandate" in the same way the exploited fear of the mythical "death panels" last year. These are not genuine arguments against the Affordable Care Act. Instead they are political means to the end of eliminating health care reform so that the private insurance industry can continue to dominate our health insurance system and rake in profits that are not limited by "inconvenient" provisions like the Affordable Care Act's requirement that at least 80% of insurance premiums actually go to pay for health care and not profits and CEO salaries.
Armey acknowledges in his "strategy memo" that when the Right argues to "repeal and replace" the Affordable Care Act, they don't expect that it would actually be "replaced" for many years.

"Replacing the law will take years," he writes, "but its repeal could come sooner than expected, if health care reformers stay on the offense and foment divisions among the fragile coalition that squeaked the bill through last march."

The "mandate" is just one more bogus argument - one more bright, shiny object - intended to distract ordinary Americans from the fact that the new health care law protects them from losing the insurance they have if they get sick, or are one of 129 million Americans that has a "pre-existing condition" that would prevent or limit their coverage - or raise their rates - if they were laid off from their employer and forced to seek insurance on the private market.
It is just one more way to try to distract everyday people from the fact that Armey and his cohorts are really interested in putting the big private insurance companies back in charge of their health care - without the Affordable Care Act's provisions that rein in their power to raise rates, and their ability provide insurance only to those who are not sick.

Armey and company are not looking out for the average "Tea Party" adherent. They are looking out for a bunch of insurance CEO's that fly around in private jets and spend their multi-million dollar bonuses on second, third and fourth homes.

Don't let Dick Armey play you for a chump. Call your Member of Congress and Senators. Tell them to vote against repealing the Affordable Care Act. Or sign an on-line petition at www.stoptherepeal.com. The attack on the health insurance "mandate" is intended to benefit big insurance companies by destroying the protections that the Affordable Care Act provides for everyday people.

Robert Creamer's book: Stand Up Straight: How Progressives Can Win, available on Amazon.com.

Browse articles by author

More Current Affairs

Jun 12th 2021
EXTRACT: "China’s recently published census, showing that its population has almost stopped growing, brought warnings of severe problems for the country. “Such numbers make grim reading for the party,” reported The Economist. This “could have a disastrous impact on the country,” wrote Huang Wenzheng, a fellow at the Center for China and Globalization in Beijing, in the Financial Times. But a comment posted on China’s Weibo was more insightful. “The declining fertility rate actually reflects the progress in the thinking of Chinese people – women are no longer a fertility tool.” "
Jun 12th 2021
EXTRACT: " I remember recounting fellow leaders of the story of a Rwanda schoolboy caught up in the genocide of the 1990s and now immortalized in the Kigali Genocide Memorial museum, where, in a section devoted to children, one can find his photograph and a plaque that reads: ----- David, age 11 ...... Ambition: to be a doctor ...... Favorite sport: football ...... Favorite hobby: making people laugh ...... Death: by mutilation ...... Last words: the UN are coming to save us ----- In his idealism and innocence, David believed the international community would save him and his mother. We didn’t. "
Jun 8th 2021
EXTRACT: " While many conservative Republicans opposed Trump and saw that he posed a danger to their party and democracy itself, they were hesitant to buck the mass movement they had created, fearing that it would turn against them. Some of these same conservatives assumed that with Trump's defeat, the horror of January 6th, and the former president's banishment from social media, the time had come to restore sanity to their party. But the GOP leadership’s continued cowering in the face of what they now call "Trump's base" has caused them to circle the wagons and purge their ranks of those who call for sanity. "
May 26th 2021
Editor's Note: This article is about the Federal Reserve, inflation in the 1970's, and possible similarities to today.
May 25th 2021
EXTRACT: "Netanyahu claims to be acting in the name of the Jewish people. He certainly is not. Many Jews around the world, including me, despise Netanyahu’s racist politics. As an American, I am also deeply troubled by the US government’s knee-jerk support of Israel. Fortunately, I am not alone in this view. A growing number of Democratic Congressmen, Jews and non-Jews alike, have called on the United States to stop supporting Israel’s lawlessness. The truth is that the US government’s uncritical support for Israel has come to depend more on evangelical Christians, such as former US Secretary of State Michael Pompeo, than on American Jews, who are deeply divided by Netanyahu’s actions. And the evangelicals’ real interest in Zionism is not Jews’ security, but Armageddon, the end of the world, which they believe will come only when all Jews are in Israel."
May 18th 2021
EXTRACT: "This period in US history could go down as the moment when America’s democratic system for electing a president – the most consequential duty of US citizens – was broken, perhaps for good."
May 16th 2021
EXTRACT: "While reading Human Rights Watch’s (HRW) monumental report “A Threshold Crossed,” I felt a range of emotions. It also left me with one big question. I was deeply impressed by the report’s rigorous scholarship. At the same time, it brought to the surface feelings of anger and profound sadness. It’s an extraordinarily complete study detailing not only the many ways Israel has violated a broad range of Palestinian human rights, but the ideology of racial superiority and entitlement that Israel has used to justify its repression." ..... "My advice to both Israel’s defenders and weak-kneed liberals is​, “Read the damn report.” "
May 16th 2021
EXTRACTS: .... "He transformed a transitioning market economy into a stable statist project that rests on an alliance of his inner circle," ..... "He transformed Russia from a respected member of the international community into a rogue state" .... ". He energized NATO by providing it with the adversary it lacked after the end of the cold war," ..... "He befriended hopelessly corrupt, dysfunctional, and unstable dictatorships..." ..... "He forged a quasi-alliance with China, thereby enhancing Russia’s dependence on the one country that might have reason to appropriate those Russian territories inhabited by Chinese."
May 15th 2021
EXTRACT: "On the face of it, the latest escalation of violence is following the template of all inter-ethnic wars. Muslims observing Ramadan shouted nationalist slogans and clashed with Israeli right-wing groups chanting “Death to the Arabs.” The Israelis haughtily marched with their national flag on Jerusalem Day, marking Israel’s capture in 1967 of East Jerusalem and the Temple Mount, the site of the biblical Second Temple, and of Al-Aqsa, completed in the year 705. Battles in and around the Al-Aqsa compound erupted, with worshipers inside throwing stones at the Israeli police, who responded by firing rubber-tipped bullets and other projectiles, wounding hundreds."
May 13th 2021
"Regardless of how the current and future violent conflicts between Israel and the Palestinians in Jerusalem will end, there will be no Israeli-Palestinian peace unless East Jerusalem becomes the capital of a Palestinian state while the city remains united."
May 7th 2021
EXTRACT: " Would the United States be prepared to risk a catastrophic war with the People’s Republic of China to protect the Republic of China, better known as Taiwan? "
May 5th 2021
EXTRACT: "Human history, ancient and contemporary, is replete with instances of genocide – that is, the effort to eradicate a people, erase their history, denigrate their culture, and destroy their physical presence. Many of these atrocities have been recognized by the victims and other nations who support them. But, with the notable exception of the German acknowledgment of the Holocaust, rarely have the perpetrators of these crimes accepted responsibility and offer recompense "
May 2nd 2021
EXTRACT: "The best way to defend liberal democracy is to practice it at home and abroad with the “courage and self-confidence” that Kennan touted at the dawn of the Cold War. This is also the best way to ensure the survival of our own conception of human freedom. And survive it will."
May 1st 2021
EXTRACT: "Ann Arbor (Informed Comment) – Sammy Roth at the LA Times/ Boiling Point Newsletter reports that California’s main power grid was powered for several hours last Saturday by 90% renewables. For just four seconds that day, the grid, which covers 4/5s of the state, reached 94.5% generation by green energy. California is the world’s fifth largest economy. The main grid does not cover Los Angeles County. On the other hand, these figures do not include the electricity generated by the Diablo Canyon nuclear plant, which is not counted as renewable but which is also very low-carbon."
Apr 23rd 2021
EXTRACT: "It is no accident that there has been an economic divergence in Central and Eastern Europe. Those countries that have joined the European Union have improved their economic governance, and GDP has begun to converge with Western Europe. Between 2014 and 2019, Hungary, Poland, and Romania grew at an annual average rate of 3.9%, 4.1%, and 4.7%, respectively. Meanwhile, Belarus and Ukraine experienced minimal growth during this period, and Russia’s economy expanded at an average annual rate of just 0.7%. Though Russia had a higher per capita GDP (in terms of purchasing power parity) than Croatia, Poland, Romania, and Turkey as recently as 2009, all of these countries have since overtaken it. Russians today are shocked to learn that they are worse off than Romanians and Turks. Among EU member states, only Bulgaria is still poorer than Russia. With its close proximity to the EU single market, Russia could have had higher growth if it had pursued sound economic policies. Instead,..... "
Apr 22nd 2021
EXTRACT: "As far as anyone can tell, the US military is not on the verge of an internal breakdown, let alone primed to stage a coup d’état. But few predicted anything like the US Capitol riot before protesters equipped with body armor, stun guns, and zip-ties breached the building. Before the US is blindsided again, its leaders must act resolutely to root out extremism in the military."
Apr 17th 2021
EXTRACT: "The new report on 2020 by the International Renewable Energy Agency reveals that the world’s renewable energy generation capacity increased by an astonishing 10.3% in 2020 despite the global economic slowdown during the coronavirus pandemic." .... "In 2020, the global net increase in renewables was 261 gigawatts (GW). That is the nameplate capacity of some 300 nuclear power plants! There are actually only 440 nuclear power plants in the whole world, with a generation capacity of 390 gigwatts. So let’s just underline this point. The world put in 2/3s as much renewable energy in one year as is produced by all the existing nuclear plants!"
Apr 16th 2021
EXTRACT: "When we examined the development of nations worldwide since 1820, we found that among rich Western countries like the United States, the Netherlands and France, improvements in income, education, safety and health tracked or even outpaced rising gross domestic product for over a century. But in the 1950s, even as economic growth accelerated after World War II, well-being in these countries lagged.
Apr 11th 2021
EXTRACT: "Some presidents indulge in the “Mount Rushmore syndrome” making an obvious effort to achieve greatness. Normally soft-spoken and apparently modest Biden is making his own bid for immortality."
Apr 9th 2021
EXTRACT: "New ways of thinking about the role of government are as important as new priorities. Many commentators have framed Biden’s infrastructure plan as a return to big government. But the package is spread over eight years, will raise public spending by only one percentage point of GDP, and is projected to pay for itself eventually. A boost in public investment in infrastructure, the green transition, and job creation is long overdue."