Tuesday, June 26, 2012

The mandate as Obama's achilles heel (which wouldn't have been fatal had Achilles had insurance)


It looks like the big SCOTUS decision on Obamacare will come while I'm in the air, flying from Honolulu to Fukuoka (and then on to Seoul). Major news, like the death of KJI, tends to come while I'm flying across the ocean.

To make this Korea-related, if the ACA is overturned, that means I'm stuck living in Korea or Hawaii.

Anyhoo, while we wait, take time to read this excellent piece on Republican hypocrisy as it pertains to the actuarily sound insurance mandate:
The individual mandate in the health care law was originally proposed by the Heritage Foundation, the most conservative think tank in the country. It was supported by almost every Republican in the country, including the first President Bush, Mitt Romney and conservative stalwarts like Orrin Hatch. Simply put, it was a conservative idea. There is no question about that; it is a fact.

Let me immediately digress to point out how terrible our media is since about 2% of the country knows that fact. If you asked the average American now, I'm sure they would say it was a liberal idea originally proposed by Barack Obama. Another fact -- Barack Obama was originally opposed to the mandate during his campaign for president.

So, this brings us to the central problem with President Obama's administration. They were under the unbelievably mistaken impression that if they worked with the Republicans, compromised with them and gave them what they wanted, that the Republicans would react likewise. Progressives (and anyone that was paying attention to politics in the last decade) warned them that would not be the case. We were dismissed. Now look at what's happened.

Not only did the Republicans not thank the president for including their mandate in the health care law, they have turned around and pretended they are against it. But of course it goes much deeper than that. In fact, they are now using it as the principal argument to take down the whole law.
Oh, and kudos to the Supremes for not going and completely legalizing "driving while Mexican." must've taken restraint.

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5 comments:

  1. The mandate excites Americans' reflexive and uncritical worship of "Liberty". The Obama administration should have sold the program like an insurance salesman conning a sucker. Americans appreciate a good con, especially when the sucker accepts that he/she was the real winner.

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  2. With your mention of "a good con," you seem to be suggesting that universal health insurance or insurance in general is a fraud or a bad deal for the consumer.

    Indeed, if the insurance providers are all hawking a service that has tremendous overhead or extra costs that would be avoided by the uninsured, then that's a problem.

    But health economists across the spectrum point to the value of a wide pool and the use of mandates to prevent adverse selection in an economic activity that virtually all persons participate in, and that reduces anxiety and risk and allows — for minimal cost — more confident participation in other aspects of life, be they economic or recreational.

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  3. I understand how insurance works, and how the mandate would function, But, I think most consumers buy insurance because the price is right and they trust the agent, not because they realize they are doing a good thing for others. Or, also they do it because it's just the usual thing to do (and, the opposition has argued enough that voters should not trust the government on this, that most voters would not just go along on the mandate). It's easy to sell insurance when the dynamics involve two people in an office or some other negotiating space. Selling a mandate just doesn't fit that scenario.

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  4. I might agree with you that many Americans don't buy health insurance because they're being altruistic, but you made it sound like national, universal, or mandatory health insurance is "a con." It is not.

    At any rate, they should realize that the mandate is not just good for others but good for themselves if they already have insurance, and not just because it reduces the number of people who end up getting their expensive emergency care paid for (directly and indirectly) by those with insurance and taxpayers.

    Anyway, much of the point of the post (and linked article) is precisely that stuff about what the opposition is doing: an insurance mandate was a conservative idea that Obama's people co-opted because they knew they could not get a single payer system passed. The conservatives are vociferously against the idea precisely because Obama supports it. That is foolish, immature, and downright detrimental.

    I'm hoping that the entire law is upheld. If not that, then the mandate is the only thing overturned. That would require something to prevent the insurance companies from either folding or jacking prices through the roof. Allowing medical insurance sign-ups like dental insurance (e.g., you can only start a new policy after a certain period of time or on a certain date) might mitigate that.

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  5. I couldn't agree with you more on all counts. When the bill passed and I finished my Master's in December 2011, I was elated, because health care and study were two very real reasons why I stayed in Busan. Now, I can't find a job in the States and SCOTUS could overturn the law.I'm despondent.

    It was a strained joke. If a Republican president could "sell" a similar reform to the voters by acting like an insurance agent, I would be relieved.

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