Fortunately for you, no candidate has proposed requiring anyone to buy insurance from a private insurance company. In fact, the existence of a public, Medicare-like option is a central feature of the Clinton/Edwards plan.
That's yet another deceptive ploy Obama's been using to try to make his health care plan sound more "progressive" than Hillary's (when it's really less). Obama acts like all Hillary does is "force people to buy insurance they can't afford", when Hillary's plan actually GIVES PEOPLE A CHOICE of either an affordable private plan OR opt-in Medicare. Oh yes, and her plan has just as many measures to make health care more affordable (if not MORE!) than Obama's.
So yet again, we have a health care myth from Team Obama that's just been debunked. ;-)
It's worse. They don't admit that these plans as I understand them provide for subsidization so the argument is false on its face. But that's rather the point. They can't win on a straight up and down comparison of what the plans actually say.
One of the problems, though, is that it's not precisely clear how much of the costs will be subsidized and how substantially Clinton will be able to reduce premiums. Clinton has not been able to say exactly what a person who makes, say, $50,000/year will be paying for health insurance. That's because the actual amount will depend on so many complex matters like how the insurance is underwritten (premiums, deductibles, copayments, etc.), the ability of Clinton's plan to lower costs, and exactly how substantial the subsidy would be for a given person.
As a result, until Clinton provides assurances of affordability, it's disingenious to speak so confidently about her plan's universality. Moreover, without specific information about costs, it's difficult to evaluate whether the burden associated with a mandate is fair. If insurance is going to cost someone $1000/year, that is far different than $5000/year. I might not oppose a mandate in the case of the former, but I certainly would in the latter. Adding $5000 per year as a state-imposed burden (which is effectively like a tax) would be very big deal to your average middle-class person--certainly, more than it would be for a wealthy person. That raises serious fairness issues, as well.
This post does a good job of describing the problem.
http://sentineleffect.wordpress.com/2007 11/28/even-more-on-mandates-and-the-80- solution
Mandates may ultimately be an appropriate thing to do (although, I'm skeptical), but first we need to make put the plan to work without mandates so that we can evaluate feasibility and cost considerations.
Also, mandates are not going to be popular at all in a general election. I'm convinced at this point that single-payer is more palatable to the average voter than hybrid approaches involving mandates.
What exactly makes you think that Obama's plan will be any cheaper? In fact, by insuring only sicker people (with younger, healthier population opting out), it will be even more expensive and therefore further away from achieving true universal health care.
I never said his plan would be cheaper. I just said that mandates shouldn't be implemented until we can be certain that the burden imposed is affordable and fair. Presently, I see single-payer as the only fair way to ensure that everyone is covered. That is, the only progressive way to finance social insurance like this is through normal income tax collection; otherwise, the distributive burden is going to be regressive (at least partially).
THe problem is that the benefits will be hard to come by without eliminating issues like free riders from the mix. In other words, the very things you are requiring much like the conservatives approach to such discussions will help guarantee failure.
She does say that it will be capped at a percentage of income....
She doesn't say what the percentage will be, but since she does acknowledge a realistic view of the current cost of insurance, I'm hoping the percentage cap would also be realistic.
In contrast, my Congressman thinks a $600 tax credit would help the situation which I think is a laugh, not a plan.
From page 9 of her plan.
The average family premium for employer-based coverage (including employer and employee contributions) is over $12,000.ix For half of Americans, this total premium accounts for at least one-fourth of their annual income.x This helps explain why two-thirds of the uninsured have incomes below 200 percent of the poverty limit (roughly $40,000 per year for a family of four). (snip) The American Health Choices Plan will make health insurance more affordable for the millions of Americans who want it. It includes a number of straightforward policies to achieve this end: 1) Ensuring Premium Affordability Through Refundable Tax Credits: Premiums have skyrocketed over the last several years - nearly double since 2000. The American Health Choices Plan helps working families afford coverage through refundable, income-related tax credits to ensure that accessible, high-quality health coverage is affordable to all. 2) Limiting Premium Payments to a Percentage of Income: This credit will ensure that securing quality health care is never a crushing burden for any working family. This guarantee will be achieved through a premium affordability tax credit that ensures that health premiums never rise above a certain percentage of family income. The tax credit will be indexed over time, and designed to maintain consumer price consciousness in choosing health plans, even for those who reach the percentage of income limit.
(snip)
The American Health Choices Plan will make health insurance more affordable for the millions of Americans who want it. It includes a number of straightforward policies to achieve this end:
1) Ensuring Premium Affordability Through Refundable Tax Credits: Premiums have skyrocketed over the last several years - nearly double since 2000. The American Health Choices Plan helps working families afford coverage through refundable, income-related tax credits to ensure that accessible, high-quality health coverage is affordable to all.
2) Limiting Premium Payments to a Percentage of Income: This credit will ensure that securing quality health care is never a crushing burden for any working family. This guarantee will be achieved through a premium affordability tax credit that ensures that health premiums never rise above a certain percentage of family income. The tax credit will be indexed over time, and designed to maintain consumer price consciousness in choosing health plans, even for those who reach the percentage of income limit.
All bunk if the plan isn't passable in congress.
Never forget that there have been great health-care (some "Universal") plans proposed over the last 38 years, but none have been passed due to a lack of political will and bipartisanship from from both sides.
I guarantee you that Hillary will have a problem getting this passed as it is. Simply won't pass. A blue-ribbon panel with unimpeachable economists and health-care experts from both sides of the aisle will need to come together and publicly put a plan together, that we can all agree with. I doubt a mandate will be agreed to by both sides unless the democrats have an OVERWHELMING majority in congress. This is where Obama's advantages and ability to get everyone together comes in.
"no candidate has proposed requiring anyone to buy insurance from a private insurance company. In fact, the existence of a public, Medicare-like option is a central feature of the Clinton/Edwards plan."
You understand of course that doctors have the option of refusing to take lower payout medical insurances, just as many do today and refuse to care for Medicare recipients. And when you look at the variables left that could conceivably lower medical costs apart from insurance company profits, exuberant drug costs, and outrageous hospitalization costs, people who opt for the Medicare-like option will get the Medicare-like option and all the drawbacks that it entails.
Until we get a single payer not-for-profit universal health care system, the kind that Hillary abhors, we will not control medical costs and rationing will continue. This system, which feeds the corporations, is part of the Republican Lite version of the Democratic party Hillary and Bill are attempting to bring back.
We can do better than this and with a Democratic Congress, it is doable.
"Until we get a single payer not-for-profit universal health care system, the kind that Hillary abhors, we will not control medical costs and rationing will continue. This system, which feeds the corporations, is part of the Republican Lite version of the Democratic party Hillary and Bill are attempting to bring back."
The problem with the health care system is the cost which shuts people out and rations care.
The cost is so high because we have a private system that is inefficient. And it's inefficient because we support a parasitical insurance industry through our health care payments. Every other advanced industrialized country in the world does it a different way.
That way is single-payer health care. Eliminating costs by eliminating profits from the middle man.
Any attempt to graft universal coverage over the top of our present broken system will only dramatically increase costs and would be unsustainable.
Naturally, this is a political loser for everybody. Obama's coverage is NOT universal. Hillary's isn't really universal either. But, frankly universal health care will be WILDLY UNPOPULAR if it is put into place by mandates because you are forcing millions of people (the young and healthy) who don't currently pay for health care to purchase it.
Why? Because unless you eliminate runaway cost from the system, by getting the insurance industry out of it, you're forcing people to pay more for health care coverage, to cover the older and sicker.
Maybe that's sensible, even necessary, but it they won't like it. At all. And those are only the tip of the iceberg flaws with the way both plans are proposed.
I remember back in 1993 Bill Clinton talking up his health-care proposal at the time. He asked the audience what percentage of them liked their HMOs. He looked absolutely shocked that so many people HATED managed care (for reasons that everybody understands now).
Democrats need to avoid being chained to an albatross of "universal health care" that is neither universal, nor solves the problem of run-away cost, and is wildly unpopular to boot.
If we get caught in the trap of "doing what's possible" even though it won't work, we'll be crushed by the Republicans for years afterwards. The first failed attempt to introduce health care reform helped bring down the Democratic congress in 1993. We can't afford another mistake like that!
Keeping talking.
You put the problems with both the Hillary and Obama plans, which exceed their trivial differences, in a nutshell. They do not come close to the liberal social democratic systems in play in the EU and the English speaking countries.
Hillary has said repeatedly that she would support and sign a single payer bill if it passed Congress, she favors single payer. It is deception to say "she abhors" single payer, that's obviously untrue. Even the Congressional sponsors of HR 676, the Conyers/Kucinich single payer bill, insist we must build the political will and movement to get single payer in the US, now far too many Americans no longer trust government to administer a single payer program, only 35% favored single payer in the last major poll, while over 50% favored the hybrid plans, like the Clinton plan, that preserves their choice to keep what they have now if they like it. 80% of Americans are report being relatively content with their current health insurance, many because they have never needed to use it for a major, or chronic illness, and put it to the test to see whether it really meets their needs.
