I don't understand the love for private insurance "mandates".  That is the most un-Democratic idea ever to be proposed.  Have the government force you to pay for an insurance company CEO's swimming pool?...  It sounds like a Republican dream idea, and, in fact, it is...

Romney, Schwartzenager, and even our friend in Ohio Ken Blackwell have all either endorsed or implemented "mandates".  A bet a bunch of other Republican gubernatorial candidates were for it, too.  Romney's plan was all the rage a couple of years ago. Why not?  Taking money from private citizens and giving it to the rich?  That's a Republican dream plan!

Mandates would be so unpopular, it would set the cause of universal health care at least a generation.  Ask people in Mass. how they like their "mandates" for overpriced junk insurance.  Yet, too many Democrats have been duped into this very Republican and authoritarian "government get involved in every aspect of your personal life" position.  It is a sure loser in so many ways, as well as being an affront to our values as Democrats.

Now, maybe there's a way that "mandates" can be made more Democratic, less invasive, and more fair, but at the moment, I don't relish the government putting the gun at my back to pay some rich guy a lot of money for overpriced junk insurance.  I'd like a better option.

Thanks,

Mike

VERY astute analysis!  I don't wish Obama any ill will, but it is this type of stuff he need to answer before he gets my vote.  I've had enough platitudes.  Please, Mr. Obama: YES YOU CAN talk about the details of your programs!

He has ridden for much too long without people digging in and asking him the tough questions.  Please, keep it up!

You see this is one of my main points! If Obama is willing to compromise on one of the biggest fights we progressives are involved in, what else is he will to compromise on?

All the Kos wackos over there are willing to give this fight up just to stop Hillary who has fought for things they care most about!

Todd I take back what I said a while ago that there is no one standing up for Hillary! Im sorry and I was wrong about you! Thanks for really saying what needs to be said!

I have yet to read a positive Obama column by Paul Krugman.

I bet he votes for McCain if Obama wins the Dem nomination.

The problem with this argument, or at least one of them, is that there is an assumption that Hillary's plan meets the definition of "universal."  While she has repeatedly refused to answer - or should I say be SPECIFIC about - what her penalty would be for those that don't purchase health insurance under her mandated system, should admits that some sort of penalty would be essential.

This point concedes the fact that even under Hillary's plan some people will choose not to purchase insurance.  If the same can be said of Obama's plan - that some who could afford it will choose not to purchase it - then the only real difference between the two is whether or not you are going to punish someone for not purchasing coverage.

Neither guarantees universal coverage any more than the other, and therefore Hillary has no standing for claiming a monopoly on the word "universal."

on one side it's self-employed childless adults who are doing fine, are healthy and like to game systems. On the other it's inner city underemployed parents who would see even a couple of dollars as money they could spend on their kids, and they'd rather take a chance with their own health than deprive their children any more than they are already disadvantaged. I know single moms who pay for their children but not themselves.  Obama's plan it heartless, it will take it's toll on those least able to game the system. Those parents will avoid seeking needed health care cause in his plan they'll penalized when they see a doctor, which won't bother the richer people, they  know how to do things like that, but will so intimidate and stress poor folks that they'll get sicker.  

that will be left out.

win a damn fight to save our lives.

Clearly single-payer is the way to go but that sort of plan appears to be off the table.

Mandates are a losing proposition. The GOP will either crush the plan in the GE (HRC if she's the nominee will drop it) or put a stop to it in Congress.

Commercial after commercial about the government forcing you to pay more to them or private insurers or they'll garnish your wages..or worse (cue scary music) will sink this plan quick fast and in a hurry.

It still boggles my mind that we're losing the fight for universal health care in the Democratic primary. The insurance companies should take the money they were going to use on new Harry and Louise ads and donate it to the DNC. It's the least they could do.

hard to say-but the thought crosses my mind that JRE may have had enough of Obama's purposeful deception

He was supposedly meeting with Obama today

Maybe--maybe--JRE may now endorse HRC and use the public platform to set the record straight so Mar4 votors are not deceived?

Now that MyDD has become the Clinton site and dailykos has gone all in with Obama, where is most of the reasonable dialogue happening?  Seriously, can somebody tell me where to look?

From the MyDD home page, my left menu has (among others) "Write New Diary" and "Write New Entry". What's the difference? Thanks.

Todd,
Great post.

As someone who used to work in insurance there are some points that need to be made.

First of all, you will not achieve universal coverage unless you have mandates? Why is that? It's because unless you have mandates there will continual cost shifting. Unless the risk is spread among a large group of people the costs will skyrocket.

Obama's plan is an expensive boondoggle. It won't eliminate cost shifting nor cover everyone and probably less people will be covered because prices will spiral under his plan.

1. As long as Clinton keeps putting out the fear of 15,000,000 uninsured, then it is well within Obama's right to fight back with the Government will garnish your wages argument.  Especially when Clinton's plan leaves out 12,000,000 illegal immigrants.

2. The government bureaucrat phrasing is not right-wing framing. It is a preemptive strike against right-wing framing.  They will say that and it is not true so here it is in their language.

3. Let's all stop confusing Universal Health Care with Universal Health Coverage.   Universal Health Care means everyone has equal access to Care and Coverage comes into that equation by having no Insurance exclusions because of pre-existing conditions and affordable coverage for all, and subsidies for lower income.  Is it really your concern, or even a violation of the principle of Universal Health Care if I choose to risk the equity in my house because I don't want to pay the Insurance Industry money.  

This strikes me as an argument about what color your imaginary castle should be. Without a filibuster-proof margin in the Senate neither plan will become law. And once the special interests weigh in it will become an even more remote possibility. The medical and insurance lobbies spread their cash heavily on both sides of the aisle and carry considerable weight...

That's why Obama places responsibility where it belongs to get them covered, namely parents. There will also be much more help available through SCHIP etc.

"Whose wages will he be going after to enforce that, I wonder?"

I can think of one approach for this: in theory, make SCHIP available to every child, at no cost. Even if all the currently uncovered children are enrolled via SCHIP (and paid for by the govt; federal govt making funds available as needed to the states), it still would only cost tens of billions, not hundreds of billions. Most likely, the requirement of parents getting their children covered would make parents to explore available options, and in that process get themselves covered.

Obama also places responsibility on employers: to either provide HC to their employees or to pay into Obama's new public plan.

~~

BTW, the only really "universal plan that I can see is a single payer system.

Even in HRC's plan, there will be people defying the mandate and remaining uncovered. Therefore, technically, you can't call her plan as being a "universal coverage" plan either.

One can also argue that Obama's plan is "universal access" healthcare plan, i.e. that it would attempt cover everyone that actually wants to get covered.

Obama's plan is probably a lot easier to pass than going overcoming the resistance one would likely encounter trying to pass a plan that mandates adults. Why not get help to as many people as we can ASAP and consider what to do next to make it better (via, perhaps, making a switch to single payer) later? Even implementing mandates, as a second phase, would be far easier once we have a working "universal access" system out there.

Universal health care is the dealbreaker for me. And neither Clinton nor Obama has a halfway decent plan proposed.

I've resigned myself to the fact that universal health care will never happen in my lifetime. It's sickeningly ironic that it would have had a better chance of passing 40 years ago than it does today.

Unreal that we're still talking about this. I don't think anyone has a trademark on the term "universal health care", and if anyone did, I'm quite sure that anything short of single payer would fail the test.

I think Obama can legitimately call his plan "universal health care" in that under it, everyone who wants health care will be able to get it. It's "universal access" if you will. Maybe he's fudging a bit between universal access and "universal health care", but no more so than Clinton, who is claiming that her plan will be universal just because everyone is forced to buy health care, even though in Massachusetts for example, we have found that mandates do not catch everyone. Some will simply violate the law.

The main point for Obama I believe is that Clinton's plan needs to be criticized now, because it's just not going to fly in the general election. I'd like to see a poll: do you favor mandating that all Americans buy health insurance, given lowered costs and subsidies for the poor? I suspect it would not be a winner.

Anything short of real, total, universal health care, like the health care you can have in Canada, England, France, Sweden and every other western hemisphere nation, is just something to prolong the insurance companies bleeding us to death.

Neither Obama's nor Clinton's plans are worth a hill of beans.  When are Americans going to stop settling for something less than we deserve?

when will we have a politician whose not afraid to offend the health care for profit industry?

How long is the flight from Panama to Cuba? anyone know?  

Without getting into a candidate shooting war, I suggest that looking at the Massachusetts experience with health mandates is a good place to start

Prior to the health care mandate law now in its second year, Massachusetts had an estimated 657,000 uninsured (estimate by the US census) -- constituting approximately 10% of the 6,400,000 state population.

According to the Health Connector (the agency responsible for implementing the law)  a total of 290,000 people have been enrolled in health care through a variety of public and private mechanisms since the law went into effect.

That would mean that, even with the health care mandate, there are still more than 350,000 people in Massachusetts without health insurance. (That number will, hopefully, continue to fall as additional people are enrolled in various public and private programs).

That means that, even with a individual health mandate in effect, 5.5%  of the state population remains uninsured.

If that number were extrapolated to the country as a whole, it would mean that 16.5 million people would continue to uninsured in the country as a whole - even with a health insurance mandate.

So, strictly speaking, neither candidate's plan is truly universal - perhaps both should be talking about universal "access" instead of universal "coverage"

It is much harder to get to "universal" than people sometimes think. Mandates may be part of the solution, but they certainly don't guarantee universality. (Any more than mandating auto insurance assures us that no uninsured drivers are on the road)

The only way we will get to universal coverage is through a single payer system -- recognizing health care as an essential human right, truly pooling risk by having everyone in the same risk pool, and eliminating the tremendous administrative/profits that constitute the private insurance racket. But we all recognize that, unfortunately, that is not politically achievable in this country right now. I'm thrilled to have two candidates who each are offered plans that will move us toward universal "access" and, at some point I hope, truly universal coverage.

The problem is that ALL of the Democratic proposals ignore the proverbial 800 pound gorilla in the room that the real reason costs are spiraling is liability costs, both due to ridiculous jury awards and unscrupulous lawyers.  I think that single-payer universal health care IS the answer for the country.  However, it should be accompanied by transformative liability insurance regulation where the whole system is converted to a no-fault payment system similar to workers compensation.  In work comp, if you get injured on the job, you get your medical bills paid and reasonable lost wages no questions asked.  There is no need to prove any tort or liability on anybody's part to get benefits and the benefits are proscribed by law (although in WC, it's by 52 different laws which unnecessarily complicates the system...).  This cuts out BOTH unreasonable jury awards that tax the system AND nearly ALL lawyers fees on both sides.  

Medical liability insurance should work the same way.  If you are injured during medical care that requires further care, then the doctor's or the hospital's insurance would automatically pay for the additional care and some reasonable lost wage expense.  You don't have to sue the doctor or hospital to get benefits, there are no more unreasonable awards, doctors do not admit any wrongdoing, and, most importantly, liability insurance costs are reduced by the amount of the lawyers fees (which can be as much as 60-70% of the total insurance costs in some cases).

This reduction in REAL costs could easily be coupled with the single payer universal coverage that we all want.  Both candidates talk about reduction of costs, but really, without addressing how the real costs are being reduced, all that talk is just a red herring.  If the cost reduction is through government subsidies and not taken out of the lawyers pockets (who ae not a part of the health care process anyway), then we're all still paying for it one way or another.

We're living through INDIVIDUAL MANDATE HELL at this very moment here in MA, so I'll use that as my excuse for cross-posting this hard-hitting comment against individual mandates and she who supports such ill-fated policy, and my own post on mandate hell in Massachusetts that follows:

From Ezra Klein's blog
"And for the record, Krugman - and you - are both simply wrong that mandates are the key to "universal" health care. The key short of single-payer, is as Obama points out providing affordable alternatives. To call for IRS-enforced mandates to buy health insurance BEFORE you've actually created a reformed system is politically toxic and morally dubious, at best. It's a gift to the GOP for November '08 - and most likely a gift to the insurance industry when the final bills get passed. It's a fact - based on her already consulting with them and with her campaign donations - that Clinton is in bed with the industry she promises to "reform." Putting Hillary Clinton - who by virtue of political incompetence and technocratic arrogance ensured that health care reform would be political poison for a decade and a half - in charge of bringing "universal health care" to all Americans is like asking Donald Rumsfeld back to take another crack at successfully occupying Iraq. Just how dumb are we Democrats, not to mention the general public ? (Don't answer that...)...
Posted by: Anonymous | February 11, 2008 9:31 AM

---------

For those who seek more of the macabre on individual mandates, check out my post
    Cost Control and Health Care Reform on BlueMassGroup.com
excerpt:
"The public, including its "opinion makers", is beginning to understand that the MA Health law rearranges deck chairs on the Titanic while throwing many uninsured and underinsured overboard to the sharks. A public backlash is sure to come.

There's likely to be over 200,000+ individuals in Massachusetts who can't afford the mandated insurance and aren't eligible for state subsidies nor for a "waiver" (state permission to remain uninsured - how perverse is that?). Under this law they are facing tax penalties of up to $920.00 annually, all for the pleasure of remaining uninsured.

To get a sense of the coming storm take a look at this all-too-accurate one line excerpt from the recent Daily News editorial:
"To risk oversimplifying a most complicated area of public policy: That's what you get when you let the health insurance industry write the reforms."
read the full article here - it gets better!
EDITORIAL: Cost Control and Health Care Reform, Waltham MA Daily News Tribune, 2/10/08

------------

Really,now. The excerpt this MyDD post pulls from Krugman's blog begs for a little fleshing out so read on, please:

"As Paul Krugman puts it:
But as I've tried to explain in previous columns, there really is a big difference between the candidates' approaches. And new research, just released, confirms what I've been saying: the difference between the plans could well be the difference between achieving universal health coverage -- a key progressive goal -- and falling far short."

A Commentor on Krugman's blog actually went and read the glorified Grubber research on mandates and guess what?:

"I found a little problem with the Gruber paper you are so happy to promote. On page 58, it says:

"We have no experience to date with such a mandate, so it is hard to predict the success of enforcement. But, if penalties are strong (as they are in Massachusetts, where individuals are liable for half of insurance premiums even if uninsured), the mandate is likely to be close to universal. For simplicity here I assume that the mandate provides close to universal coverage"
Then, in a footnote, he adds: "In particular I assume that 95% of those who would not voluntarily choose to insure are forced to insure through
the mandate."

He ASSUMES. It is just an ASSUMPTION that 45 million people would be insured. He starts from there and he concludes that "good things" happen. He never proves it.

There is NO PROOF for the 45 million figure, it is as simple as that"

--------------

To those who are terribly annoyed by this disjointed comment or it's strident content, or both, I don't wish to offend anyone but I do want us to be ready to make great strides towards achieving the long long overdue health system reforms come 2009. For 20 years I've been a part of this protracted David vs Goliath/ People vs Profits health justice struggle and cared for countless patients who suffered horribly, just because their job didn't provide insurance so they had no access to primary care for timely care and treatment of disease.

Improved and expanded Medicare For All is what ALL the Dems should be working toward, together with the American people; an individual mandate will cripple that effort.

My single biggest issue with Obama is what Todd calls his "intellectual dishonesty" about his health care plan, that along with the right-wing talking points about mandates and government bureaucrats, and the sweet-talking about Reagan, got me to the point where I actually distrusted Obama MORE than I distrusted Clinton, which is saying a lot, since I have distrusted the Clinton's because of many of the pro-corporate policies they have supported since the 90's. Obama has just made too many GOP-like noises for me to be comfortable with him. I do not think younger Democrats are as sensitized to this; since they have grown up with a continuous drone of pro-corporate conservative noise in the background, it may not even get their attention.

More so that most voters I've talked to, I've based my impressions on what the candidates actually said in the debates. On that basis, Edwards was my first pick, and I was surprised to find that Clinton was a clear second choice.

I do not like personality or identity based politics, but I do think gender issues are more significant in our culture than race issues. For example, in the debates, Obama could wear the same clothes as the white men, and he was addressed using the same words. Clinton was obligated to dress differently from the white men, and was addressed differently. There is just no getting past that, not matter how open minded you are.

I consider Obama and Clinton to be flawed but otherwise good candidates. I am very excited by Obama's apparent ability to win, which is a very good thing. Losing would be a nightmare now. Later I will find time to complain more about Obama's more conservative domestic policies.

I see from the story and reading elsewhere that Obama is again saying and advertising that his plan is universal. It is not. There is absolutely no sense in which it is. He is lying. Whether or not you think Clinton's plan qualifies as universal, Obama's plan is not.

Obama's behavior on this issue just gets worse and worse. He is lying, and he doesn't care. And the dream of universal health care is fading away as a result.

THE REAL UNIVERSAL HEALTH CARE DECEPTION

Doc: Looks like with Hillary it's gonna be another battle on health insurance when she's President.

Insurance company exec: Bring 'er on. We'll dust off Harry and Louise and whip her butt a second time. Obama too. I don't care.

Doc: But 43 million people are running around with no health insurance, don't your profits go up if they have to be covered?

ICE: Screw 'em, they're the really sick ones. We ain't covering them now and I don't want to cover them period. Let 'em smoke, feed 'em full of corn syrup, get diabetes and die of heart disease. Not my problem. Give me the hypocondriacs any time. I make more off them any day of the week. I don't want higher per capita costs. It's always cherry-picking seaons on my farm. I want high paying, low cost patients.

Doc: So do I, but we all end up paying for the chronically sick in taxes instead of managing their care better from day one.

ICE: Like I care. Look, if we start giving people universal coverage, there's a chance it could end up looking a lot like medicare. Not from the get-go maybe, but in time, just watch out. Then see what happens. The government will start negotiating not just for pills, but for every damn thing else. And it won't be them just putting downward pressure on pills and x-rays and what you can charge for a PA visit, they'll start going after your little buddy-buddy relationship with the pharmas. You think they're going to let the pharmas pay you to run around at lunch time doing brown bags touting their latest little gizmo or pill that's been developed that's no better or maybe a little worse than something their competitor's had on the market for 10 years. Kiss that income good-bye doc. They'd call it for the conflict of interest you know it to be.

Doc: They'd never.

ICE: Sure they would.

Doc: So it really doesn't matter if Hillary or Barack get elected, it's all just part of the great march to socialized medicine, whether it's 5, 10 or 50 years from now.

ICE: Hey, cheer up doc. We've managed to forestall the inevitable for 50 years, you and I will be dead in 30 if we're lucky and then it will be somebody else's j-o-b to forestall the inevitable, if you want to call it that. But every year it doesn't happen, is a year I make my bonus.

Doc: And I stay in business with the patients I got, and that tidy little side income.  

ICE: And the patients that you don't got mostly don't vote anyway.

Doc: Thanks for straightening me out. I was almost thinking it was immoral to have so many uncovered Americans, especially kids.

ICE: Don't go soft on me doc, I need ya. I really need ya.

Doc: Don't worry. I'm there for you man.

You can mandate all you want but some people won't abide by the mandate.  Those people won't have health care.  So the idea that Hillary's plan is universal and Obama's is not is just stupid in my opinion.  Under both there are inevitably people without health care.  the question is how many and which system is over all superior on a number of metrics.  Hillary's argument that "my plan is universal while Obama's is not" is just oversimplified campaign silliness.

How will she mandate? Willing to fine? Willing to deduct payroll?

Obama focuses on making it cheaper, not on making you pay more.  And at least Edwards was honest about how to make it happen.

I don't know why people on this HRC blog are so much against Obama and Edwards' honesty.

Just spoke to my communist cousin -- but she's uber wrapped up, she didnt even know they are having a universal health care debate in the election.

Do the following policy points sound like a good starting point for a non-universal health care plan?

1. Health policy should focus on making health care of ever-increasing quality available to an ever-increasing number of people.

2. To achieve "universal coverage" would require either having the government provide health insurance to everyone or forcing everyone to buy it.  Government provision is undesirable, because government does a poor job of improving quality or efficiency.  Forcing people to get insurance would lead to a worse health-care system for everyone, because it would necessitate so much more government intervention.

3. In a free country, people should have the right to refuse health insurance.

4. If governments must subsidize those who cannot afford medical care, they should be free to experiment with different types of subsidies (cash, vouchers, insurance, public clinics & hospitals, uncompensated care payments, etc.) and tax exemptions, rather than be forced by a policy of "universal coverage" to subsidize people via "insurance."

If you agree with these, then feel free to go over to the Cato Institute blog and join their Anti-Universal Coverage Club.

If you like these, you can find more real, authentic, right-wing talking points available there.

Beeton, no matter how many time you mydd hacks write about how Obama's plan isn't universal, neither he or his supporters are going to agree with you.  Nor will we stop calling it universal.  Get over it.  You and Krugman can write about how anyone who is against an individual mandate is using "right wing frames" or some other bullshit, but that won't have any effect either.  Beating a dead horse won't make it any more dead.

Neither of their plans will ever become law in the form they are being proposed.  I only care about the broadest expression of presidential candidates policies and in that context they are absolutely equal.  If you are suggesting that Obama wants people to not be covered, well, that's absurd.  Beyond that, obsessing over these details is silly because they will never happen.  Congress will make the law and what ever they come up with (probably far less progressive than what either of the candidates are proposing,) if it's better than what we have now, they'll sign it.  But which person will be in a better position to push congress for more?  Which person can bring the scrutiny of the American people to bear on the issue better? And the answer to that is fairly subjective and so my vote for Obama continues to be an act I am not ashamed of.

stretchin g the truth.

I also noticed here in WA state, that his commercials talked of "Universal Health Care"! My g/f and I just looked at each other and said... WHAT?!

Progressive Blue

If I as an adult choose not to get insurance under Obama's plan but then I get sick or need emergency help, who will pay for this? All of us right?

I believe I heard that Obama's way to deal with this problem is to require that person to then pay ALL back payments, plus a penalty, for an insurance plan that they should have had.

So... if this is true, how is he planning on getting that money? Is he going to garnish their wages? What if they have cancer, were in a horrible car accident or something else like this and they can not work or maybe will never be able to work again. How is HE going to get this money from them?

THINK the WHOLE problem through before offering up a "plan" that will be so full of holes that it will most likely be a huge mess and set back TRUE Universal Health Care by DECADES.

My g/f was just reading about President Truman when he tried to get Universal Health care back during his time in office. I would like to spell out what happened but I think this comment would be a mile long.

But... we have ALL waited too long for this to happen. WE Need this NOW!

Progressive Blue

I feel odd writing this given that I completely advocate single payer as the only system that will get universal healthcare or coverage, but one of the reasons I'm supporting Obama over Clinton is that I think the mandate plan won't work and is a gimme to private insurance companies who provide junk coverage.

Maybe I'm being too cynical, but I think the opt in to government employee insurance and/or medicare will be quite expensive and will end up not being affordable enough for everyone.  Under a mandated plan, in order to avoid breaking the law, people will end up stuck with trash policies (the sort with $5000 deductibles that only offer catastrophic coverage).

I'm also not as concerned with the details of either plan as I think we're kidding ourselves if we belief any candidate is going to see their policies enacted whole.  Once the lobbies for the drug and insurance companies start lobbying, where we'll get is anybody's guess.  Where I don't want to end up is a place where poor people are forced to pay anything for near worthless coverage while the insurance industry (because that's what it is) reaps the subsidies.

I'm not keen on Obama's plan either -- I think universal health care means single payer.  Having lived in the UK and seen how well NHS works, I'll always hope for it here in my own country.  What I do like about Obama's plan is his pledge to hold negotiations in public view.  I think the secrecy last time around damned the health care plan even before it was completely written.  

If Clinton and Obama think single-payer is unachievable now, just what exactly are they waiting for?

The central problem with both plans is that ANY plan including the for-profit private insurance industry will fail, because they've all failed before.

As for the notion that single-payer is a political drawback, polls have consistently shown that the American public favors such a plan, even if it means higher taxes.

Blue Cross of California is demanding confidential patient information from providers for ammunition to cancel or deny coverage. See today's Los Angeles Times story "Doctor's Balk at Request for Data"

http://www.latimes.com/business/la-fi-bluecross12feb12,0,4319662.story

I'd have more to say; unfortunately I'm pressed for time. Go to Physicians for a National Health Plan at pnhp.org, the single best source of information on single-payer.

Well, as an Obama supporter who actually favors Clinton's "mandates" over Obama's plan, I will say that I think that he's perhaps using a different definition for "universal".

If I'm not mistaken, both plans allow people to buy into a policy offered by the government, and also get rid the "pre-existing condition" problem, essentially making health care AVAILABLE to all, and therefore "universal".  Perhaps it doesn't match your definition of "universal", but it seems reasonable enough to me.  Clinton's plan could be similarly criticized for not being universal because, quite simply, someone could still opt out of health coverage and just pay the penalty.

Again, I think I'd rather see the "mandates", but I understand why he's not pulling for that right now. I have friends who are absolutely TERRIFIED of universal healthcare, thinking it will bankrupt our country.  They are more right-leaning, but there are lots of independents who think the same way.  By saying he won't "mandate" coverage, it at least gives the impression to these people that they can at least opt out of it.

That being said, my hope is that if Obama wins the nomination that, with Hillary back in the senate, she'll re-introduce her health care plan (with mandates) and that he'll be willing to negotiate with congress on it, and eventually just sign a bill that mandates coverage (saying either that after discussing it with them, he agrees with it, or simply that, though he disagrees with the mandates, he won't veto the one chance they have at universal health coverage).

It's also quite possible that, unless the Democrats manage to pull off 60-61 seats in the Senate (which is unlikely), they simply won't be able to pass universal healthcare with mandates.  It's possible that the absence of mandates may be the only thing that allows it to get passed.  Mandates may have to come later.

By Clintons definition, we have Universal Coverage right now except for pre-existing conditions being covered.

If you have enough money right now,you can buy a healthcare policy. That makes it universal.
Under HRC plan, you will have to buy that policy and boom..we got univeral coverage.

Single payer is the only universal coverage.
Anything short of that is universal coverage if you have money. Children should be covered by mandate, that is something that could sell in congress..but total mandates will sink her plan and we will go back to our 14th try in another decade.