Why should liberals care at all about preserving the private health insurance market?

[Better Believe It]

The Weird “Liberal” Obsession with Defending the Individual Mandate
By Jon Walker
December 21, 2010

Liberals never claimed a private health insurance system was good – until President Obama began his push for health care reform. They are now bending over backwards to defend it. The latest acrobat is Adam Serwer from the America Prospect, making a bizarre call for liberals to actively defend the individual mandate:

Asked about the constitutional basis for the individual mandate, some liberals mumble quietly about legal precedent before making the compelling policy argument that without the mandate, you can’t preserve the private insurance market and ensure affordable universal coverage. As Attorney General Eric Holder and Kathleen Sebelius wrote in an op-ed on Tuesday, “Imagine what would happen if everyone waited to buy car insurance until after they got in an accident. Premiums would skyrocket, coverage would be unaffordable, and responsible drivers would be priced out of the market.”

This is not a compelling policy case because it is completely wrong as a matter of policy. There are many possible alternatives to the individual mandate that would serve the same function, preventing individuals from “gaming the system” by not buying coverage until they get sick. A back premium payment system is just one option. As we see with Medicare Advantage it is even possible to “preserve” a large private insurance market within effectively a single payer system.

Even if this was a priority — which it is not — why on Earth should liberals care at all that the individual mandate is the only way to “preserve the private insurance market?” We can ensure affordable universal coverage more cost effectively for more people through a Medicare-for-all program, the constitutionality of which is not in doubt. There is nothing progressive about needlessly preserving some wasteful private middle man who has a history of being a bad actor.

Read the full article at:

http://fdlaction.firedoglake.com/2010/12/21/the-weird-liberal-obsession-with-defending-the-individual-mandate/

[egoclothes]

1. It was and IS a free market health insurance "reform" which I will NOT defend!

[Davis_X_Machina]

2. Firedoglake...

...is where the distinction between 'means' and 'ends' goes to die.

[Better Believe It]

3. I get it! The way to end the private health insurance industry is to save them!

Give them 30 million new mandatory customers, trillions of dollars and that should put them out of business!

Good plan to pave the way for Medicare for All.

:)

[Davis_X_Machina]

4. It sounds as though your end...

...is to eliminate private health insurance.

I thought the end was to increase access to and provision of health care services.

What happens to access to or provision of health care services in the meantime, before you get the sixty senators you need to pass Medicare for All, that is?

[Better Believe It]

7. You're right! The private health insurance industry provides nothing of value to health care.

And until we get Medicare for All, the sad fact is, we'll continue to get screwed even more under the Health Insurance Industry and Big Pharma Protection Act! This was a big leap backwards, not a step forward in our health care system.

And just wait .... once the budget cutters get to work on Medicare and Medicaid, the U.S. health care system will take yet another giant leap backwards.

[LWolf]

19. Private insurance doesn't provide care.

The role of private insurance is to limit care.

I have private insurance. It's costly. I pay for insurance. I don't get care. Why? After I pay the premiums, there's nothing left for the deductibles and copays. TI pay the insurance company, and then I pay for the care.

[TheKentuckian]

21. The mission is accessible, affordable, quality health care for every American.

Our current "plan" does none of that. Instead it will work with current industry trends to shift costs to the "consumer" which will shrink the "death panels" down to one or so as we deprive ourselves of care due to financial hardship.

[Hello_Kitty]

14. You may not like FDL but Jon Walker has done outstanding analysis on HCR. eom

[CTyankee]

5. Of course we

"can ensure affordable universal coverage more cost effectively for more people through a Medicare-for-all program, the constitutionality of which is not in doubt."

We CAN but we DIDN'T. That's the problem here.

The argument is not about Medicare for all vs. HCR that includes an individual mandate. Liberals wanted Medicare for all. We didn't get it. what we have here is called "compromise." :sarcasm:

I hate it, too. I think it is wrong, too. But this is a waste of time if we don't have some reasonable way to get Medicare for all. It's just blather, stating the obvious.

[Davis_X_Machina]

6. It's righteous blather, though..

...and all I've got is compromised, instrumental, incremental, pragmatic, gradualist blather...

So I lose.

[CTyankee]

8. I know and it makes me heartsick...

I wish we all wouldn't "lose" as you put it...but we did...the debates on the HCR bill were mostly insane. We liberals thought we could get the public option and that would eventually drive the private health insurers out of business. We saw what actually happened...what were we thinking???

[Uncle Joe]

9. I can't and won't, this was/is a major step backward securing the

for profit health insurance industry's stranglehold on the people and the government.

What was bad, has been made worse.

Thanks for the thread, Better Believe It.

[obxhead]

10. If a Republican had signed this exact same law

not a single person on DU would support it.

[Gravel Democrat]

18. hard to find a more truthful statement in the whole health insurance ripoff scam

[mmonk]

11. I don't and won't. That's why if a state goes single payer, I'm moving there.

[Vincardog]

12. No real liberal backs the shit

[fascisthunter]

13. No actual liberal could back this crap

privatization and deregulation are the cause of our woes today.

[blindpig]

15. Mebbe cause liberalism ain't what a lot of people think it is.

Seems to me that a lot of liberals on the street have bought a pig in the poke. Liberalism doesn't do what a lot of everyday liberals want it to do because their expectations don't match what liberalism is. It is one of the two governing philosophies of Capitalism, the other being Conservatism. The difference being that Liberalism is activist, tinkers and innovates whereas Conservatism is for strictly market based solutions. Both are firmly committed to Capitalism the differences are of style, it is an intramural competition of the rich. Liberalism doesn't care about people, peace, rights or the environment, except as a tactical stance.

[leftstreet]

31. +1 Liberalism is firmly committed to Capitalism

I don't know why people still can't get this

[Gravel Democrat]

16. super big K/R

[pitohui]

17. which liberals? i say private insurance needs to be ILLEGAL

it's my opinion that our best chance to supply great affordable and genuine health care to EVERYONE is to make sure that EVERYONE has to participate

the rich have to be in the same system with the rest of us or "the rest of us" won't get decent care, look what happened to our public schools, once the world's best, when we allowed the rich and upper middle class to exit the system

now look at social security, which is pretty much required of EVERY working person, rich or poor, no matter who you are, if you work and put in, you get back -- one of the most successful usa programs ever, if not THE most successful usa program ever

universal needs to be universal but i realize it can't be done in a day, sigh

[girl gone mad]

20. It's the opposite of progress.

I continue to believe that we would get far better results by allowing more people to opt out of the insurance scam system and into alternative payment schemes, even if the short term result is more medical bankruptcies. The private insurance system has failed. 50 million Americans see it for what it is - a defective product. Surely, the solution cannot be to force them to buy into this broken system, in what would amount to a gross wealth transfer from the young, who are already facing dim employment prospects and seemingly insurmountable personal and national debts.

[Still a Democrat]

22. Previous state = 0, HCR=2, Single Payer = 10

HCR is a modest improvement - still plenty of flaws. The mandate is a lynch pin if you're going to disallow exclusion for pre-existing conditions.

[Hydra]

23. But if you say the company can charge whatever they want to the pre-existing?

And they HAVE to buy SOMETHING or get fined?

[BzaDem]

25. Under HCR, they can NOT charge people with pre-existing conditions ONE PENNY more than people

without any conditions.

Anyone telling you otherwise is making a false statement.

[Vinca]

26. But they can charge older people - who are more likely to have

pre-existing conditions - 3X the going rate.

[BzaDem]

27. Yes, they can (as oposed to 10-20x the rate or more pre-HCR). But they cannot charge an older person

who is sick one penny more than an older person who is well). They can discriminate slightly (relative to pre-HCR) on age, location, smoking status, etc. But not pre-existing conditions.

[Vinca]

28. It shouldn't be that way since the point of insurance is shared risk.

Someday the 20-somethings with the cheaper policies will be the older people getting screwed and it would make more sense to charge everyone the same amount. But why do I waste my breath on this? Big health insurance companies are now enshrined and that's that.

[BzaDem]

30. In a more ideal world, that is correct.

However, we are moving from the current system, so that has to be taken into consideration. In the current system, the 20-somethings pay a few hundred a month, and pure community rating would result in them paying much more than that (an amount they couldn't afford in their first job).

They should have increased the subsidies and then made it equal (so the 20-somethings who can't afford a 5x rate hike compared to now would be able to get insurance). But given that we couldn't raise the cost of the bill above 950 billion or so, 3x is FAR better than market rates.

[Selatius]

32. I could see the next health care reform bill fought specifically to eliminate age-based premiums.

That's going to take another war, and probably a lot of concessions on our part.

[BzaDem]

24. Because the alternative to the post-HCR market is the pre-HCR market, not no private market.

If the individual mandate falls, they will simply allow companies to charge more for people with pre-existing conditions. The idea that they would pass single payer is pure fantasy.

[Unvanguard]

29. Because the choice isn't between "private insurers" and "public insurers."

The choice is between "sorta-kinda functional private insurers" and "totally dysfunctional private insurers."

Live with it, because Medicare for all is not in the cards anytime soon.