Since it is certain, with most plans, that the insurance won’t be affordable, I hope the penalty for non-compliance is affordable. If they cap the penalty at, say, 2% of income (similar to the health expense tax deduction floor), then I can afford the penalty, rather than over $8,000 per year for insuring two self-employed adults. But if the penalty exceeds, say, 10% of income, well, we’ll have to donate to our local health insurance “charity”. And still probably pay over $3,000 per year in deductibles and uncovered expenses. What a country!

Single payer would be a mandate. It would mandate that all Americans receive health care without being exposed to the sharks.

How can you force people to make a commercial transaction?

Even with auto insurance the argument is that you need to insure others re your negligence. But this appears blantanty unconstitutional.

If the government insists we have coverage for health care, let THEM pay it from the general revenue.

This is all about letting the rip off insurance companies remain in business and continue with their disgusting business model of profits first and foremost.

We’re having that very conversation in my living room, right this minute. How can this possibly happen?

Because we planted listening devices in your living room?

Now I really am outta here.

Namaste

How are they going to force people to pay for something they can’t afford? Are they also going to force companies to give COLA raises — you know, the ones they haven’t been giving the past few years?

Oh, you silly. *g* Better than cameras in my bedroom.
I just cannot understand how the citizens will stand for for a mandate. If people can afford insurance, they will get it. I must be too blond today.

The term “bailing out the insurance companies” keeps being repeated. This implies that they are hurting. They are not hurting. Their profits keep growing. We need to think of a new way to phrase this.

“Without effective protections, they will be eaten alive.”

Feature, not a bug.

Making the rich richer?

How dare Maine voters contradict Her Royal Highness Senator Olympis Snowe? Do they have no sense of decency? How dare the Los Angeles Times disrupt the Rahm Emmanuel’s Blue Dog gravy train? Where is the humanity?

Keep health insurance unaffordable now and forever, I say. And if it isn’t the constitutional right of private insurance companies to screw all Americans who aren’t members of Congress, then we need to amend the US Constitution to make it their right to do so.

For profit health insurance companies are people too!

Save the mandates!!

OT, but this is way kewl.

How is a mandate with a hobbled PO not also a taxpayer bailout to the insurers? I’m pretty damn sure it is. None of the proposals crafted thus far in Congress have a viable Medicare-like option to private insurers. But, then, if Democrats were serious at all about not bailing out the private insurers they would have just given everyone without insurance Medicare. I assure you, as someone without insurance, I could give a crap about a “choice” of insurers, I just want health care. The Democrats ought to be ashamed of themselves. Every tax payer dollar wasted on the private insurance industry is money (our money!) that could have been spent on something else, like education.

Wait a minute, wait a minute Pat Roberts (R ins co,) needs time to get his marching orders from the insurance company representatives.

Rather than racing around this healthcare racetrack Americans have been on for several decades where employers are placed in this conflicted position of chasing profits,seeking control of labor costs and then being at same time also the prime health insuring agent for employees can Americans not just finally get off the track?

Employers (GM,WalMart,McDonalds,the local foodstores and mall stores,your local,county and state government employer etc.) under current American regime of employer based health insurance are placed in direct conflict (control costs,keep costs down,shop it around constantly) with the for profit insurers who likewise want to keep profits up and growing,prune costs ( those who they insure who claim to much too often) and have no inherent interest in offering what they sell to anyone unless the profit is there to be had.

This is an insane Alice in Wonderland game Americans are in which a American Single Payer Plan/Universal Medicare would solve.

Employers cannot be/should not be the agency for health insurance. For them it is a cost. What employer does not want to cut costs?

For profit healthinsurers likewise are in this to make money by selling to Americans health insurance that for profits by premise of the profit motive are most interested in not seeing used,used sparingly or having the means to cut out the overusers or those who cannot pay for it on profitable basis.

Expecting this Rube Goldberg mandate/subsidy/employer/for profit insurer concept to work or be workable is…well…Rube Goldberg!

The motives and motivations are too much in conflict.

It is time (way past time) for Americans to put in place a simple,well understood,common to all and restricted to none American Single Payer Plan.

Do it now. Not five years from now. Not a decade from now. Not two decades from now.

Do it now. Now.

The whole mandate thing really bugs me. For all the reasons already listed. This isn’t like car insurance, because you can always opt out of owning a car (even if that’s really difficult in rural America). You can’t opt out of owning a life – except in Oregon, I guess.

When you really think it through from the mandate perspective, single-payer seems to be the only real option. I’ve been willing to accept the Public Option compromise, but the more I think about it, the more it seems like too much of a compromise.

If the government can force us to buy the product of insurance companies, what else can they force us to buy? Maybe they should mandate that every family buy a certain amount of broccoli every month – that would surely improve public health.

I really like your Rube Goldberg analogy – that is a very fitting description of even the best of the proposals coming out of of congress so far. Good work.

yeah, if they’d asked me how to reform health insurance, the first thing I’d have done would be disentangle it from employment. I’d force employers to convert the health insurance benefit they give their employees into a raise, and then throw open the insurancing pool to ALL the people. But no one asked me. Far less complicated than the mess it is now.

yeah forgive the OT Jason,

but the pics of ALL the treasures are up on flickr!

That works around here, but out in the world, it gets portrayed (incorrectly, but nontheless…) as class warfare.

Yes, Elliott. Take it out of the company’s hands. Everyone gets insurance and the rate you (and everyone) pays is based on how much money you earn. Wouldn’t that be simple?

It just seems that we approach everything all ass-backwards these days. Even the banker bonuses issue seems all turned around to me.

Under FDR and for a few decades after, we had a very simple solution to excessive salaries. No, the government didn’t tell anybody how much they could pay, but they did say that anything over a certain amount would be taxed at 90 percent (or so, it fluctuated). So they didn’t limit your freedom, they just encouraged responsible behavior through tax policy.

And with health care, the simple elegant solution would be to get rid of the whole employer-sponsored thing and open up Medicare for all. But that’s just too simple. Instead we have to come up with some complicated, bureaucratic and invasive solution that protects insurance company profits.

It’s just maddening.

Think of the big insurance companies as Tony Soprano and Baucus/Conrad as the slubby sporting goods owner who was his dear good friend from high school.

Yeah, it’s what they are….

Well, you either have to buy insurance or pay a penalty, but it is like car insurance, in that uninsured who have medical catastrophes (like car accidents) end up hurting the rest of us.

Mandate if it’s affordable and we have choice isn’t a bad idea, but it’s got to be affordable and have choice.

THe only problem is that Nixon proved that wage and price controls absolutely positively don’t work. They didn’t work in Russia (except create shortages), so by what leap of logic will they work here? It’s nice to have a poll saying that “the people want it”, but the “people” also want bread and circuses. DO we provide it? I think not.

Very cool!

Even the most uninformed person understands “bailout.” The fact that the insurance industry doesn’t need a bailout makes it worse.

And Reagan proved deficits don’t matter!

/Biggus Dickus

It’s simple. If 30M people say no way and refuse to enroll in this blatently unconstitutional rip off gift to the thieving insurance companies, they’ll have come up with a po. They can’t fine or tax us all.

As the saying goes, you can’t get blood out of a turnip.

It is time (way past time) for Americans to put in place a simple,well understood,common to all and restricted to none American Single Payer Plan.

Do it now. Not five years from now. Not a decade from now. Not two decades from now.

Do it now. Now.

frontpagers are following Democratic Party message discipline, and avoiding referring to the benefits of SP. Still trying to revive the confusing, conflicted PO that has no authentic constituency.

Even Garamendi is saying the word insurance. Fuck him. It isn’t going to be insurance, it’s going to be health care. It is our god damned right.

You beat me to it. Bailout means your boat is sinking and you need help. In what manner of intellectual honesty can someone say that about any private insurance company, yet you see/hear/read it everywhere, nice framing!

In fact the business model of the private “death panel” companies is in trouble. The number of people with private insurance is declining.

“The percentage of Americans with private health insurance declined to 67.7 percent in 2005, marking a pattern of erosion for the past several years. A new research study by Jack Hadley, a health economist at the Urban Institute, found that the main reason that adults’ private insurance coverage has faded in recent years is that the costs of insurance premiums have climbed, making coverage less affordable for employers and employees alike.”

http://www.cbpp.org/cms/?fa=view&id=628

And then there’s the fact that fewer and fewer people are employed.

Let us just say no in concert to this beneficence bestowed upon us by leering gasbags rubbing their oily little smooth palms in orgasmic excitement over the prospect of wringing another pound of flesh from our already flensed corpse.

We’re insured with Blue Shield through my partner’s job with government, and our share of costs has risen 300% over the past five years. We’ve got a friend fighting acute leukemia with the same insurance who is now on disability and the copayments alone are draining his finances; we predict he will pass away the moment his bank account is emptied by copayments.

Obama and the Democrats’ mistake is to continue to support the employment based health insurance regime, just as they continue to support Wall Street’s exotic home mortgage industry and refuse to address the very real issue of retirement security.

When each and every transaction needs to pass through the Finance, Insurance or Real Estate sector of the economy we get screwed. Binding health care to work and binding people to homes through nonportable mortgages limits worker mobility which should be an essential component of the neoliberal “free trade” regime. If you can’t move about in order to find the best job, then you end up being a serf working for a house and insurance. Layered on top of this is the need for folks to do what it takes to ensure a dignified retirement, and that means fetishizing housing as a retirement account.

For the past 30 years, economic policy has been to bulk up the FIRE economy through dropping regulation and federal encouragement. This has allowed FIRE to generate rates of return on capital that had never been seen before. This attracted capital away from objectively productive economic pursuits which hollowed out the manufacturing economy which was helped by the proactive efforts to outsource good jobs offshore as well as insource cheap south Asian tech workers to undercut American wage levels.

So when Obama and the Democrats insist that the employer based health insurance system remain fixed and any “reform” take that as a given, he has already forfeited the game, and is doing little more than bolstering up the FIRE economy which is gunning for whatever good is left in the American way of life.

The notion that reform comes packaged with a requirement that all persons become customers of an industry with a business model predicated upon taking in premium dollars and denying coverage cannot be sold to the American people. There is no “personal responsibility” involved in coercing the payment of premiums to an insurance industry that pools profits rather than risk.

Health care is more similar to a life necessity than driving a car. One might drive a car and never be in a collission and never need to draw on auto insurance. Health care is more like a utility than a luxury, a privilege like driving.

It is impossible for anyone to live a human life and never draw on health care. Utilities are traditionally highly regulated. We can all recall what went down during the go-go years post-repeal of Glass Steagal, when Enron led the charge to electricity and natural gas deregulation, when California’s energy “markets” were made to crash and profitably at that. We’ve seen the disruptions worldwide when neoliberal governments have tried to privatize water.

Just as Californians were made to pay the energy utilities $25b for their “stranded assets” in 2002, all Americans are being held up at political gunpoint to pay the insurers a similar bit of extortion.

Senator Max Bought-Off.

That’s how a called to Randi Rhodes described him, and to me it’s such a perfect nickname that it should henceforth replace the outdated “Max Baucus” on the intertubes.

Not shared eqaually by all. The wealthy pay almost nothing as usual.

Brilliant analysis. I like it!

Selling the bailout.

I suspect the Baucus types will try to make people think they are getting an acceptable deal by raising the subsidies as much as they can get away with. Of course that has the advantage of funneling more public money to the corporations. It also increases costs to everyone in the long run, which they don’t really care about, taking advantage of our current cultural tendency to view short-term gain as the only factor worth considering. Perhaps even add a weak public option that hardly covers anyone, as a “compromise”, and they may be able to sell this. They will have done their job for their lobbyists, with all the benefits entailed for them.

So you want universal health coverage but you don’t want anyone to have to actually pay for it.
The welfare state….ain’t it great!

Why are we wasting so much time on the Baucus bill? Aren’t there 4 other bills in the Senate? Fuck the Baucus bill, let’s discard it and move on. Don’t be distracted by the shiny thing being waved in front of our faces.

When you really think it through from the mandate perspective, single-payer seems to be the only real option.

That’s because it is the only real option. As long as the profit motive exists in the provision of health insurance, unprofitable people will be denied care. That’s just simple economics 101. But (most of) the idiots in charge can’t wrap their pea brains around that idea, so we’ll rearrange the deck chairs some more until enough people are dying in the streets every day and/or being made homeless and destitute that it’s no longer tolerable and revolution threatens. That’s always the only way social progress gets instituted, it seems. We couldn’t get an 8-hour day until unions fought the Pinkertons and blood ran in the streets, we couldn’t get Social Security until the Great Depression and old people were dying destitute, we couldn’t get equality for blacks until Watts and a lot of other places burned and people died, and on and on.

It sucks.

Too bad “progressives” screwed up their strategery so badly, and ended up pushing the vacuous [a|the] [strong|robust]? public [health insurance]? [option|plan] instead of single payer — the only legislation on offer that can actually be shown by evidence to save both lives and money (as opposed to bailing out the insurance companies, which all the other bills will be quite successful at doing).

As Doctor Dean remarked when Susie Madrak interviewed him:

So then I asked him what he thought the strategy was behind the administration starting with the public option instead of single payer. “I think it was a terrible mistake,” he said. He said he thought they were afraid of it being labeled as “socialism.” I agreed with him (that it was a terrible mistake).

Afraid of labels… And I thought the “creative class” were masters of framing? Lakoff, and all that?

You have the IRS act as the collection agent. It’s a sure-fire political winner!

Can Jason or his boss at HCAN explain what value the insurance companies add to any health care transaction?

If they can do that, then there’s a case for the public option’s preservation of the insurance companies’ role in making health care decisions. Otherwise, not.

His is the money committee. Without a bill from Baucus, everthing grinds to a stop. He is also in charge of Medicaid/care, ss etc.

So we are stuck with him and his insane bill. And the rethugs can drag it out for months reviewing every single one of the 564 amendments.

Yeh, it sucks big time.

Using the car insurance mandate as a precedent means guaranteed FAIL, if your goal is universal health insurance (let alone universal health care, which is the only meaningful goal). WaPo via PNHP:

In California, the car capital of America, the injustice of mandatory insurance laws sparked one of the great voter revolts of modern history — and that still didn’t solve the uninsured motorist problem. In 1988, the people of California passed Proposition 103, which required auto insurance companies to seek permission through an elected insurance commissioner for premium increases. It created an intervener system that allows members of the public to challenge unnecessary premium hikes. The law also made auto insurance pricing fairer in various ways, including banning ZIP-code based auto insurance.
The Consumer Federation of American reported in 2008 that Proposition 103 had saved Californians $62 billion on their auto insurance. The market is competitive, prices are down, and the number of uninsured motorists has decreased some from pre-Prop 103 levels. Yet in the most competitive auto insurance market in the nation, the uninsured motorist rate is still 18 percent, among the highest. That’s true even after California took more punitive measures against uninsured motorists. Stiffer fines, the impounding of cars and the loss of legal rights for uninsured motorist have not significantly impacted the uninsured motorist rate.

(mandates + subsidies) – controls = pipeline from Treasury to insurers’ coffers.

“give the American people what they want – affordable coverage and a public health insurance option that’s available everywhere on day one.”
Jason, the p.o. only makes a mandate conscionable if a good, affordable p.o. is available to every person who is mandated to purchase insurance, (and as you say, on day one). I don’t think most p.o. proposals that are being bandied about come anywhere near being available to all.

Of course, Versailles lobbyists who are paid to work against the only legislation on offer that can actually be shown by evidence to save both lives and money — single payer — hurt “the rest of us” too. Just saying.

I like the equation. There’s another one:

means test + subsidy = welfare.

So, our GENIUS Democrats have managed to frame universal health care as a welfare program, so conservatives and Blue Dogs can chip away at it for another generation or so. It’s a surefire political winner!

Remember that “Day One” is “Day One of 2013.” That’s the problem with confusing marketing — sorry, “principles” — with legislation…

Yeppers. “Failing business model” = the need for a bailout. Check the AP quotes here and this from Ian Welsh:

Is forcing people to buy insurance the real goal? The best way to make money, bar none, is to have government force people to buy your product.

It’s particularly ironic that Obama’s forcing the next generation — many of whom voted for him — to buy into the insurance market instead of offering them a real solution like single payer.

As they say in the Navy: You can’t buff a turd.

Gotta admire the message discipline, though! It’s totally party- and conference-call worthy!

“Remember that “Day One” is “Day One of 2013.” That’s the problem with confusing marketing — sorry, “principles” — with legislation…”
Just don’t get sick for 4 years, and you’re fine. Meanwhile, pay the profiteers. We’re told it will take until 2013 to set up the public plan. Funny, Medicare-for-all could be made available tomorrow. Sure, there would be a flood of paperwork to deal with to enroll so many new people, but not 4 years worth. Care delayed is care denied.

Actually, spacefish, the insurance companies are beginning to hurt (hurt being defined as constraints on their excess profits). The reason behind that is more job loss = more people without insurance. Predictions of the future indicate that wage increases will not keep up with inflation. Something will have to be cut. Most families will decide to go without health insurance, hence the mandate, which will give the insurance industry a guaranteed piece of a shrinking income pie.

“individual mandate” + fine = tax + “insurance company free lunch”

They couldn’t have figured out a more politically poison combination if they’d tried.

They weren’t trying, right?

In the LAT article, Sen. Jeff Bingaman (D-N.M.) is quoted as saying that regulating what insurance companies can charge in premiums “would be a very substantial additional intervention in the marketplace.”

And forcing people to purchase crap private insurance at any price wouldn’t be?

Exactly. I think ‘bailout’ should be replaced by ‘windfall.’ A mandate to buy insurance from for profit companies without any other option would guarantee them windfall profits.

I don’t know where you get this idea. People who have insurance through their employer have to pay at least a percentage, generally a large percentage if they insure their family. On top of that wages have remained stagnant, presumably because employers are paying so much for health insurance. People on Medicare have to pay for their coverage every month, as well as having to pay separately for medication insurance (and still there is the doughnut hole). So please explain how anybody is asking for free health care without contributing anything.

Health insurance company welfare.

The legal basis for mandatory auto insurance is that driving a car on public roads is a privilege that can be regulated or revoked (this is why you don’t need a license, insurance or registration for a vehicle driven solely on your own land). The default is that if you don’t want to buy auto insurance, you don’t have to own or drive a car. Many people choose this option for many reasons.

So obviously, the legal basis for a mandatory requirement for someone to buy health insurance for themselves and all of their dependents, and to have their wages seized or garnished if they do not, must have some other legal basis than that used for mandatory auto insurance. Anyone with an idea?

So you want universal coverage everyone pays for, but you don’t want to provide any services?

Ain’t Buccaneer Capitalism great?