The Madness of the Mandate

What's wrong with the government forcing individuals to buy health insurance.

Over the summer, the health-care debate focused on the controversy over the so-called "public option"—a government-run insurance plan intended to offer a low-cost alternative to private insurers. But squabbling over the public plan has diverted attention away from the true centerpiece of all current reform efforts: an individual mandate requiring every American to buy health insurance. Even without any form of public option, a nationwide mandate opens the door to de facto government control over the entire insurance industry, while potentially killing off the low-cost plans that could truly revolutionize American medicine.

An insurance mandate is a crude solution to the what many liberals consider the primary problem with America's health-care system: the large number of uninsured. One of the most frequently repeated statistics in the health-care debate is that there are 47 million people without health insurance in the U.S. Anyone looking for a way to get all of those people insured is left with only one option: force them to get insurance.

Problem is, the 47 million statistic is misleading. And even with a mandate, health reform legislation is projected to leave tens of millions uninsured.

Let's start with the 47 million figure. The number is presented as a static fact, but instead it's the total number of people who go uninsured for even a single day each year. The number also includes several million illegal immigrants, 11 million individuals who already qualify for some form of government health assistance, and 18 million individuals who make more than $50,000 a year, many of whom presumably could buy insurance but simply choose not to.

Meanwhile, mandates don't actually bring everyone into the system. Some people simply wouldn't comply. Others would choose to pay a penalty in order to avoid buying insurance. The latest report from the CBO estimated that the health-care plan put forth by the Senate Finance Committee would leave "about 25 million nonelderly residents uninsured (about one-third of whom would be unauthorized immigrants)."

In other words, a mandate is, at best, a leaky solution to an incredibly exaggerated problem.

Yet advocates claim that it's the only way to cover everyone and bring down costs. In the real world, however, that's just not true.

As Cato Institute health-policy analyst Michael Cannon pointed out in a recent paper, mandate supporters often argue that, by bringing everyone (or nearly everyone) into the insurance pool, a mandate will save money on so-called "uncompensated care"—the unpaid-for care doled out to free-riders throughout the nation's emergency rooms. But according to the Urban Institue, a left-leaning think tank, uncompensated care only accounted for about 2.2 percent of health spending in 2008. So, at most, savings would amount to measly 2.2 percent—and that's before accounting for the additional costs imposed by a mandate.

And those costs can be significant. As Cannon explains, "when government makes health insurance mandatory, it must define a level of coverage that satisfies the mandate." That means that many lower-coverage, lower-cost plans no longer make the cut—and premium costs go up. As Cannon calculated based on a study by Massachusetts Division of Finance and Policy, mandatory coverage requirements can "increase the cost of insurance by as much as 14 percent—or nearly $1,700 per year for family coverage." Two-and-a-half years after first imposing a mandate, the state now has the dubious honor of having the nation's most expensive health insurance premiums, and the future looks even more grim: Insurers have already announced plans for double-digit hikes next year.

Nor does the existence of a mandate guarantee that public spending on health-care will be kept in check. Indeed, the opposite has occured in Massachusetts. The state's medical spending is so out of control that, according to the Boston Globe, state insurance commissioners now worry that it "could threaten the state’s model health insurance law and bankrupt employers and patients." 

Supporters claim the Massachusetts plan has been a success because it's increased the percentage of people in the state with health insurance. And it's true. Estimates suggest that, these days, the percentage of uninsured in Massachusetts numbers somewhere between 2.2 and 4 percent (although given that 86 percent had insurance before the mandate took effect, this isn't as much of an accomplishment as they claim). But what good is insurance if the program that funds it isn't sustainable? Even among those who view the plan as a model for the nation, there's concern that skyrocketing costs "threaten the long-term viability of the initiative."

Meanwhile, a mandate's minimum coverage requirements would effectively outlaw low-cost health-care solutions like health-savings accounts (HSAs) that let individuals pay for care out of accounts they control—and, unlike traditional insurance plans, have a legitimate (if not yet definitive) record of lowering health-care spending.

But in Washington's current reform-crazed atmosphere, sensible ideas like giving consumers more control over their health-care don't stand a chance. Instead, liberal reformers appear to have succumbed to the power of compulsory insurance. And if they get their way, it won't be long before we're all in the grips of mandate madness.

Peter Suderman is an associate editor at Reason magazine.

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  • ||

    We're already living under the rule of a mandate-gone-mad government.

    There isn't a single thing you can do that doesn't have some sort of law or regulation attached to it. From the bedroom to the boardroom, the government's wishes are made known everywhere.

  • ||

    Meanwhile, a mandate's minimum coverage requirements would effectively outlaw low-cost health-care solutions like health-savings accounts (HSAs) that let individuals pay for care out of accounts they control—and, unlike traditional insurance plans, have a legitimate (if not yet definitive) record of lowering health-care spending.

    Indeed. It isn't the public option that is the real problem. It isn't the mandate that is the real problem.

    It is the mandated minimum that is the real problem.

    That minimum is what makes the mandate unaffordable, and therefore subsidized, for so many healthy people. That minimum is what prohibits private offerings from being any less expensive than the public option.

    The mandated minimum is the root of all evil in health care reform.

  • ||

    They have to make the minimum expensive, or they won't have enough money to cover all the people with pre-existing conditiosn they are force to pick up.

    Ultimately, this is all an elaborate effort by the public to have their cake and eat it too. They want free unlimited health care paid for by someone else, no rationing.

    What they will get is shitty health care and rationing that occurs mysteriously and indirectly through shortage, unavailability, and mysterious committees and cost-savigns panels, so that nobody, anywhere, will ever have to take responsibility for ir.

  • Billy!||

    Didn't reason run a cover story years ago about how mandates might be a good idea? I'm pretty confident i remember it.

  • Sean W. Malone||

    That sounds remarkably hard to believe.

  • Russ 2000||

    Ron Bailey's written in support of mandatory health insurance several times.

  • ||

    Well, the trouble with the current batch of legislative proposals is really the mandate that insurance companies take people with pre-existing conditions.

    If they are going to do that, then they HAVE to force people to buy insurance, because otherwise, nodody in their right mind would do it until the day they got sick. In which case, all the insurance companies would go bankrupt.

    Unfortunately, the public is so horrifically misinformed about this subject, and the Democrats so eager to seize as much power as they possibly can, that the mandate on pre-existing conditions is locked in.

    Either way, the proposals are going to have disastrous consequences for health care in the US, no matter which version is adopted. It's vitually inevitable that insurance rates are going to skyrocket and the Democrats will use this as a pretext to force more people into government-run programs.

  • Mike||

    The pre-existing conditions are the real problem. Once a person has a pre-existing condition, the insurance model breaks down. They are no longer pay a percentage on an informed risk - they are a charity case.

    So, as a charity case, we (as a society) have an option of either a) giving them money they have not earned, but need to survive or b) letting them die.

    This is the part problem that has no good solution - there is no real money to be saved, it is just who is going to pay for these people, and whether they will be forced to do so.

  • ||

    There are several ways to address preexisting conditions.

    First, the problem is mitigated considerably if we can remove the perverse incentives that bind one's health insurance to one's employer and, importantly, one's lack of health insurance to one's lack of employer.

    Second, people can opt for health status insurance, whereby they buy insurance that guarantees their ability to buy affordable health insurance in the future.

    If it really comes down to welfare, providing vouchers valued for preexisting conditions -- just as government could provide vouchers valued for low incomes -- would allow the unhealthy to participate in the otherwise free insurance market.

  • ||

    There isn't really a problem with pre-existing conditions; there's a problem with the fact that insurance is tied to your employer.

    I mean, no one has a problem with the fact that you can't buy life insurance after you're diagnosed with cancer. You just take care to buy it before, and you pay the modest premiums, and the company promises not to cancel it or change the premiums as long as you continue to pay them, even if you get sick. Works fine.

    It would work fine for true health insurance, too, if it was something individuals bought. Even if you got sick, you'd continue to pay the premiums, which would be the same, and your coverage would continue.

    It isn't even a problem that the premiums would not be cheap. The time during which you're unable to work and still needing to pay the premiums isn't that long, either way. I mean, either you die, which means the time isn't long, or you don't, which means you get better and go back to work. (Besides, you have the same problem paying the mortgage and buying food while you're sick, too.)

    The real problem, the thing that makes people despair, is that if you get cancer, say, and then you have to quit your job for a year or two while you cope, and you lose your insurance, but then you get better (or at least into remission), and you even go back to work part time -- you're screwed. You can't buy insurance for love or money. People would probably be OK if they could just continue to pay what they paid when they were employed full-time. And they could, if the insurance wasn't tied to the employer by the evil tax system.

  • ||

    At the moment, it looks like the Dems are going to blow their wad on healthcare reform, and not be able to get it up for the carbon tax.

    Would we have been better off with the carbon tax, instead?

  • ||

    No, the cap and trade shit is worse. Well, it was a lot worse until the wretched and now hated(at least by me) Baucus got his slimy paws on it and came up with the mandatory opt in crap. Cap and trade is still probably worse for the country overall and long term, but mandatory health insurance as something I do not want to buy as a healthy young(IMO) adult, is worse for me in the short run.

  • ||

    Why is it wrong to force people to buy insurance? Easy, because it's FORCE. Force is an idiot's fast way to prove his own point. "Why should you buy my stuff? This fist."

  • Andrew||

    Without mandate, rational people will waite until they are sick to get insurance. The insurance market will collapse. Altenatively, insurance companies will have to deny coverage for people with pre-existing conditions. That's what we have today and we don't like the results.

    For the health insurance market to function, it is essential to have the young and healthy to subsidize the old and sick. There is nothing unfair about it. Everybody will get old and everyone may get sick.

  • josey||

    Andrew, your definition of insurance is flawed; what you describe is a cost-sharing scheme. That is not what insurance is.

    Also, it is exactly the fact that a person cannot obtain insurance after the fact (similar to purchasing a policy on an alread-burning house) that compels them to do so beforehand. What you are proposing is to remove the natural motivation for a healthy person to obtain insurance, only to replace it with the gun of government.

    I am uninsured by choice. I do not want to purchase insurance. Andrew - will you personally come to my home and enforce your mandate, or will you cowardly send your government enforcers to do the job?

  • ||

    There is an alternative. You could, for instance, require insurance companies to take responsibility for any long-term condition that crops up on their watch. For life if necessary. I've gotten into some lengthy discussions about how this can work.

    The main problem people are complaining about is NOT those who get sick while uninsured and then want to buy insurance. It's people who get sick and then lose their job, and consequently lose their insurance.

    To me, the obvious answer is to make it illegal for insurance companies to stop covering people who are already sick, especially if they had insurance through an employer.

    The unfairness I see is not the fact that someone who is sick can't get insurance, but the fact that they WERE insured, and somehow the insurance company got rid of them.

  • smartass sob||

    It's people who get sick and then lose their job, and consequently lose their insurance.

    Don't such people generally lose their insurance because they can no longer pay the policy premiums (because of the job loss?)

  • Chad||

    Or their COBRA runs out, and no one will insure them because they are already sick.

    There is no reasonable way around the pre-existing-condition problem.

  • ||

    ...besides doing whatever we can to break the tie between employer and insurance.

    Just as 401K's marked a great stride in portability of pensions, health insurance that gets the same tax treatment whether purchased by the employer or by the employee would mark a great stride in keeping people continually covered by the same insurer.

    No break in coverage, no pre-existing condition.

  • Chad||

    So I am locked into one insurer for life?

    What if that company goes out of business?

    What if, after I get sick, they claim a check didn't arrive, and cut my insurance?

    What if they make changes I disagree with?

    What if they raise rates?

    What if they just behave like dicks in general?

  • ||

    Did I say you can't change insurer? I just said that you weren't forced to change your insurer when you change your employer.

  • ||

    What Chad's referring to is the notion that if you develop a chronic condition, and change insurers, he thinks it makes more sense to force insurer B to pay for your treatment, even though paid for insurance with A when you developed the condition.

  • ||

    Because Chad thinks its "too complicated" to hold insurer A responsible for long-term treatments.

  • ||

    No, the one insurer can pay you a lump sum, or pay a lump sum to the next guy down the road to deal with their responsibility.

    I know you are too stupid to understand the concept. But I'm going to repeat it anyway.

  • Chad||

    Again:

    You refuse to explain how this system would work. Negotiating all the "lump sums" up front would, indeed, be complicated and require all sorts of speculation (on interest rates, inflation, etc) for both parties. You then fall back on using a "formula", without defining who gets to do the calculations, who is watching them, and who resolves disputes. Indeed, you repeatedly seemed to indicate that there wouldn't be any disputes, despite tens or hundreds of thousands of dollars on the line (haha funny funny yeah right). You refused to indicate what would or should happen if my "lump sum" from my current insurer isn't enough for my potential new one. Nor did you address how this makes it very easy for people to abuse using asymmetric information (get sick, buy insurance, wait minimum time, get diagnosed, collect loot).

    You are right in that the "lump sum" system would make health insurance like other insurance, which are also "lump sum". However, lump sum won't work and hasn't been tried for any number of reasons. In trying to fix one problem, you just create more.

    You also say "unless it is related to the existing condition" in a post below. Therein lies a flaw in your reasoning...in medicine, there is easy way to sort this out. At best, you can say things like "If you have diabetes, and then have a stroke, there was a roughly 40% chance the diabetes was the cause". I say at best, because you could endlessly break it down into severity or classes of either conditions. What a mess that would be to sort out.

  • ||

    Yes there is. Force insuance companies to continue paying for existing conditions that people paid insurance for before they developed them.

  • ||

    Yes. But the insuance company should continue to pay for an *existing* illness. They don't have to cover anything NEW that crops up, unless it's directly related to the existing condition (i.e. complications after surgery).

  • EscapedWestOfTheBigMuddy||

    Not only is Hazel's idea here not stupid and less intrusive and authoritarian than most "solutions" we see waved about, but there is no reason you can't write these type of contracts in the current regime. Unless your State's insurance regulator body tells them not to.

    To be sure, this is a fairly complicated bet, and it isn't every insurer who will be will to write such a policy. However, if they become popular, they will become more common.

  • ||

    For the health insurance market to function, it is essential to have the young and healthy to subsidize the old and sick.

    This is so wrong.

    But if you must spout such nonsense, please add to "young and healthy" the adjective "poor" and add to "old and sick" the adjective "rich". That better illustrates the intergeneration theft of this sort of thinking.

  • ben tej||

    I saw Trent Lott making a similar argument on my local Fox affiliate's morning news yesterday. He was actually accusing the "young and healthy" of being selfish for not wanting to support the "old and sick." He seemed unaware that the "young and healthy (workers)" are already significantly supporting the "old and sick (retirees)" with minimal complaint for the most part (except for around here of course.)

    I almost punched my TV screen.

  • Chad||

    It's not "theft" if the system is generally stable, like, oh, every other advanced nation on earth. In that case, everyone gets a chance to be the beneficiary and the payee.

    It's only a question of how much we want to smooth this out. If we paid for it like most other nations - with taxes - then those poor, young people wouldn't be paying much for the system anyway, would they?

  • ||

    Of course it is theft. The government takes money from the poorest cohort by age and gives it to the richest. It is utterly insane.

    Can you imagine the Bentley old age health insurance plan you could buy if you were to invest your 3% Medicare fee over your lifetime rather than have it taxed and given to millionaires?

    As for "smoothing this out", if people need welfare, they should get welfare straight out of the general fund. The large majority of people who don't need welfare should pay their own way.

    We simply should not invent market-destroying fictions to hide the impression that some people need to be on welfare.

  • ||

    Actually, the better objection to this argument is that it is factually nonsense. It's not possible for the "young and healthy" to subsidize the "old and sick" because there is no such thing as a permanent "young and healthy" person. Even if young A subsidizes old B now, who is going to subsidize A when he gets old in turn? C? You're going to establish a giant intergenerational Ponzi scheme, where you have to keep increasing the number of new young subscribers to subsidize the increasingly large previous generations of graybeards?

    It won't work. The number of incoming "young and healthy" people won't exceed the number of "old and sick" people they need to subsidize except for the first few years of a new scheme, or if we go back to a four children per woman rapidly growing population. The only rational accounting basis for considerations of subsidies is comparing lifetime costs, the price of medical care any one person absorbs over his entire life.

    From that point of view, the only subsidization possible is for those who die cheaply -- e.g. of sudden fatal heart attacks while standing at bus stops -- to subsidize those who die expensively, e.g. after heart transplants. But that's a little harsh to explain: the only way this system can work is if lots of you die without much benefit from medical care. They can subsidize the rest of us. Even Democrat doublethink couldn't compensate for the ugliness of that truth.

  • ||

    No, rational people GET insurance.

  • ||

    Not if the government mandates that the insurance companies have to pay for pre-existing conditions.

  • ||

    The essential flaw in the current "reform" effort is that what is broken to reformed is not ever clearly articulated.
    What are we reforming?
    What EXACTLY is broken?
    Insurance by no means is a guarantee of health care.
    Too much of the language from 0bama side of the conversation is couched in pejorative terms of classism and is thereby divisive and sets up contentious language.

  • ||

    Good point.

    As I've argued earlier, what the left thinks is the problem is that some people are uninsured or unable to pay for expensive treatments.

    But what most of the country thinks is the problem is the overall cost escalation in insurance rates, and the increasing efforts by insurance companies to dump sick patients.

    I see these as perverse effects of the employer and medicare dominated market. The left just sees them as some kind of effect of evil greedy capialists trying to make profits.

  • Chad||

    Well, Hazel, why is our care so damned expensive? There are generally two things that we spend more on that everyone else:

    1: Paperwork and insurance overhead
    2: Specialist's pay

    The paperwork and overhead costs are just obscene here in the US. Anyone else in the world complains if it hits 5%. Ours estimated anywhere from the high teens to the thirties, depending on what you count. Unfortunately, as long as we have our current system, things are not going to change much....the paperwork is inherent in the system.

    Additionally, while our general practitioners are compensated similarly to their international peers, our specialists are not. It should be obvious to anyone paying attention that our medical schools have all but ceased producing general practitioners, as all the students want to be specialists. Most new GPs you see nowadays are imported. Given the clear supply/demand inbalance, it is obvious that either GPs are underpaid or specialists overpaid. Comparisons with other nations, as well as other career tracks, indicate the latter.

    Tort reform is another issue that could help address cost, but only a few percent. It is still a good idea though. I personally think that doctors should be protected by a "Good Samaritan" policy, and lawsuits should only be allowed in cases of fraud or other malevolence. We would be better off forgiving them of their mistakes, so they could then be honest and forthcoming about them...aiding research into how to mitigate them.

  • ||

    Meanwhile, a mandate's minimum coverage requirements would effectively outlaw low-cost health-care solutions like health-savings accounts (HSAs) that let individuals pay for care out of accounts they control—and, unlike traditional insurance plans, have a legitimate (if not yet definitive) record of lowering health-care spending.

    Indeed. Though I note that HSAs were given gentle encouragement (through the tax laws) by Republican Congresses, who then stepped back and waited for the market to implement them.

    This of course was described as having "no plan" on health care "for years," which is understandable coming from people who want a public system, but a little more confusing coming from someone who both is a libertarian and acknowledges the worthiness of the HSA experiment.

  • Chad||

    Peter: Try to buy health insurance for your family of four while making $50,001 per year. Most of those 18 million you are talking about are the working poor, and coughing up $12000 per year for a family plan is not an option, when housing, transportation and food are on the line.

  • ||

    Um yeah, and that $12,000 is largely going to subsidize those sick people that you think have a "right" to health care.

  • Joshua Holmes||

    $50k/year is not working poor.

  • Chad||

    For four people it is. It surely isn't for a young single engineer just out of college.

  • ||

    It's $50,000 per individual. If you've got a family of four, then there's a mother, too, right? Presumably she's earning another $50,000 (or at least $30,000, which is McDonald's shift leader wages), so we're talking about $80,000 in family income, plus generous deductions for the four kids. And unless you are working for Simon Legree, the average amount of dough your employer asks you to fork over for very nice family coverage is more like $400/month.

    I don't see a big problem for an $80,000 a year family to fork out $4800 a year for their medical coverage.

  • Chad||

    John Thacker|10.9.09 @ 4:58PM|#

    This of course was described as having "no plan" on health care "for years," which is understandable coming from people who want a public system, but a little more confusing coming from someone who both is a libertarian and acknowledges the worthiness of the HSA experiment.

    Why do libertarians like HSAs? Do you all feel that people are too stupid to save on their own, and need the nanny state to subsidize it?

    I love it when you compromise your principles, as once you concede any hole in your logic, the whole edifice beings to tear apart.

  • ||

    HSAs differ from ordinary savings accounts because they have the same tax advantages that employer provided comprehensive health insurance receives.

    It is only a subsidy to the extent that it matches the subsidy of employer provided high-cost health insurance.

  • Chad||

    So, now I have a libertarian arguing that one group should be subsidized because someone else did.

    Hell, you just conceded half the political battlefield. It's fun watching your world crumble about you.

  • ||

    I argue, as have for a long time, that the distortions in the market caused by the differential tax treatment of various ways to get health care and health insurance are among the worst problems with health care in the US today.

    I would prefer that health expenses paid by the employer were taxed as income, but I can live with health expenses not paid by the employer not taxed as income.

    Why do you imagine this makes worlds crumble?

  • Chad||

    If you can live with one subsidy, you can live with them all.

    I think the health-insurance subsidy is a problem, but a minor one, similar to tort reform. Both are maybe 5% of what is wrong with our system.

  • ||

    Every libertarian would agree that it would be better not to have any tax subsidies for anything.

    Apparantly, according to you, when the government creates perverse incentives, that provides perfectly legitimate justification to create even more regulations to mitigate the effects of the other regulations.

  • ||

    The problem is not the subsidy per se.

    The problem is subsidy's perverse incentive to bind health care to one's employer.

    It is so perverse that many proposals in legislatures to "reform" health care try to turn the incentive into a mandate -- when the whole notion is in reality mind-bogglingly stupid!

  • ||

    By the way, Chad, I can't believe that you are so nonchalant about this subsidy.

    First, it is wildly regressive. The tax advantage to someone making $30,000 is only his 15% SSA and Medicare tax, while someone making six figures might gain a tax advantage of over 50%.

    Second, since the worker making $30,000 and the worker making six figures both get the same $12,000 insurance benefit, it would mean a hell of a lot more to the janitor for that payroll cost to show up in his paycheck than it would mean to the manager.

    Of course, I think both those pale in comparison to the appalling incentives it forces on a market as critically important and as large as the health care market.

  • Chad||

    I don't support this tax subsidy. I just don't think it is a big deal, nor the source of any major part of the problem.

    Our tax system should be radically simplified and all the deductions except a simple, single per-person deduction, removed. However, it should be progressive.

    What is a bigger concern to me is that our tax systems need to be sychronized internationally and state-to-state, to avoid races to the bottom.

  • Marc||

    What on earth is the Chad going on about now? I can't follow its line of thought, nor parse its sentences.

  • ben tej||

    It has something to do with having less of your income taxed being a "subsidy". So not really worth following.

  • smartass sob||

    ... once you concede any hole in your logic, the whole edifice beings to tear apart.

    Uh, Chad, a "hole" in the logic of any "ediface" - including your own - would make it fall apart.

  • Chad||

    Wrong.

    Libertarianism is built upon an internally-consistent logic. It can accept no cracks without crumbling. Once you concede that anything that follows from your assumptions is wrong, you inherently concede that your assumptions are wrong or incomplete, and therefore can no longer conclude anything follows from them.

    I am simply driven by data. What works works. In the case of health care, we pay much more and bear much greater risk, but only get care similar to that of other advanced nations. Therefore our system is a failure, and we should adopt plans similar to those of the nations that are doing better than us.

  • ||

    Since the current health care system in the US bears no relationship to libertarian thinking, I fail to follow your non sequitur.

  • smartass sob||

    Wrong

    Hahahahaha! Really? Do you think that your "ediface" is somehow immune to holes in its logic? Do you also think your shit doesn't stink?

    Therefore our system is a failure, and we should adopt plans similar to those of the nations that are doing better than us.

    What's this "we" stuff - you got a mouse in your pocket or something? If you think it's so god damned wonderful in those other countries, then don't let the gate hit you in the ass on your way out of this one, turkey. Don't try to force your con on others.

    I think I'll just take this opportunity to do as others have done and "join the meme."

    FUCK OFF, slaver!

  • Invisible Finger||

    coughing up $12000 per year for a family plan is not an option,

    Where was this mathematical sensibility when the states were passing laws mandating that every insurance customer pay the same rate?

    Oh yeah, right. It was coming from the evil insurance companies that said exactly what was going to happen as a result of such legislation. But it must have happened because the insurance companies are evil, not because of logic and mathematics.

  • ||

    The progressive answer to every perverse consequence of their policies is always "evil capitalists are sabotaging my perfect utopian scheme!"

  • ||

    It amazes me that the mandate isn't the topic of fierce opposition from anyone who has any concern about constitutionality and individual rights.

    Let's put it in the simplest terms: the government is contemplating a law that will coerce every individual American citizen to buy something, perennially, as a condition for merely existing.

    Come on! It's one thing to associate a tax or a mandate with behavior. But here the behavior is simply: you exist, and you're mortal, therefore you cost the system money, therefore pay up.

    How is this different than passing a "mandate" that everyone work as "solution" to unemployment?

    But I own my time, my effort, my body, my life - certainly even as fundamentally as I own my speech and my faith. The government can't force me to work because being able to walk away from a job is absolutely essential.

    Guess what: being able to walk away from a corrupt insurance cartel is as well.

    It doesn't matter whether or not there's a public option yada yada - an individual does not owe money to any system, least of all a quasi-private cartel, simply because one has a body.

  • josey||

    Chris - if a government threatens innocent persons with bodily harm, what then is the definition of moral behavior? We have a choice.

    I would refer you to Thoreau...

  • ||

    Josey, if in referring to Thoreau you're suggesting that civil disobedience is an appropriate response to a health care mandate, I am inclined to agree. But I'd prefer to see the legislation shot down.

    I don't follow your first sentence. The "definition of moral behavior" doesn't change; bodily harm against innocent parties is wrong regardless of who the author is.

  • josey||

    Inasmuch as many, or most, people are apt to consider paying their taxes to be a 'moral' behavior, it does change the definition; that's what I meant.

  • ||

    It's the topic of fierce opposition from ME ...

    I am pretty confident that the annual fine will be cheaper than paying money into one of these government-subsidized insurance cartels.
    Especially given that the state is forcing them to pay for my health care regardless of whether I buy "insurance" before getting ill or not.

    So, I plan to fuck the system into the ground in revenge. Fuck you and your mandates, I'm going to consume all the free health care I want until the system crashes. If you want to force me, you'll have to raise those fines to a point that will have the majority of the electorate in open revolt.

    The problem with socialism is that eventually you run out of other people's money.

  • smartass sob||

    So, I plan to fuck the system into the ground in revenge. Fuck you and your mandates, I'm going to consume all the free health care I want until the system crashes.

    Might not work - they'll probably make co-pays so high that they would bankrupt you. Afterall, the whole thing is really about more revenue for the government. It can't afford the entitlements it is already obligated to pay, so this is a way to pump more suckers, er... money, into the game.

  • smartass sob||

    Also, I'd be very leery of getting treatment from the sorts of doctors this proposed system is likely to produce and subsidize. Hell, I'm already hesitant about being treated by doctors - as a professional class they probably aren't any more conscientious, honest, or skilled than any other.

  • ||

    I'll gets lots of second opinions. Wastes mroe money that way.

  • Chrispy||

    I disagree with your last sentence, just because it takes so much effort to become a doctor. Anyone who is willing to put that much time and effort in probably cares about the job. Sure there are bad doctors out there, but there are probably far fewer (as a percentage) bad doctors than there are, say, bad fast food workers.

  • Chad||

    He said "professional class". I would agree that doctors aren't any more skilled, honest, etc than, say scientists. MBAs and lawyers? Not more skilled, but the honesty...

    We do, however, pay doctors (particularly specialists) more than our international counterparts, and more than American scientists, which is the most similar in terms of education. This is true after accounting for the loan payments (a $200,000 education loan needs around $30,000 in extra annual income to pay off over the course of a career).

  • ||

    The original draft of the Baucus bill called for a $1900 fine and, according to the JCT, a misdemeanor and up to $25,000 fine or a year in jail if you refuse to pay the $1900.

    Gee, thanks gov!

    http://tinyurl.com/ydzc6zs

  • ||

    We'll see how long that survives politically.

    I know plenty of healthy young people who would be up in arms about being fined $1900 per year.

    Most of them liberal and progressive. Nothing will kill THAT faster than this insurance mandate. They may be suckers for leftist politics, but that doesn't mean they won't feel $1900 where it hurts.

  • Isaac Bartram||

    Sort of like how the geezers turned on that catastrophic illness bill that was passed about twenty years ago.

    Nothing's faster for changing someone's mind about a welfare scheme than finding out how much they'll have to pay for it.

    The biggest tax cheats I know are socialists.

  • monkeys||

    The biggest tax cheats I know are socialists.

    'Tis true.

  • ben tej||

    Interestingly, many of my liberal progressive friends who are uninsured think they're going to get free insurance out of it. They don't realize their income's too high to get a subsidy.

    They are going to be super pissed when they find out what the fine is, though I'll consider it poetic justice.

  • ||

    Similar to something I posted a few day sago, but I have to bring it up again. I think we should have a reality TV congress survival show on prime time TV. Each week we select a pool of our favorite congress people, and place them atop a Mesoamerican style pyramid. We begin a series of rounds where Americans(working only), ask questions. As each of the congress people are voted off the pyramid, a lucky American gets to chose their fate. I envision that Baucus gets voted off. Next scene is where I get to choose that Baucus pays my fine for refusing mandatory health insurance. In payment, he gets his heart ripped out with an obsidian axe, his head severed, and his lifeless body hurled down 3000 stone steps as the hungry natives await below to eat his wretched remains.

  • Enrique||

    Of course all Congressman taste like chicken.

  • ||

    Good God man, everyone knows that Congresscritter tastes like pork !

    SteveinTX

  • smartass sob||

    Lol. ;-)

  • ||

    the EPA would put a stop to this too soon though.

  • Ebeneezer Scrooge||

    Congress is hereby disbanded due to lack of interest. Lack of my interest in anything they're trying to do.

    Congress may however continue as a game show. "Let's Play Congress".

    Seriously, why do we let these idiots meet for more than 10 minutes, about once every three decades or so? The only exception to be an invasion of the US by a foreign army.

    On second thought, if we got invaded would you want to rely on these idiots to save all our asses?

    Somehow we need a way to divert the restless energies of all those who would remake the world in their own image.

  • Wicks Cherrycoke||

    "As Cannon calculated based on a study by Massachusetts Division of Finance and Policy, mandatory coverage requirements can "increase the cost of insurance by as much as 14 percent—or nearly $1,700 per year for family coverage." Two-and-a-half years after first imposing a mandate, the state now has the dubious honor of having the nation's most expensive health insurance premiums, and the future looks even more grim: Insurers have already announced plans for double-digit hikes next year."

    Why are supposedly intelligent people always shocked -- shocked! -- to learn that the price of a good or service such as insurance increases whenever the purchase of that good or service becomes mandatory?

  • ||

    Mandated health care is racist. For example, asians require lower doses of statins (which are not even known to be effective in asians, for statistical sample size reasons). Which means that asians overpay. Well, let's say gov't healthcare attempts to address this by mandating lowered statin dosages for asians. Well, then what happens to the one asian that does need it and gets a heart attack.

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  • ||

    Insurance reform is snake-oil medicine for what ails our health care sector. "Needing to eat" is a pre-existing condition that is addressed most effectively not by introducing or reforming "food insurance," but by making food affordable. Any reforms we embrace must have, at their core, the aim and ability to make health care truly affordable, especially for those with pre-existing and/or chronic conditions. Otherwise, we are just wasting our time and effort.

    Nobody should need insurance of any kind to access or pay for routine and commonly-needed health care goods and services. If they don't have enough money for even affordable health care, they can appeal to charity. But first, we need to make health care affordable. The focus on health insurance reform distracts us from the thing that is most urgent, and guarantees that we will be no closer to solving our problems ten years from now than we are today.

    Eyes on the prize, people.

  • Ned Netterville||

    I'm surprised a libertarian criticizing mandated health-care insurance wouldn't point out the biggest problem: From whence comes the upside-down authority for one's servants (aka, public servants in congress and the administration) to make anyone do anything about his or her health, or anything else for that matter??? Mandatory insurance? Over my dead body. http://www.jesus-on-taxes.com/.....VER_M.html

  • ||

    The major problem is we are not talking about insurance, we are talking about a benefit called free healthcare.

    Insurance would be if you paid all the cost up to the deductible and the deductible were more than a co-pay, e.g. $5. What they are talking about is not insurance.

    Here's an idea; everybody pay for their own doctor visits and healthcare.

  • abercrombie milano||

    My only point is that if you take the Bible straight, as I'm sure many of Reasons readers do, you will see a lot of the Old Testament stuff as absolutely insane. Even some cursory knowledge of Hebrew and doing some mathematics and logic will tell you that you really won't get the full deal by just doing regular skill english reading for those books. In other words, there's more to the books of the Bible than most will ever grasp. I'm not concerned that Mr. Crumb will go to hell or anything crazy like that! It's just that he, like many types of religionists, seems to take it literally, take it straight...the Bible's books were not written by straight laced divinity students in 3 piece suits who white wash religious beliefs as if God made them with clothes on...the Bible's books were written by people with very different mindsets

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