I’m so glad you wrote about this, Jon. I spend alot of time posting to articles in the blogosphere, on facebook and twitter, and not only do I have to battle tea partiers on the right, but now I have to spar with those on the left of center who want to support the president no matter what. This goes against my sense of right and wrong. It goes against what Obama told us. To hold him accountable.

Still, I can see the White House doesn’t take critisizm very well. They even send people to the blog post comments to defend this or that.

So, to recap, we have four different types of people fighting it out:

1. Tea Party – where facts are like cryptonite, only personal insults. Occassionally you will find one who wants a genuine conversation.

2. Obama Loyalists – AKA Obamabots or O-bots; to them, the president can do no wrong and they will defend him even if they have no logic or data to back it up. They disdain anyone who questions the president and you will feel their sting.

3. Progressives – These are the people who took Obama at his word. They want the president to succeed, but they won’t be fooled by victory laps for fake reform. They watch everything very closely and are fierce opponents.

Until the first two groups get real, the last group will continue to be frustrated, fighting from the left and the right, but called “far left”.

The fourth type would be the increasingly-rare sane republican, they are also ignored by their party. You’d think the progressives and sane republicans never even existed if you watch the mainstream cable news.

I’m certainly not going to defend a mandate to buy private insurance. Sadly I don’t see the law changing for the next 7-10 years.

I still think the Supreme Court is going to throw it out. States have general police powers that are far broader than federal enumerated powers. so Massachusetts can mandate every resident buy health insurance, the Federal Government cannot.

The bigger problem is that the Senate healthcare bill screwed up the tax provisions. Without going to far into the weeds with the difference between income taxes (permitted under the 16th Amend.) and other direct taxes, the way the Senate bill structured the tax penalty (with a $695 minimum penalty regardless of income) is really going to be a bone in the throat of the Supreme Court.

Even if the Court went along with that, the state-based insurance exchanges impose a duty on state government (unlike the new high risk pool system, the insurance exchanges which start in 2014 have no state opt-out provision wit a backup federal plan, the new insurance database requirements have already been imposed on state governments). Ironically, the House bill was on firmer ground because it used a federal exchange and I seem to recall the tax system didn’t have the direct tax issues the final law has.

But the health insurers didn’t want a federal exchange, and as they say on Wall Street.. pigs get fat, hogs get slaughtered. The state-based exchanges gave standing to state governments to challenge the HCR law’s constitutionality (under the House bill, the states had no duties imposed on them, so one would have standing to sue until a uninsured citizen in 2014 was mandated to buy insurance).

The crusher for the Administration when this gets to the Supreme Court will be even if the Court accepts that universal healthcare is a public necessity, they’re not going to cut the President any slack because there is an existing universal healthcare system and tax code provision that is clearly constitutional. To paraphrase what Chief Justice Roberts said of recess appointing NLRB members, “And Medicare doesn’t work why?”.

The 13th Amendment along with the Equal Protection Clause of the 14th Amendment makes the present federal Healthcare Reform Law’s Individual mandate unconstitutional. State requirements imposing same are also unconstitutional.

Should America find a way to “fund” healthcare “access” for all Americans equitably, the equal protection would be met. This is one issue. Currently the “individual rights” of Americans are subordinate to the corporate due process rights of Health Insurance corporations, many of which operate “tax exempt” under state law. The patchwork make up of state based providers and insurers is a legitimate regulation under the interstate commerce clause. Reminds me of segregation, corporate style! To impose a individual health insurance mandate using the ICC, on individuals is misapplication of law on the individual also precluded by the 13th Amendment. The corruption of of the corporate bought IRS Tax Code is deeply involved here……..

The imposition a tax penalty on “CITIZENS” who fail to comply with this mandate is unconstitutional. The law evinces to coerce the individual into contracts with corporate health insurers, under fear of a punitive financial penalty in violation of a clear prohibition of the 13th Amendment. It is a deprivation of life and liberty, avoiding due process of law, under the color of law. Congress and the Executive no matter how well intentioned, at present cannot find an effective manner to control “Cost,” within a broken “CORPORATE HEALTHCARE DELIVERY SYSTEM,” which could equally protect the rights of all Americans, and the corporations which at present provide the all important life sustaining yet money sucking services, in the monopoly of life. So instead they have placed the American people and a Nation into a state Involuntary Servitude, to the very corporate interests which fund the politicians who are suppose to represent US? This an outrage! There is no equal protection when politicians craft law and enable corporations to violate basic constitutional protections designed for “Individuals” so they would not be owned as property or placed in a state of perpetual servitude to a King, a Master a government, or corporation in the form of a “insurance premium” on life? The Ghost of Dred Scott lives…..

A universal single payer health care system, such as Medicare for All, is probably as close as you can get to an optimal solution. It is dramatically better by all measures than a system based on an individual mandate.

It would certainly be nice if FDL supported that optimal solution next time around, rather than getting trapped in “public option” wonkiness.

I agree with the those who think the mandate in unconstitutional, but I also think that the Roberts Court never met an authoritarian law it didn’t like. So, I’d be pleasantly surprised if they declared this one unconstitutional.

If you are hit with that tired canard about states require you to have car insurance as a reason to have health insurance, eh, not really.

States do not require you to have insurance to do things many consider a natural right such as riding a horse, bus, buggy, motor scooter, farm tractor, raft*, walking, etc. on that state’s public roads.

Even if you do choose to exercise a state regulated revocable privilege such as operate a motorcycle or motor driven car on that state’s public roads, not all states require you to pay money to a private company as a hedge should you cause damage to other individuals using that same public road. In some states, such as Tennessee or Kentucky, residents can post a bond (pay a cash deposit) with that state and that resident has met their obligation towards exercising a revocable privilege. Additionally, because of our Constitution, those residents can exercise that privilege in other states without paying money to any private insurance companies.

Universal health care should be a right to all people and we do have the means to get this for all people without bankrupting ourselves in the name of corporate profits.

*rivers and streams are often considered part of the state public roads.

It would certainly be nice if FDL supported that optimal solution next time around, rather than getting trapped in “public option” wonkiness.

Hear, hear!

A universal single payer health care system, such as Medicare for All, is probably as close as you can get to an optimal solution. It is dramatically better by all measures than a system based on an individual mandate.

Last part of this statement = Universal single payer involves a mandate of “everybody in” to make it work. I would reword to say “. . . better by all measures than a system based on being forced to buy a corporate profit-centered insurance product.” It’s not the mandate per se but what we’re forced to buy that’s the problem.

Obama did his wink-and-nod with Baucus and others to snow the public (and some progressive followers). I was amused no end when, of all people, Ron Paul addressing (I believe) a bunch of T Party people who were calling Obama a socialist, “He’s not a socialist. He’s a corporatist.” This was proven to the max when Obama recently appointed Liz Fowler, Baucus’s chief of staff and former Wellpoint lobbyist who wrote much of the HCR bill, to help administer the plan. Wow, that was a sinker. Smooth as silk.

PS: I’m not a Ron Paulist by any stretch of the imagination. Even a broken clock is right twice a day.

Dean predicted the mandate would be dumped by 2014:

http://www.huffingtonpost.com/2010/08/06/dean-individual-mandate-w_n_673218.html

I hope he’s right, and I hope the WH and the DC Democrats get on board with making it happen. The “realists” always pushed passing the BS HCR law now and improving it later – this is a significant improvement that Dean backs up with real world experience. So let’s see the “political realists” get behind a push for improvement. (Fat lot of chance of that happening even as those same “realists” get their ass handed to them in the 2010 and 2012 ballot box.)

Forcing everybody to buy health care insurance from the same crooks that screwed American health care into the ground was ALWAYS a stupid idea.

Beowulf, the minimum penalty is actually not constitutionally problematic at all. No one who is making less than 695 is going to be covered by the mandate, because everyone making under the poverty line (well over 695) gets free Medicaid and is exempt from the mandate.

If you want to look at it as a percentage, 695 is a little over 6% of the poverty line ($10,830). Obviously, a 6% tax for people making the poverty line (with a linearly decreasing percentage for those that make more than the poverty line, to maintain the $695 tax) is constitutional. This is a textbook income tax.

In addition, you are completely wrong with regards to an opt-out for exchanges. The law absolutely and clearly contains a provision that says that the HHS will set up its own exchange in any state where the state voluntarily chooses not to do so. It does not mandate that the state do anything of the sort. This is the Senate bill I am talking about — the one that became law. The only “commandeering” that could even plausibly be claimed is the mandate that states cover Medicaid for people up to 133% of the poverty line. But there is an opt-out for this too — states can simply opt out of Medicaid entirely (and all the federal funding that goes with it). If they do this, they have no mandate. This regime is clearly constitutional under South Dakota vs. Dole.

If the Dems lose in 2010, the mandate may be gone much before that, depends very much on how the campaign develops now.

Great post!

I think you forgot to negate this sentence:

Obviously, I feel that NOT giving people the choice of a public option makes the individual mandate a noticeably worse policy.

Z

Progressives Shouldn’t Defend the Individual Mandate…

When you’re right, you’re right.

As someone who has been without health insurance since 1992 (because of cost and a preexisting condition) I applaud your first paragraph. I would offer the constructive criticism that you equivocate too much in the rest of your article. Say it loud, single payer is cheaper and better. To put it simply, a Canadian-style system in which ALL health care is delivered by the government and paid for through (progressive) taxation, and without the ability of the wealthy to opt out and set up a two-tiered system, is what progressives should demand.

Damn good thread, Jon. And an overdue one.

Along with the HCR Trojan Horse “progressives”, we can add in the let’s-don’t-talk-about-the-clusterfucks…now that they’re OBAMA’S clusterfucks, bunch.

Hey, newt. how are you?

Good, Twain.
Love the handle.

Thanks for this post. I got a sick feeling in my stomach this morning when I saw a post on Thinkprogress trashing Dean for daring to call the mandate unnecessary. I didn’t understand why they were throwing their support behind the mandate. I would have expected an article about what happens if the court throws the mandate out–a ‘where do we go from here’ type post, with reference to the many other progressive options for bringing down the rate increases. There was a real disconnect there to me.

I think there are progressives, and I think there are centrists who call themselves progressives. They are fighting for the Democratic party, we are fighting for the Democratic ideals. I don’t think we should count on them for any real progressive support. They are the “hold your nose and vote for the least objectionable candidate” crowd who are fighting for the status quo so things don’t get EVEN worse. I can understand their caution. But that caution is paralyzing the movement.

I think there are centrists who would sell their soul for a “victory”, regarless of the policy outcome.

Great post, Jon Walker!!!

It would certainly be nice if FDL supported that optimal solution next time around, rather than getting trapped in “public option” wonkiness.

The “single payer” was never a choice, if it was, FDL would have fought hard for it.

The veal pen strategy by the White House seems to be working very well on some of our “progressive” friends. The Obama administration (Hi Rahm!) have successfully divided the progressive movement and weakened us significantly. So much could have been accomplished if only the White House would put such effort into enacting the change we can believe in.

Obama is a complete fraud. He did the old bait-and-switch and severely damaged any chance we had of correcting Bush’s legacy. Why is anyone supporting him at all?

Sheeple.

I love it when “centrists” lecture us about how insurance works, spreading risk around etc., while ignoring what we are buying and whom we are buying it from. We are expected to look the other way while our health care system is run by the equivalent of the mafia.

Cognitive dissonance. In case you hadn’t noticed, Obama supporters have massive egos. It’s far easier for them to defend Obama than to admit they helped put another neocon in the White House.

http://www.veoh.com/browse/videos/category/entertainment/watch/v20310905ZKWaj9BS

I agree Jon. The mandate is not something worthy of defense. I have opposed it from the beginning. Even when the GOP was proposing it.

With so many workers now going to really day labor status with no employer responsibility I personally think there is a good chance Obamacare will not be actualized. Hopefully in another year or two it will become so obvious that in our current economic situation, which promises to be near forever, single payer is the only solution.

Just hate to think how bad it has to get before that happens

Haven’t read comments yet, so excuse if I repeat.

Individual mandate is a red herring. The real issue is cost control, which includes but is not confined to, corp profits of insurance corps (including hidden costs, like inefficiencies) and not so hidden costs, like executive comp. The rest is small potatoes.

*heh* It’s amazing how powerful a disinfectant, a little Sunshine is…! ;-)

I separate “Democrats” from “Progressives” largely on grounds of partisanship vs policy. If liberal policy is more important to the individual, they are Progressive in my mind. If, on the other hand, the most important thing is whether or not somebody has a “D” or an “R” in to go with their names, that person is a Democrat or a partisan. I really have no use for partisans and those are the only people who seem to be trying to defend the indefensible personal mandate, (without a public insurance option).

About time someone focused on the core issue here again. Thanks

Great OP – great responses.

Sadly the “the Roberts Court never met an authoritarian law it didn’t like” will control and the mandate will be with us for a while – and as noted in the comments, existing law permits the mandate as an income tax because of the poverty line income test before any penalty, plus we will have the pointless exchanges (they do no more than act as your current insurance broker does) because the States can opt out and therefore are forced to do nothing, similar to the option the States have to op-out of Medicaid if a State objects to the new 133% of poverty mandate.

I did like the creative thinking on the options to the current mandate – the public option “extremely bare-bones default public health insurance plan that would automatically cover anyone who didn’t sign up for a private insurance plan” makes a lot of sense – but I do not expect any GOP – or Obama – support for the idea.

There is a “government …select the private plan from the lowest level with the best metrics (medical loss ratio, consumer service, etc…)” study likely but rather than enroll anyone it will be simply tell the public of the results via a PR release by the Secretary of HHS. Again a public option “select a plan that is the best of the ins. co’s offerings” will not get GOP or Obama support – because the ins co’s don’t want it to happen.

The replacement of a cash penalty is not needed to get by the review of the law, but the right to charge extra premium for delayed purchase that will not count against the loss ratio calculation is an interesting replacement for the penalty.

Like yourself, I do hope Chief Justice Roberts includes in his opinion a comment based on his prior comment on recess appointing NLRB members,

“And Medicare doesn’t work why?”.

But Obama and Roberts and the GOP and the ins co’s are in bed with each other, so I expect to not see that witticism.
.

mikeyhemlok is up @ Attackerman!
The Curious Case of the Warlord and the Supermodel

“And Medicare doesn’t work why?”.

Becuz it’s run by the govt (and has some cost controls). QED.

The only people who I know of that are actually defending the personal mandate are doing so always in terms of, “it’s better than nothing” or “it’s still a ‘win’”. No, it’s worse than nothing and it’s only a ‘win” if you are a health insurer. Chances are people who are willing to defend this as some kind of “victory” over Republicans don’t foresee ever having to be subject to it. Either they have decent employer based coverage, make enough money to be largely immune from the whims of the abominable system that’s been created or are just thoughtless about the future. While the partisans pat each other on the back and deliver high fives because of those “defeated Republicans”, some of us aren’t going to be able to afford nor do we want to buy an incredibly expensive and all but useless product. This is akin to being forced to buy a Yugo by paying ten times it’s real value.

Howard Dean said the mandate would be gone by implementation-time in 2014, on TRMS this past week. I hope he’s right, it’s an idiotic part of the law.

BINGO – spot on comment.

But the US is not ready for single player health and a national health budget with prioritized services as in Oregon Medicaid (Oregon operates its Medicaid program under an 1115 waiver that uses a priority list of covered services to define coverage instead of the standard state list, their list changing based on their annual budget). Indeed the US is not ready for single payer and a minimal list of covered services as a basic plan – with no national budget concept.

The best we can do – or could have done if Obama was not such a sell out – was a public option to keep ins. company folks honest.

Now we are left with studies on how to change the way health services are paid for so that there is not an incentive to order un-necessary services just to increase the Doctors income. Mass has such a study going – going nowhere since it equates to a cut in MD and Hospital income, and the commission members can agree on nothing, other than more study.

By 2014 Obama may be gone, too. Also.

LOL – so true!

You are so correct – in Mass the Exchanges “affordable policy” sucks, so many are choosing to pay the penalty rather than send funds to the insurance companies.

In Mass the Exchange does not offer a public option policy, but it does decree the design of the affordable policy that ins. co’s must offer.

I just finished reading Hill’s Europe’s Promise, so now I feel as if I know a little about Europe’s medical industry. Lot’s of different organizing principles, including individual mandates, enforced via tax deductions, but key is cost controls. The general model seems to be that they are arrived at thru negotiations among stakeholders. Nothing like that could ever happen in the U.S.

No, it’s worse than nothing

Yes it is, and I would add another reason why it is, IMO.

I think we all agree that single payer or something like it is the only real, long term solution. And IMO, this law is not only NOT a step closer to that (as proponents claim when they say it’s just a “first step”), but it actually makes it LESS likely in the future than if they had done nothing.

Pardon me, Twain, but those are my fellow citizens you’re denigrating. Surely you know that calling our neighbors and family dehumanizing names, in the context of or as a prelude to, political action, has a long and sordid history.

Why don’t those people do as we think they should? Obviously, they can’t be quite as human as we are.

Do we really have to go through that again?

I resent the implication that people I know and love are sheeple. That’s an oh-ain’t-I-clever way of blaming them, the victims of decades of weapons-grade mind-fucking, for getting jacked to hell and back by “manipulating the media narrative,” in Scott McClellan’s perfectly Skinnerian phrase.

No, our unconvinced friends and family are not stupid, genetically deficient (sheeple is an inherently dehumanizing term), crazy, or inherently evil. What are we? Two things.

We’re kin, baby, kin, and we’re getting jacked to hell and back (how many tours of duty have our servicemembers done? how many financial crises have we been through lately?), stuck with the bill in every freakin’ way.

Is it OK if we call pols sheeple, or assert that O has put them in the veal pen?

If you don’t like sheeple, pick a word. These are people who will follow Obama and the Dem party right over the cliff and wonder why it happened.

but it actually makes it LESS likely in the future than if they had done nothing

Spot on! This just further entrenches the for profit private insurers. Just another layer of profit making that we now have to strip away in a quest for single payer, now enshrined in law.

Could you possibly be more vague? Are you saying that “your people” are Obamarahma staff or insurance and drug company executives?

Phlegmmings? (“‘Snot my fault!”)

LOL

1st time here / posted already?

No. Otherwise one can just game it (get insurance when they’re sick.)

Health insurance is an oxymoron–all humans get a risk factor
sooner or later, there being no such thing as the unlikely event here.

We should want to live longer, better, and for providers to want to grow
to achieve and render brilliant skills, using astoundingly effective
tools. That requires all hands on deck, and today’s youngsters will need help from their follow-on generation as well.

further know:

you’ve paid for the uninsured all along, as they’ve been going to the county hospitals

their costs have been passed to yours, built into your premiums

Medicare has all along been National Health Insurance for those 65 and older–the people the health insurance cartel would never want to hear from (except on a cost-plus basis, of course.)

As soon as you belong to a cluster of customers deemed possibly
expensive for your carrier, your cluster will receive letters indicating
you’re welcome to stay but your premiums will rise considerably. Welcome to the “PREMIUM DEATH SPIRAL.” Most of you will experience it sooner or later, particularly if you don’t go naked for 6 months

http://www.healthcare.gov

at least until 2014.

Such is immunity from anti-trust laws and (to me:)
now-you-see-it, now-you-don’t health insurance.

Such is the business of holding a gun to sick people’s heads.

http://sites.google.com/site/evernewecon

hey evernewecom — your comment posted twice — as moderator i removed the duplicate

and welcome :)

The fact is the congressional Democrats and the White House sold out. There are NO viable acceptable, consumer protections in this bill. Forcing people to by insurance in an uncontrolled insurance market is throwing us to the wolves. The same wolves that right now kick out cancer patients and other people who need care to LIVE. Until this bill goes into effect the insurance companies are going to jack up rates and cut benefit levels like crazy. By 2014 they will have a license to steal from every citizen of this country. I am independent and I buy individual insurance now which is almost unaffordable. I was counting on Obama to honor his promise and provide some relief from the predatory system now in place. No such luck. I won’t vote republican but you can bet I won’t be putting any votes in for Democrats anymore. They are just as bad for the middle class of this country as the GOP. Until people wake up and throw off our two corrupt parties the nation will sink further into corruption and decay. The only thing we regular folks have is the vote and it is wasted if it goes to incumbents or Democratic or Republican party members.

I think it’s perfectly reasonable to hold three separate opinions regarding the individual insurance mandate.

1. It was a Republican idea to begin with.
2. It was a really bad idea, especially absent the public option.
3. It’s not unconstitutional, though.

Thanks to the zero-sum game, if you aren’t voting for the Democratic ticket you make it easier for the Republican ticket to win by lowering the threshold of “first past the post” for them.

I like that.

Health insurance is an oxymoron–all humans get a risk factor
sooner or later, there being no such thing as the unlikely event here.

And you can call me Ray, and you can call the Health Care Reform Bill insurance company insurance.

Actually I think the individual federal mandate (to buy a product from a private company and only from a private company) is something that is an extremely important legal matter. I have serious reservations establishing that people can be compelled to buy products by the feds. Theoretically if forced consumerism is the new norm, the government could enact reverse stimulus forcing people to spend money on products – with of course those reverse stimulus bills written by the corporate fatcats to make themselves fatter. The claim is that the individual health insurance mandate is for the “greater good” could just as well be used requiring that you spend at least $20 per week on gas, go to at least one movie per month, buy a new car at least once every three years, etc etc etc as all those mandates could be claimed to be for the “greater good.” It should not stand or else it opens up the possibility for all sorts of crazy stuff and as HIR showed, it would be the the corporations benefiting who actually write the bills and cut the deals behind closed doors.

As I understood it, and perhaps I have it wrong was that it wasn’t that Congress was forcing us to buy insurance, but that our taxes were going to go up by X% and by buying insurance, we deferred those particular taxes. In a way, it is like owning a house. You pay more in taxes if you don’t own a house. You buy a house and then it decreases your tax burden. I was the impression they were using that sort of silly hedge to make it viable.

…Not that I agree with it, but that’s how I understood it.

Actually there is a precedent: the SCOTUS ruling that decided the 2000 Presidential Election, wherein the court included in its decision that its ruling would not and shall not constitute a legal precedent. I think the legal term of art is ‘Only Once, I Promise’.

Boycott right wing donors and pressure them for legislation. See http://hoflink.com/~dbaer/help-me-change-america.htm

This regime is clearly constitutional under South Dakota vs. Dole.

Well, Roberts and his crew will get the last word on this one.

So make us vote Dem – make us!

There is post after post after post on this blog telling DC Dems HOW TO GET OUR VOTE.

This is one of them.

I do not see how someone who supports the health insurance mandate can even call themselves a progressive. It is one of the more regressive pieces of legislation to come out of 30 years of more and more regressive government.

Since the Democrats have acted as parsimonious as the Republicans in the health care law, I have a solution to this nonsense. One needs to organize huge consumer boycotts of those donors who have given money to Democrats and Republicans. Once elections have taken place, the congress appears quite unaccountable. However when people organize in the tens to hundreds of thousands to say to a company like Rite Aid that we refuse to do business with them until we get a strong public option and a prescription drug benefit in Medicare Part B, a huge group of people can force a company CEO to take action or their company loses a lot of money.

Unfortunately I have found that a lot of progressives suffer from Stockholm syndrome and won’t boycott the friends of conservatives. So to those progressives who refuse to boycott conservative donors, you deserve what you get.

Boycott right wing donors and pressure them for legislation. See http://hoflink.com/~dbaer/help-me-change-america.htm Please spread the word.

Yes – the key to EU mandates are cost controls via regulatory authority on prices where the authority is exercised via negotiations between stakeholders, the gov budget being a large stakeholder.

The US has corporations that find it no problem to have subs in those countries with heavy regulatory authorities, but feel they will collapse if the US ever gives our government anything similar to the EU regulatory authority. Gov. Dean was educated on this during the HCR debate and was on MSNBC stating how he would be for an ins co run system with mandates if it came with German type regulatory authority – no one ever took him up on a discussion of the German system.

The Univ of Illinois has implemented the children to age 26 rule but the way it works is you continue to pay the family plan premium (your portion is a percentage of what the University is charged) plus you now begin to pay a separate charge for that 22 year old – in my sister’s case, her son would be about $7,000 (additional to the employee portion she pays for the family plan) for his coverage – there is no subsidy for the son’s coverage.

Hard to see how there will be many folks making use of this benefit.

CherokeeGirl not speak with forked tongue. :o)

(Sorry, I couldn’t resist…:o) Damn good post, ‘Girl…)

Margaret; perzackly!

That’s what pisses off so many of us. Obama and the dems are doing this shuck-and-jive bullshit and calling it “reform”.

It’s not. It’s piss-thin gruel to try to cover their corporatist asses.

And I believe the voters are getting on to it.

I agree with your assessment. The real problem, for me, was that now that we passed some kind of bill, that everybody would rest on their laurels and do a high five and say things like, “This is a big fucking deal,” or that they would use icons of the movement (like Ted Kennedy) and have people like, I don’t know, his son, go to his grave and say “We did it dad!” and then my fear was that if those situations happened, that they would get LOTS OF MEDIA COVERAGE implying that Obama had accomplished a “major legislative victory.” I was worried that I would be bombarded with Obama campaign emails (since I voted for him and donated to his campaign) and they would be all about the “Big VICTORY.”

I even heard some local PAcifica radio programs tout that “OBama had finally brought universal healthcare to all, and the Republicans didn’t like it.” Wow!

So, in hindsight, all those things REALLY DID HAPPEN. The Democrats REALLY THINK that this was a BIG FUCKING DEAL! No kidding. And they swore that they would “fix it” in the next budget resolution process.

But guess what… they didn’t even pass a BUDGET in 2010 to have a resolution on it! Wow. This just gets better and better.

And of course, this law takes effect only in 2014 (2 years AFTER OBama hopes to be reelected). Well, when Pacifica radio can broadcast programs geared towards certain communities that are expected to be die-hard Democrats, and those programs unequivocally state that “OBama deilvered Universal Healthcare” then we have a problem. Its blatant lying about the bill to the lowest information voters out there. It a cowardly and craven attempt by Obama to betray his high information progressive base by lying to his less advantaged, low information base. And he will hope to ride to victory on the backs of those lies, and by the time people figure out that “they got played” it will be too late to make Obama suffer politically for it. Heck, many provisions of this law don’t even take effect until 2017!

Can’t you just see the Democrats saying “Give it some time, already! You’re getting uppity! You want to change a law before its even taken effect! Give it a few years at least!”

So, yes, this law is FAR WORSE than passing nothing at all. Because it has given the ILLUSION of REFORM. And that illusion has a shelf life of at least a decade, if not more. Anyone (like Howard Dean) who advocates further changes to this law will be booed down by the Establishment Democrats and treated as a traitor to the cause.

And lets not forget the way in which this compromise was delivered. Progressives were called “Fucking Retards” by the White House chief of staff, Rahm, while Blue Dogs and Conservadems were handed the reins of control over the debate. This was a raw sell out at all levels, and every attempt to “rotate the villain” and “pass the potato” were nothing but attempts to keep Obama’s hands clean while the dirty deeds of secret deals and corporate favortism were accomplised. Until someone can explain to me why “Bipartisanship” was the highest ideal of this president, to the point of catering to Joe Lieberman, Olympia Snowe, and the half dozen conservadems like Baucus and Nelson, I will not forgive nor forget the cowardice and collapse of the Progressive agenda when Democrats had MAJORITIES IN BOTH CHAMBERS AND CONTROLLED THE EXECUTIVE BRANCH.

In fact, OBama even made that point himself during the campaign. He said that individual mandates were about as stupid as trying to solve homelessness by mandating that people buy houses.

Then he got elected, and trotted out the “car insurance” analogy.

Car insurance comes in two varities. Only one is mandated. The Liability Coverage is only mandated for people to cover the damage they cause to others. The other variety, Comp and Collision, is not mandated by law. Its optional. It is the one that covers yourself from damage.

Health insurance is only like Comp and Collision. Where you cover yourself. And only LENDERS require that (since they want to protect their underlying collateral).

So, Obama, who is the lender that owns ME as Collateral? And if there is none, then why force me to cover myself? Bad analogy. I liked your “solving homelessness by mandating the purchase of homes” analogy better. Then again, I liked everything you said as a CANDIDATE and SENATOR. I actually like nothing you have said or done as a President.

In fact there’s another type not mentioned: that is, progressives who always thought Obama was a three dollar bill, and cannot therefore be said to have been disappointed. Some of these were PUMA’s, some disdained any label; many supported HRC in the primary, and still think she’d be a much better POTUS than Obama, despite her corporatist leanings.

I’ve said all along, if you have an individual mandate you must also have a system that requires every insurance company to offer a NON profit fully regulated base policy. Premium increases would essentially be decided by state/national insurance regulators.

IOW if you are going to do the Swiss plan, you do the Swiss plan. I don’t think it is perfect, but it requires much more of the insurance companies then this joke of health reform does. IOW, it doesn’t just shackle their populace as slaves to the private insurance industry – it makes the insurance industry provide the access to care without profit, kabuki paperwork, imaginary benefits, and unjustified premium increases.

Until our government wants to inform the private insurance companies that the base policy is a very public utility and the people are the beneficiaries of this not you, there can be no individual mandate.

Mr. Walker…

About time someowne tackled the “servitude gorilla!” If you can’t own people, just make them pay a premium on life? Great post along with great comments…..

It took 100 years for effective civils right legislation to adress the inequities polically and economically leveraged against my fellow Americans of a different race, in southern states for the benefit of a specific group, after Emancipation and reconstruction ammendments. Mandated health insurance is no different, it is servitude to corporations enable under the color of law. Call it a modern day fuguitive slave law, for the benefit of corporate health insurers; tax exempt?

OH boy that .75 cents of evey American dollar spent and wasted on “GASOLINE” for decades could benefit America now!

DOES AMERICA UNDERSTAND THE MEANING OF THE WORD SERVITUDE???????

Nothing less than Medicare for all, no co-pays, no insurance companies. Period. **NO BUSINESS WITH NEBRASKA VENDORS WHILE NELSON HOLDS A SENATE SEAT**

If they were going to mandate health insurance the Government had to at least set a baseline minimum reguired policy standard that insurance companies must offer. Any affordable policy now is a joke with high deductibles, 20%-30% copays, no doctor visits, and only generic drug benefits (which mysteriously don’t ever work), additional for maternity, and some with an additional $600 a day charge for hospital stays. The absurdity of this is mind numbing. If we have 50 million Americans without health insurance now we must have another 100 million who are underinsured and would be threatened by bankruptcy if they or their family suffered a serious health issue. I can’t believe they would subsidize or mandate this garbage.

Agreed, Jon.

The private mandate is nothing more than Corporate Fascism enacted on the masses. Anyone, or any political party, that endorses this is an enabler and co-conspirator. Apologists of the private mandate are no friend of the general populace.

IT IS CALLED PROTECT THE CORPORATE SLAVEOWNERS. PEOPLE ARE NOT PROPERTY BUT THEN GOVERNMENT IN COHOOTS WITH CORPORATIONS CAN PLACE A INSURANCE PREMIUM ON LIFE?

MORE LIKE A FUGITIVE SLAVE LAW??? KEEP PEOPLE IN SERVITUDE TO THE MASTER…..CORPORATIONS????

That’s precisely what the credit bubble was all about. It’s economic slavery taken to an extreme degree knowing that the government was duplicitous in the crime and would bail them out.

While I agree with the spirit of this article, let’s not forget the history involved. There was a substantial push for single-payer “Medicare for all” early on, but it was defeated by Republicans and Conservative Democrats. Then, for much of the rest of the history of the legislation, there was a Public Option, which everyone realized was a second best alternative to single payer. Unfortunately, late in the game, the GOP and Blue Dogs managed to excise the Public Option as well. So yeah, we ended up with the third best option in the form of the mandate. I don’t particularly care for the mandate, or for that matter, the subsidies. I do care very much for the restrictions on insurance companies denying coverage for pre-existing conditions and rescinding policies. I accept that the individual mandate and subsidies had to be part of the package if we were to get the consumer protections.

Your two alternatives to the individual mandate are not particularly inspiring. The automatic enrollment is still a mandate, just with a different name. The back payment approach wouldn’t be particularly effective in preventing free riders when you compare the cost of 6 months of premiums vs the cost of catastrophic medical care (though the same argument could be made about the relatively small $695 of 2.5% of AGI penalty in the mandate).

The mandate no matter what it’s intent is simply a form of extortion with the State acting as the bag man for the extortionists the Ins. companies.

A Nat’l Health Service or a Single payer system are the only humane systems. We all are taxed to provide certain societally determined services such as police, fire, schools, Nat’l defense and many others. Why the most important service of all Health care is seen as any different has always eluded me? It makes absolutely no sense. The present system is predatory and counter productive.

the back payment penalty would normally be slightly large than the individual mandate fine. I don’t say it was a good idea just would be equal to the mandate in terms of policy impact without creepiness.

I generally agree with your observations. I also think that without this legislation we may have had to wait for something for another generation. At the least there is something to work on. That is what we should do. I suppose there coulda or shoulda been a dozen or more alternatives. As for the requirement to buy insurance, it ain’t gonna happen in the present form for lots of reasons and, so, I don’t get exercised about it.

no.in a handful of states NY,Vt.Ha, people who make below the poverty line are elegible for medicare…everywhere else only parents (who are the legal gaurdians) of dependent children are eligible…

I’m not for the mandate, I’m against state nullification

I’ll defend even measures, like the mandate, that I consider to be bad policy and foolish politics, when they are attacked by means that are even more destructive.

However bad and foolish, the mandate is not unconstitutional. Even if it were unconstitutional, the way to vindicate our supposed rights against it would be in the courts, not through the states passing nullification bills, or staging nullification plebiscites like this Prop C in MO.

However bad the policy and foolish the politics, there is no way that the mandate could do even a fraction of the damage that will result if even one example of state nullification is allowed to succeed. Or should I say “secede”.

The right way to correct the bad policy and foolish politics of the mandate is through the regular political process, not through states’ rights run-arounds. Do everything to have the Congress correct the mistake. State the reasons that the mandate is bad policy and foolish politics, as cogently and eloquently as you can, as publically to as wide an audience as you can manage. Then, after thus prepping public opinion on this issue, go to work doing your best to influence the next election to Congress by every other means at your disposal. But the Congress has to be the sole forum in which you are willing to have this issue decided, or you’ve lost me. No appeal to states’ rights is allowed.

Nullification attempts are not the right vehicle for change. Prop C is so disastrously wrong and dangerous in its form, that no good content should shield it from categorical denunciation, period.

That’s just not true. There was no push for single payer. Obama took it off the table before the debate even began. The Republicans had nothing to do with it.

Firstly, I disagree that the mandate is constitutional, as the product we’re being forced to buy has no price controls and is for-profit. Secondly, I can see no downside whatsoever to Missouri leaving the union. Thirdly, the Obama admin is working very hard to define this as a tax, so it can’t be challenged in court until someone actually pays it- onerous and underhanded.

Coverage for preexisting conditions won’t go into effect for adults until 2014. Plenty of time for the insurance industry to gut that. Also, insurers can still rescind a policy if they claim the insured acted fraudulently or made an intentional misrepresentation of material fact. That is what they have been doing all along, finding some weak link by scouring old medical records and claiming it was a misrepresentation. The insured gets 30 days to refute this, during which time they are not covered by insurance. Hopefully, the insured can get some legal help and does not have something life threatening that is put on hold. The Democratic party has lost my vote. I’m back to picking independent candidates, even if it is “throwing away my vote”.

“I do care very much for the restrictions on insurance companies denying coverage for pre-existing conditions and rescinding policies. I accept that the individual mandate and subsidies had to be part of the package if we were to get the consumer protections.”

I do accept that some sort of mandate would be necessary for universal coverage. That being said, a mandate to purchase insurance from private companies is unacceptable. Even a non-profit entity of some kind would be better, if government-run single payer is off the table to silence the screams of “socialism” from the masses of people who don’t want government hands in “their Medicare”.

I separate “Democrats” from “Progressives” largely on grounds of partisanship vs policy. If liberal policy is more important to the individual, they are Progressive in my mind. If, on the other hand, the most important thing is whether or not somebody has a “D” or an “R” in to go with their names, that person is a Democrat or a partisan. I really have no use for partisans and those are the only people who seem to be trying to defend the indefensible personal mandate, (without a public insurance option).

Well said.

I’m sure that Jason Rosenbaum will feel bad, though. After all the work he did trying to sell this faux HCR as a progressive victory. Poor little shill.

“I can see no downside whatsoever to Missouri leaving the union.”

As attractive as the idea of MO (And we could all name a few other states.) leaving the Union might be in the abstract, where things can be separated into their own neat little drawers, in the real world all sorts of things are too mixed up together for this to work at all well.

The most obvious problem with letting the Yahoos of MO take that state out of the Union unimpeded, is that MO has all sorts of non-Yahoos who do not deserve to be abandoned to the tender mercies of the Yahoos.

Even if not carried all the way to secession, the end point of nullification, the thrust of Prop C itself is to oppress the people of MO. Nullification, state interposition, and states’ rights in general, have only been used since 1860 to defend the rights of states to mistreat some or another class of its people. This is no exception. A 10th Amendment claim that the federal govt does not have the power to impose a mandate is not at all a claim that no govt has that right. MO is claiming, in Prop C, that only the state of MO has the power to oppress MO citizens with such a mandate. That is the only theory under which the state can object to the federal mandate on individuals. If you just want to protect the supposed right of individuals to not have any govt impose a mandate on them, then you have a 9th Amendment claim, not a 10th claim. The Yahoos behind Prop C want to keep the wage slaves of this state dependent on the xisting health care insurance industry.

And, success at staking this claim would have effects far beyond health care reform, even insofar as the other instances of nullification it gives rise to are not intended as preludes to secession. All sorts of states would suddenly discover all sorts of powers reserved to them, if even once it is allowed that the states themselves get to make the call on what powers they have, as opposed to the federal govt. The Union would become unworkable for all of us, on all sorts of issues.

Our national politics would become dominated by a series of games of nullification/secession chicken, in which the side that blinks first, is less willing to go to the brink of armed conflict, loses every match. Well, loses every match right up until that side is so disgusted that it doesn’t blink, and we find ourselves in another war among the states.

These Yahoos behind Prop C, and behind every other Tea Party idea, don’t actually want to secede. They want to control. They don’t look on their little nullification games as the first step to leaving the Union, they look on them as ploys to control the Union. If they do leave, it will only be to allow themselves to more effectively “gather their armies”. It will only be Round One of an intended Second Civil War.

I don’t see much on the horizon indicating any real likelihood of change regarding health care legislation. When the bills moved their way through congress and the senate we were looking at something like 12% unemployment. Single Payer, which is the only really viable path, IMHO, would mean adding at least 2-3% to those unemployment figures-for hundreds of thousands, likely millions, earn their daily bread working for insurance companies or work fighting insurance companies to get coverage. I just don’t see how anything could pass that would put such a large number of people out of work(even if passing such would mean the creation of new bureaucracies, which in turn would create lots of new jobs).

To many people put food on their table and their kids through school by actively hurting their fellow citizens as par course of their daily wages. How many people take care of their families by denying us coverage? America has gotten itself in a real fine rut, with millions of people taking care of themselves at the expense of their fellow citizens, and the numbers involved here are not small-they are gigantic. Our economic system, as a whole, pre-programs our population to work at cross-purposes.

I have a hard time imagining anything really changing until universal health care is recognized as a right(whether by constitutional amendment or supreme court decision). And if such were to occur, what ought to happen is outright nationalization of the existing medical infrastructure(ie. NHS).

Maybe my view is too bleak, perhaps more is afoot than I am aware of. The individual mandate only had the slightest legitimacy in the context of the inferior option -the public option, which we did not end up with. Outside of that context, the individual mandate is one of the most heinous pieces of legislation ever passed.

Nice post Jon,

A lot of progressives seem to live on hope rather than results, but the issue here is to balance helping typical Americans, and feeding the beast. Nothing gets done in DC that does not guarantee that the major corporate interests come out ahead financially. Many of the proposals for sensible health care, whether a national plan like Canada’s, Medicare for all, even an aggressively regulated private system with subsidies for those who can’t afford it, they can all be made to work reasonably well.

The problem is that our health care system has delivering health care as a minor part of its reason to be. The first is to generate profit for insurance companies, MDs, private hospitals and drug companies. This requires that the cash keep flowing in our institutionalized system of bribery in DC that we call the government. Whether it’s the campaign contributions, or the option of future employment as lobbyists for Senators, Representatives, their staffers and families. It makes the first step of “policy” figuring out who gets paid off first. Even civil servants are getting caught up in the revolving door.

The “Traditional Right” rather than the assortment of wing nuts, tea baggers and fanatic supporters of state sponsored religion, actually has some interesting things to say here. First, they believe that anything done by government will eventually become corrupt. Notice that most of the “improvements” in Medicare don’t actually improve medical care, they improve corporate profits. This legitimate fear of corruption supports a rational worldview that calls for limiting the proper role of government to essential functions. Their worldview fails because none of us have the stomach to turn away a seriously ill child from the emergency room if they don’t have insurance.

Almost all other countries succeed in providing decent health care to their citizens. We can’t because of they way we choose to make decisions in DC. We tolerate institutionalized corruption.

the ice fish

“no.in a handful of states NY,Vt.Ha, people who make below the poverty line are elegible for medicare…everywhere else only parents (who are the legal gaurdians) of dependent children are eligible…”

This will be true until 2014 (which is also when the mandate kicks in). Starting in 2014, HCR mandates that all states offer Medicaid to EVERYONE under 133% of the poverty line.

In fact, starting in 2014, of the 31 million people who will become insured under HCR, 15 million of them will be insured under Medicaid.

We have ideas we were betrayed by Obama being Cynical in normal in this situation. The next question is what are we going to do about it?

Our Elected Dems can call the HCR mandate whatever they want, just as we can call our elected Dems whatever we want. The relevent questions are, HOW many regular visitors of this site will vote this fall for their Dem. Incumbents seeking reelection, and if not, will they stay home or vote Republican regardless whom their nominee is?
Personally, I wonder if Jane & team will FINALLY say, enough is enough, and encourage Dems to vote AGAINST these disgraces? I say, it won’t happen in our lifetime and THAT is the nut of the problem we Progressives really face. If Jane turns on the Dem. Establishment she loses all the chips she’s worked so hard for. If she continues to walk that very fine tightrope, she continues to be abused (until, perhaps they get struck by lightening & see the error of their ways).
What’s the answer, folks? Jane & team have consistently been THE hardest workers out there pursuing accountability & real argument on crucial issues. Where the hell are her real supporters, home worrying about Mary Jane? What’s to be done this Nov.?????

Single Payer, which is the only really viable path, IMHO, would mean adding at least 2-3% to those unemployment figures-for hundreds of thousands, likely millions, earn their daily bread working for insurance companies or work fighting insurance companies to get coverage.

The single payer advocate are a step ahead of you. The HR 676 bill includes a section to provide 2 years severance pay for anyone in the insurance industry laid off as a result of a single payer system. They could take it as a lump sum, monthly over 2 years or if they want to be like Rodney Dangerfield and go Back to School, half-pay checks for 4 years.

Sorry, but Medicare for All would not result in a net loss of jobs, but rather in a net gain of millions of them. See the California Nurses Association econometric study on this question.