Saturday, April 05, 2008

Health Insurance Mandates... Fun For the Whole Family!

In their debate in LA at the end of January, Sen. Obama said of Sen. Clinton's plan to mandate purchasing health insurance (their respective plans are fairly similar, except for this one major sticking point), "There's still going to be people who can't afford it [after subsidies]. And if they cannot afford it, then the question is, what are you going to do about it? Are you going to fine them? Are you going to garnish their wages? Those are questions that Sen. Clinton has not answered with respect to her plan."

I bring this up because, in addition to other reports on how cash-strapped the Clinton camp is in general, there was this story last weekend-
Among the debts reported this month by Hillary Clinton’s struggling presidential campaign, the $292,000 in unpaid health insurance premiums for her campaign staff stands out...

...The campaign provides health insurance to all its employees, their spouses, partners and children — and that wasn’t interrupted by any lag in payments to insurance providers, said Jay Carson, a Clinton campaign spokesman.

He said the campaign this month paid off all outstanding bills...

I post this not because it's extraordinary, but because it is ordinary. Health premiums are expensive and sometimes hardworking people/presidential candidates get a little behind. But under Clinton's proposed plan, how would this have been handled when the problem first arose? Would they have garnished $292,000 out of her presidential coffers, regardless of whether or not she could afford it? Would she have been fined, or otherwise penalized? As Obama noted in January, these are questions that Sen. Clinton still has not answered.

And then there's also this potential dilemma the Christian Science Monitor ponders-
Are health insurance mandates constitutional? They are certainly unprecedented. The federal government does not ordinarily require Americans to purchase particular goods or services from private parties.

The closest we come is when government imposes a condition on the grant of discretionary benefit or permit. For instance, in most states, you must have auto insurance to drive a car, or you are required to install fire sprinklers when building a new house. But in such cases, the "mandate" is discretionary – you don't have to drive a car or build a house. Nor do you have a constitutional right to do so.

But Americans do have a constitutional right to live in the United States. Accordingly, neither federal nor state governments can require you to purchase health insurance as a "condition" for residency.

I appreciate this because it distinguishes between health care and health insurance. These proposals really focus on the latter, rather than the former, which has been the real problem.

All that is being proposed here is universal health insurance, and not even that really, because everyone would still have something different (different policies, costs, and standards). It's the same broken system that we have now, except we'd all have no choice but to be a part of it. Her proposal would not change the reality of a having a profit-based healthcare system. And-- unless I have misheard her (please do correct me if I am wrong)-- this is her endgame. She has no larger plans to repair this system, she simply believes that it will run smoother if we all are a part of it. This is either naive or corrupt. Obama, by contrast, at least has a more consistent long-term plan in regards to health care.

A traditional, single-payer system would be better for everyone financially, be more efficient, and would not run into any constitutional battles. And while we are likely still a long ways away from that possibility, that doesn't mean the medicine Clinton offers is the cure for now.


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