More Against Mandates

The debate over health insurance mandates has intensified in recent weeks. In my view, Ezra Klein and other influential pundits are inaccurately framing the debate over mandates as a disagreement between Clinton/Edwards progressives and Obama-leaning centrists. In reality, this dispute is between liberal policy wonks (who tend to gush over the Edwards plan) and an older guard of universal health care advocates that remains cool to both proposals.

It is true that for any plan which preserves private health insurance for some time in the future, mandates will help ensure that more people are covered and that costs will go down for everybody. The Edwards plan would be much weaker if the mandates were removed and, in this sense, critics of the Obama plan are correct. That being said, why should private insurance companies be part of any progressive plan at all? While the Edwards plan is designed to result in a gradual shift to toward single payer system, advocates of health care reform fear it will actually result in a catastrophic compromise in which for-profit insurers are preserved and massively subsidized with public money. Such a system would fail to address the problems inherent to for-profit insurance. It would also be expensive, unpopular and liable to re-privatization and deregulation the next time a wave of Thatcherism rolls over Washington D.C.

Below is a digest of some recent good stuff on the web:

A Times op-ed, by PNHP's David Himmelstein and Steffie Woolhandler on the dubious history of mandates.

Matthew Yglesias, on why "massive socialism" and not mandates should be the answer to our health care crisis.

Daily Kossak, DrSteveB, on single payer why Clinton and Obama are "both right and wrong on health care mandates."

A PNHP press release on the collapse of the California's health care reform.

Another PNHP release on the Massachusetts mandates-based reforms.


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