Robert A. Levine 5-7-12
In America, politics trumps principles every time in this day and age, to the detriment of the
democratic system. Even if a measure is consistent with a party’s principles, it will be rejected if it’s important to the opposition party and particularly if it’s part of their legislative agenda. The health insurance mandate and insurance exchanges are prime examples of this practice.
The individual health insurance mandate, which was formulated in 1989 at the conservative Heritage Foundation, a GOP think tank, was included in a bill introduced by Republicans in 1993. And in 2007, a bipartisan health care bill sponsored by both Republicans and Democrats contained the mandate. Another concept, health insurance exchanges, was also generated by the Heritage Foundation and is quite compatible with the free-market ideology of the Republican Party. But because these precepts are essential for the Democratic Affordable Care Act (ACA), they’ve been attacked unmercifully by Republicans, who have mobilized citizens against this legislation.
The hypocrisy of Republicans in opposing these ideas is highlighted by two recent articles, one by Joe Klein in Time (http://ti.me/IEgTYB) and another by Jonathan Cohn and David A. Strauss on Bloomberg (http://bloom.bg/Iq3phu).
The individual mandate is a way to broaden the risk pools for health insurance. Because the mandate provides an incentive for healthy young people to obtain coverage (by a financial penalty
if they don’t), insurance companies will be able to insure individuals with pre-exiting conditions and not lose money. Without the individual mandate, insurance companies could not afford to cover those who are already sick or injured.
In questioning the constitutionality of the mandate when the ACA came up before the Supreme Court, Justice Scalia raised the possibility of a “broccoli mandate,” with government forcing citizens to buy broccoli. However, a well functioning market for food and broccoli already exists, and there is no national crisis regarding broccoli as there is with health care costs, so this argument was spurious. Similarly, the analogy of a burial insurance mandate put forth by Justice Alito was fanciful since there’s also no crisis in this area. As a possible precedent for the individual mandate, Cohn and Strauss cite the Militia Act signed by George Washington in 1792 that required all men to purchase a gun and knapsack to defend liberty. Is that very different than requiring every citizen to purchase health insurance?
As for the insurance exchanges, Klein notes that they are a “classic Republican idea ..employ(ing) market discipline to control prices.” In addition, they allow insurance companies to compete to enroll members by providing transparency about prices and benefits. Yet because the Affordable Care Plan and its provision for the exchanges were passed by the Democrats, the GOP is fighting the exchanges on a state level where there have been attempts to implement these marketplaces.
Whether or not the Affordable Care Plan is the best way to reform health care is beside the point. Republicans are trashing concepts they originated and previously supported simply because they have been advanced by the Democrats and don’t want to provide the Democrats with a political victory. This is emblematic of the way business is conducted in Washington and why the political parties and Congress have such low public approval ratings.
I personally believe a single payer system, with physicians on salary to eliminate financial incentives for unnecessary care, along with malpractice reform, is the only way health care costs will be brought under control. Since this is unlikely in the current political environment, I’m willing to give the ACA a chance to see whether it meets its stated goals. Although Republicans have been attacking the ACA, there have been no realistic plans put forth by the GOP to provide coverage to the uninsured while attempting to control costs.
Resurrecting Democracy
www.robertlevinebooks.com
In America, politics trumps principles every time in this day and age, to the detriment of the
The individual health insurance mandate, which was formulated in 1989 at the conservative Heritage Foundation, a GOP think tank, was included in a bill introduced by Republicans in 1993. And in 2007, a bipartisan health care bill sponsored by both Republicans and Democrats contained the mandate. Another concept, health insurance exchanges, was also generated by the Heritage Foundation and is quite compatible with the free-market ideology of the Republican Party. But because these precepts are essential for the Democratic Affordable Care Act (ACA), they’ve been attacked unmercifully by Republicans, who have mobilized citizens against this legislation.
The hypocrisy of Republicans in opposing these ideas is highlighted by two recent articles, one by Joe Klein in Time (http://ti.me/IEgTYB) and another by Jonathan Cohn and David A. Strauss on Bloomberg (http://bloom.bg/Iq3phu).
The individual mandate is a way to broaden the risk pools for health insurance. Because the mandate provides an incentive for healthy young people to obtain coverage (by a financial penalty
In questioning the constitutionality of the mandate when the ACA came up before the Supreme Court, Justice Scalia raised the possibility of a “broccoli mandate,” with government forcing citizens to buy broccoli. However, a well functioning market for food and broccoli already exists, and there is no national crisis regarding broccoli as there is with health care costs, so this argument was spurious. Similarly, the analogy of a burial insurance mandate put forth by Justice Alito was fanciful since there’s also no crisis in this area. As a possible precedent for the individual mandate, Cohn and Strauss cite the Militia Act signed by George Washington in 1792 that required all men to purchase a gun and knapsack to defend liberty. Is that very different than requiring every citizen to purchase health insurance?
As for the insurance exchanges, Klein notes that they are a “classic Republican idea ..employ(ing) market discipline to control prices.” In addition, they allow insurance companies to compete to enroll members by providing transparency about prices and benefits. Yet because the Affordable Care Plan and its provision for the exchanges were passed by the Democrats, the GOP is fighting the exchanges on a state level where there have been attempts to implement these marketplaces.
Whether or not the Affordable Care Plan is the best way to reform health care is beside the point. Republicans are trashing concepts they originated and previously supported simply because they have been advanced by the Democrats and don’t want to provide the Democrats with a political victory. This is emblematic of the way business is conducted in Washington and why the political parties and Congress have such low public approval ratings.
I personally believe a single payer system, with physicians on salary to eliminate financial incentives for unnecessary care, along with malpractice reform, is the only way health care costs will be brought under control. Since this is unlikely in the current political environment, I’m willing to give the ACA a chance to see whether it meets its stated goals. Although Republicans have been attacking the ACA, there have been no realistic plans put forth by the GOP to provide coverage to the uninsured while attempting to control costs.
Resurrecting Democracy
www.robertlevinebooks.com
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