The Individual Mandate & Political Poison



By David Arthur Walters


July 7, 2017 Miami Beach

Nothing is more obvious than the fact that Americans today are governed by a self-serving leadership faction and have once again been forgotten by their Congress due to unbridled political partisanship.

Take for example the continuous effort to repeal the Affordable Health Care Act.

Republican leaders want payback for having Obamacare foisted upon them by a Democratic majority in 2010. Repealing it, no matter what the effect a repeal would have on their constituents, has priority over reforming it or simply replacing it with a single-payer national healthcare system with benefits similar to those they enjoy under their own plan.

Younger, healthier people or those who do not anticipate needing potentially ruinous medical care anytime soon do not appreciate the individual mandate forcing them to buy insurance or pay a fine in order to spread the risk. If they unexpectedly wind up in the hospital and their funds are exhausted, then let them go bankrupt and the public pay the expense, which will by far exceed the fine, because they were unwilling to buy insurance when they were healthy.

While a leading minority of Senate Republicans struggle to kill Obamacare, orders have been issued not to enforce the individual mandate. Vengeance is ours, say the faux-republican faction, after scores of failed attempts to rid the nation of Obamacare and other successes they perceive as blackening the nation, after the nation was saved from the Great Recession and probable Depression and fascist consequences by the man they love to hate even after he has been replaced.

Unsurprisingly, given the insane rivalry currently sponsored by the nation’s political teapots, the individual mandate was originally a nonpartisan feature championed by reasonable Republicans. After all, national health care acts would be doomed to failure without the mandate requiring all persons not exempted for hardship to buy coverage or pay a tax to replenish the fund for at least some of the premiums they withheld. Clearly, unless everyone pays something before they need health care, the overall plan will become lopsided and go into a “death spiral” due to inadequate funding.

In 1989 Republican senators championed an individual mandate as a market-based approach, as outlined by the conservative Heritage Foundation. The idea is that every capable individual should be responsible for their health care. In 1993 President Bill Clinton proposed an employer mandate for employers to provide health insurance to all employees, but Republican Senators wanted an individual mandate, not an employer mandate, and Clinton’s plan failed. A Republican alternative introduced in 1993 by Republican Senator John Chafee, famed for his bipartisanship, included a requirement for universal coverage with an individual mandate. In 1994 Republican Senator Don Nickles’ original proposal included an individual mandate with a penalty provision. And Mark Pauly developed a proposal including an individual mandate for President George H. W. Bush.

In 2007 Republican Senator Bob Bennett and Democratic Senator Ron Wyden introduced the Healthy Americans Act, which featured an individual mandate, but the proposal did not get beyond the committee level. Governor Mitt Romney was praised by Senator Jim DeMint for his conservative ideas, and the presidential candidate said he was proud of Massachusetts’ health care plan including its individual mandate. Indeed, Democrats sided with Republicans on the individual mandate and other features, and the Massachusetts’ plan was a kind of template for what ensued, the Affordable Health Care Act of 2010.

Constitutional issues with the mandate were not broached by Republicans. The penalty was believed to be a tax, not a premium forced on people. With Obamacare, Republicans would argue that the bill was in effect a tax bill that should have originated in the House, but it had actually originated in the Senate in the guise of an amendment to an unrelated tax bill sent over by the House, rendering the Act unconstitutional.

The most reasonable plan of all, at least in theory, would be a single-payer universal health care plan along the lines of those adopted by civilized countries. But democratic republicanism does not work that way in the United States, which is poisoned by political factions beholden to special interests.

The main fault of Affordable Health Care Act of 2010 is that it is not a single-payer universal plan, although it is almost the best one can do without such national health care insurance. It may be tinkered with to overcome some of its current faults, but it shall always be plagued by its fundamental flaw.

For one thing, the Senate would have had to agree to the reasonable alternative and not enough votes could be mustered to overcome a filibuster in the Senate for such a “socialist” plan in order to bring the bill to a vote.

Yet now Republican senators may use the nuclear option, invoking the Constitutional right of each house of Congress to make its own rules, in order to repeal Obamacare, risking the lives of millions of people, with or without a replacement, giving the savings to wealthy people who do not need the money.

And they would do this while mouthing alternative facts and fake assessments to cover up the fact that their partisanship has made them a poison unto the people.



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