Friday, November 30, 2007

Mandated Health Insurance is Not a Good Thing

Late getting started this morning(afternoon). Paperwork and personal business catch-up time. Time billing submitted and so are expense reports. Personal finance all caught up and all the bills scheduled for payment. All the follow-ups with health insurance done and the open enrollment process for next year all done(only health insurance went up by $5.00 per month which us a good thing). Doctor's appointment for next week made(they want blood or they won't renew my prescriptions). I think I am caught up.

Anyhow, speaking of health care, there has been some development in the Democratic health care discussion. As you may know(or not) both Hillary's and Edward's health care plans include a mandate that will require everyone to sign up for health insurance and Obama's doesn't. Recently Obama as resorted to what amounts to GOP talking points to criticize the other two plans mostly with respect to mandates. Yesterday, John Edwards explained how his plan would deal with that:

Under the Edwards plan, when Americans file their income taxes, they would be required to submit a letter from an insurance provider confirming coverage for themselves and their dependents.

If someone did not submit proof of coverage, the Internal Revenue Service would notify a newly established regional or state-based health-care agency [which] would enroll the individual into the lowest cost health-care plan available in that area....The newly covered individual would not only have access to health benefits but would also be responsible for making monthly payments with the help of a tax credit.

....If a person did not meet his or her monthly financial obligation for a set period of time (perhaps a year, perhaps longer) the Edwards plan would empower the federal government to garnish an individual's wages for purposes of collecting "back premiums with interest and collection costs."

Paul Krugman weighed in today and calls this a "terrific idea," but for once I am going to have to disagree with Krugman and also with Edwards with respect to mandates. There are two big problems with this approach and another less serious one.

I think it would be a huge mistake to get the IRS engaged in enforcing health care mandates. I like most Americans am not a big fan of the IRS and their methods and I sure as hell don't want them acting like some kind of "health insurance police". That's not what the IRS is for. Just let them continue to collect taxes in their own bumbling and unconstitutional way. The income tax process is already a nightmare and adding one more "gotcha" to it is not the way to be successful. Getting the IRS involved is not a good idea.

Having a universal health care program that has to be "enforced" is kind of absurd anyway. If we are really serious about getting every man, woman, and child in the country insured then why go through all this enforcement and opt in and out crap? All you need to do is add the funding mechanism into the existing tax system like Medicare and Social Security and everyone is enrolled automatically. No enforcement, no individual options to enroll or not enroll. You will get the results you want...everybody enrolled and it will be infinitely easier and less intrusive. I know all the wingers will call that "socialized medicine" but so what, that is what it is.

That last problem with the idea is that it entails punitive action against citizens who, for whatever reason, whether it be philosophical or financial, do not sign up. This punitive action will put these people on the same footing with criminals, deadbeat dads and others who are forced to do something they won't or can't do by garnishing their wages. This is just not the right way to go about it and once people realize what you are proposing will reject it on principal.

I know both Clinton and Edwards are trying to mollify the big insurance campaign donors with their plans but sooner or later we are going to have to realize that until we take the profit motive out of health care we are going to continue see rising costs. Not only are our costs going to continue to rise but the quality of care will continue to decline. More and more people will be unable to afford good health care insurance and the state will still wind up paying the bill somehow. It is the old "pay me now or pay me later" thing.


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