Edwards' plan creates non-profit health care markets which allow for-profit private insurance companies to co-exist with a non-profit public health care program along the lines of Medicare (which is important because it allows the objectors to opt out of public health care plan if they want to and this choice undercuts their opposition to the plan) but
MOST IMPORTANTLY these health care markets force the for-profit private insurance companies to compete directly against the non-profit public health care program based on Medicare. Most health care experts predict that the for-profit private insurance companies will be unable to successfully compete directly against the non-profit public health care program, which is how Edwards' plan will evolve into public single-payer universal health care.
Obama's and Hillary's plans do not have this feature.
Here is why you need Edwards' and Hillary's mandates, even though Obama pretends that you don't.
Edwards and Hillary would also eliminate the ability of health care coverage providers (whether private or public) to exclude an applicant based on prior medical conditions. You can imagine what this would lead to: if a person doesn't need to have insurance unless and until he gets sick, he could just go without any insurance and then wait to buy insurance until the day he feels really sick or gets badly injured. You can't do this today, of course, because your day-before-buying-insurance illness or injury would be excluded as a pre-existing condition. But since Edwards and Hillary would both eliminate the right of insurance companies (both private and public) to exclude coverage based on pre-existing conditions, they would create the nightmare that many would drop off their health care plans to avoid paying premiums only to re-sign up for insurance once they get sick. This is one reason why coverage has to be mandatory.
More fundamentally, without the mandates, no health care plan will be universal. Many people who "go naked" with respect to health insurance become a burden on the public health care system when they suffer a major illness or injury and obtain their medical care from the emergency room under the Emergency Medical Treatment and Active Labor Act. The mandates in Hillary's and Edwards' plans re-allocate these burdens. Where people get their health care coverage from their employers, the employers get tax incentives to ameliorate that burden; where people buy their own insurance, they get it at a reduced cost and they get tax incentives to defray the cost; where people cannot afford to buy insurance and don't get it though their employer, they become eligible for government-provided coverage. If car insurance was like health insurance under Obama's plan (i.e., it was not mandated), people would elect not to have car insurance because they couldn't afford it. Under this system, those uninsured drivers (or people without health insurance under Obama's health insurance plan) are a burden on the system because the damage they cause doesn't vanish just because they are uninsured -- instead, the costs to the system from the uninsured raise the costs for the insured. In the car insurance context, this mis-allocated cost is properly re-allocated to the greatest extent possible by making insurance mandatory. It would have the same effect under the mandates set out in Edwards' and Hillary's plans. Whether or not Obama thinks mandates "are a good idea," mandates are the only way to ensure that coverage is truly universal, the only way to ensure that the mis-allocated burden on the system from the uninsured is properly re-allocated as nearly as possible, and the only way to stop the inevitable situation under Obama's plan that the uninsured will be the working poor. If Obama thinks this is a bad idea, that's an excellent reason to support another candidate.
Plus, under Edwards' plan, the vast majority would get their health care coverage through their employer, and for those who don't, Edwards' plan subsidized coverage for everyone making $100,000 a year or less (including a 100% subsidy for the poorest people).
Here is an excerpt from a good article:
Health markets would offer traditional plans from private companies such as Blue Cross-Blue Shield, Aetna and Cigna, as well as a government-run plan similar to Medicare, the federal health-insurance program for the elderly. The public-sector plan would resemble Canada’s single-payer system, in which insurance is publicly funded to control costs but doctors and hospitals remain private.
“The idea is to determine whether Americans actually want a private insurer or whether they would rather have a government-run ... single-payer plan,” Edwards said. “We’ll find out over time where people go.” The mix of market and government initiatives makes Edwards’ plan much harder to attack than Clinton’s early 1990s plan, said Leif Wellington Haase of the Century Foundation, a liberal-leaning think tank. “In this plan, the changes happen much more gradually,” Haase said. “Each element has a market element that deflects the attack. I think it’s a very smart political document.”
Although Haase thinks the Edwards plan does not go far enough, conservatives fear it would take the country too far toward government-run care. “It sets up a slippery slope to move toward a single-payer, government-run health care system,” said Mike Tanner of the Cato Institute, a conservative-leaning think tank. “He realizes that Americans are not going to take that in one bite.” Tanner contends that under Edwards’ parallel system, private insurance would be unable to compete with a taxpayer-funded system. The single-payer system, Tanner argued, sounds good. But it would not be popular with citizens because it would ration treatment for expensive and long illnesses, and would discourage pharmaceutical companies from developing new drugs. “Single-payer systems are good if you are not sick,” Tanner said. “They provide routine care at low cost. But they don’t provide intensive, expensive medicine for people with serious illnesses.”
http://www.popmatters.com/pm/news/article/38815/in-a-crowded-field-edwards-health-plan-sets-him-apart/Here is an excerpt from another good article:
All three contenders have proposed a national healthcare system that is a variant of the plan developed by Yale political scientist Jacob Hacker. The basics of the plan are to require that all firms either insure their workers directly or pay a fee to the government. The government then uses this money to heavily subsidise insurance for low- and moderate-income families. It also establishes an expanded Medicare-type public plan that people will have the option to buy into. In addition, it reforms the private insurance market, most importantly by requiring that insurers not discriminate based on pre-existing conditions.
Both Clinton and Edwards would impose a mandate that everyone buy into this system. Obama has claimed that he would not require a mandate. As a practical matter, the healthcare system that any of them are able to put in place will depend on the arms they twist and the pressure they can bring to bear against the insurance companies, the pharmaceutical industry and other powerful actors who will be hurt by real reform.
Any serious plan will require a mandate - this directly follows from its requirement that insurers take all comers. Without a mandate, no one would buy insurance until they had serious bills. This would be like letting people buy car insurance after an accident, and then sending the company the bill. That doesn't work.
http://www.alternet.org/election08/71650/
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