What's wrong about progressive lines of attack on the health care bill

[babylonsister]

http://www.openleft.com/diary/16628/special-comment-progressive-lines-of-attack-on-the-health-care-bill

What's wrong about progressive lines of attack on the health care bill
by: Adam Bink
Tue Dec 22, 2009 at 11:15


There is something that has been getting at me lately, and that is how some progressives choose to attack the health care reform bill. One of those principal routes is by attacking the mandate as "forcing people to buy insurance they don't want". Here's the first reason on Jane Hamsher's 10 reasons to kill the Senate bill:

Top 10 Reasons to Kill Senate Health Care Bill

1. Forces you to pay up to 8% of your income to private insurance corporations - whether you want to or not.

PCCC/DFA has a poll out asking "Would you favor or oppose requiring all Americans to buy health insurance -- the so-called mandate -- even if they find insurance too expensive or do not want it?" with the results of 51% oppose, 38% favor.

Now, I have enormous respect and appreciation for the work Jane, FDL, PCCC and DFA have done on health care reform, and respect arguments on the basis of affordability, which is one part of this poll question. But this business about "whether you want it or not" is one step too far.

In the first place, the messaging comes right out of the right-wing playbook. Conservative libertarian types have argued for years against mandatory participation in programs like Social Security on the basis of "the government is going to take part of your paycheck- whether you want it to or not! Tell the liberals you can make your own choices!" Making the same arguments on health care is echoing right-wing frames.

In the second, I don't care if people don't want health insurance. Do I care when people- young people just getting their first paychecks, libertarians, etc.- complain about being forced to pay into Social Security and Medicare when they don't want to? No. Pay up, folks.

Why do I say that? Because social insurance programs do not work without mandates. There are ten thousand pages worth of academic and policy economic literature on this issue. If you argue against the economic logic of mandates, or do polling just to demonstrate how much Americans hate mandates, you, as a progressive, really have no leg to stand on when arguing for compulsory Social Security, Medicare, Medicaid, worker's compensation, and so forth. None of those programs would work without a mandate.

In the third, Americans "don't want" a lot of things. I mean, I get that good people are trying to do anything they can to defeat the bill. And I no doubt have, or will, done or ignored polling results that fit my goal. For example, if we had 70% against the public option, no doubt progressive activists would be saying Americans just don't understand health care markets, and still push it anyway. Such is politics.

But one thing I can't deal with is polling Americans on academic policy concepts they don't understand, like health care mandates, and pretending like they have any clue what they're talking about. Hell, if I ran the question "Would you favor or oppose the government, without your consent, automatically deducting money from your paycheck- the so-called "Medicaid" proposal- to give to the poor, even if those receiving money do nothing to help themselves?" at the time of legislative passage, what kind of results do you think I would get? Americans don't understand concepts like risk pooling, adverse selection, moral hazard, information asymmetry, the health insurance death spiral, which are essential to understanding health care markets and the importance of a mandate. Hell, I only understand them myself because my boyfriend is a health economist. So I am certainly not going to honestly point to a poll result and say Americans know what's best for themselves when they seriously don't understand the background of the policy.

And frankly, if this were a wonderful bill with a public option and cost controls and good affordability, I would throw down money to bet a lot of progressive activists would tell conservatives opposed to the mandate, "tough shit, it makes economic sense!".

Now, that doesn't mean you can't attack a mandate. If you want to attack a mandate based on progressive principles, by all means. Talk about how Americans shouldn't have to buy insurance they can't afford. Do what Jim Dean did and talk about forcing people into the arms of the criminal insurance companies, and how that's different than a mandate for Social Security or Medicare. There are better ways to defeat the bill than using right-wing frames on choice or pretending the American public has any clue about health insurance markets.

[mzmolly]

1. Threads like this make me think we need to lose the unrec feature.

It will not likely be seen.

[silverweb]

2. K&R

:kick:

[Armstead]

3. That is mnissing the point -- This is NOT social insurance

It is an intrusion and is an attack on freedom.

The difference is that mandates would be less of an intrusion on freedom -- and a pathway to actual freedom -- if they really were mandates for social insurance. But they are not. They are limiting freedom for gtheb benefit of private corporations.

Mandates make sense if they really are part of a universal "social insurance" system that requires everyone to pitch in for the common good -- and their own benefit -- by paying what they can based on income in return for guaranteed public coverage.

This SCAM is nothing near that.

This SCAM takes the WORST sticks of it -- mandates -- without offering the carrots -- guaranteed affordable coverage for everyone.

That is what we object to. This bill might be a lot more successful if more Democrats were actually and vocally supporting the philosophy of REAL SOCIAL INSURANCE, instead of peddling this Corporate Mandate.

And before anyone talks about the "perfect and the good" -- Maybe we can;t get perfect now. But the problem is that democrats are undermining true social insurance -- even a limited optional version -- by imposing unpopular mandates on the public that will poison people against the concept of actual social insurance.

P.S. I am not among those who unrecced this thread.

[truedelphi]

6. Thank you for pointing these things out.

Most on a topic with this logic in the OP will not want to hear this.

Just as most of the 22% of the Republicans that still believe that George Bush and his Mission in Iraq have been successful, so we have some Party loyalists who are not able to use their critical faculties when it comes to this bill.

To keep this bill deficit neutral, some Five Hundred Billion bucks worth of cuts
to MediCare will become operative.

The Democratic leadership says that this will only affect the "Fat" in the program, but as someone who has already seen doctors who care for the elderly leaving the MediCare program by the droves, I do not believe it.

Also, some 40 billion dollars worth of cuts will apply to the 'in home Senior and disabled care giver program.' So this means a whole new group will be un or under employed. And the Seniors and disabled will be without help.

Then to further ensure that the program is deficit neutral some

"ONE HUNDRED AND SIXTY SIX BILLION BUCKS IN PENALTIES"

will come out of the pockets of those "scofflaws" among us that fall short of the Health Insurance Police, and all the paperwork that is involved.

[KrR]

17. The carrot is affordable coverage...

There will be a non-profit on the exchange and real competition on the exchage between the for profits. Lower incomes will be subsidized, Medicaid expanded, and ins companies will be required to spend at least 85% of thier premiums on healthcare. Mandates themselves will lower costs... that is the whole point of mandates.

[Sukie]

4. Excellent piece. Thanks for posting! Saved and rec

[AndrewP]

5. Interesting

[NJmaverick]

7. Thanks for posting this. It's good stuff

[LeftHandPath]

8. The big difference for me is...

my Social Security Administrator works for the Federal government, and is paid according to Federal payment guidelines.

I will NOT be forced to pay a profitable private insurance company whose CEO is making hundreds of millions in salary and stock options.

I will send them dog feces, but I will never send them a check.

[msongs]

9. lol you are obviously a.....hater :-) nt

[KrR]

18. There will be a non-profit on the Federal exchange...

So you won't have to.

[EFerrari]

10. Obama was against the mandate before he was for it.

Why is Jane the focus now?

[dreamnightwind]

11. I disagree with your point

Jane clearly says, right there in your post, "to private insurance corporations". She's not opposing any mandate, just THIS one, which is the correct position to take IMO.

Mandated participation in social insurance programs should only happen in a zero-sum system, where the money that gets paid in = the money that gets returned to the population, zero profit. People are paid salaries who work in the system, but the goal is to run it efficiently and responsibly to serve the interests of the mandated participants, not to remove ANY money from the system as profit.

I absolutely do not believe in requiring that people buy health insurance from private, for-profit health insurance corporations.

Too bad you missed her point, intentionally or not, you really misinterpreted the whole thing.

[Armstead]

12. xactly

[dreamnightwind]

13. Edit to reflect that I disagree with Bink not with you

Sorry I was confused as to who was saying what, I thought some of the OP was your own sentiment. I went and read the linked article and it's the positions of that article I am disagreeing with. You merely posted a link to it.

I don't know what your position is on this, so my earlier response was misdirected.

[KrR]

19. They DO NOT HAVE TO

There will be a NON PROFIT in the exchanges.....

[Cha]

14. Well, unlike Adam Bink, I have absolutley no respect for

hamsher and her "MARCHING WITH THE TEABAGGERS" hysteria.

[eridani]

15. "talk about forcing people into the arms of the criminal insurance companies"

Jeezus H Keerist on a fucking raft!! What in bleeding hell does he THINK we've been doing?

[KrR]

16. Lines of attack i have read on DU just today

The Bill stinks because it expands Medicaid and thats charity which is bad (OMG WTF)
The Bill stinks because it cutsback Medicare Advantage corporate giveaway.
The Bill stinks because i currently could afford insurance, but im too stupid to buy it so i dont want to be forced to buy it and save money for all of us.

[Jeff In Milwaukee]

20. Let's be clear on this point...

A single-payer system is a mandate. Social Security is a mandate. Medicare/Medicaid is a mandate. You don't get to pick which taxes you pay.

I can understand being disappointed about having a mandate and not a Public Option. I wish it were there, too, and I hope we can create one in the next few years. But arguing that this bill is flawed simply because there's a mandate is to use the same tired argument that the right wing has used against Social Security.