by Madeleine Kando
Today the Supreme Court is going to hear arguments on the constitutionality of the Individual Mandate, that part of the New Health Care Law that requires everyone to have some type of insurance. If you don't have insurance, you will be fined.
26 states have filed lawsuits against the Government to declare the Individual Mandate unconstitutional. They argue that 'the Commerce Clause' within the constitution, a law that allows Congress to tell the states what to do, can make them adopt the Individual Mandate. The people who are against the Health Care Bill use this as an excuse to overturn the whole law.
The Individual Mandate requires you to have insurance only if it doesn't exceed 8% of your monthly income. If you make less you don't have to get insurance. It would affect about 26 million Americans who are currently uninsured. About a third of those affected, however, would qualify for Medicaid. Another third would qualify for public subsidies. That leaves 2 percent of the total population who would be affected by the Individual Mandate.
If the Courts declare the Individual Mandate unconstitutional, the rest of the reform law would more than likely not work. Provisions of the new law, that insurance companies can not deny coverage for pre-existing conditions, or raise premiums depending on age for instance, would be impossible without the Individual Mandate.
It is ironic that the states that have filed lawsuits against the bill are the ones that would benefit the most from it. Those are the poor Red states in the south, that rely most on public funding.
Why are Americans so against an Individual Mandate? It is true that being told that you have to have health insurance when you don't need it, is a bit like being forced to buy car insurance when you don't even own a car. But sooner or later everyone will need health insurance.
In Europe this problem of agreeing to get health insurance whether you want to or not has been resolved a long time ago. Europeans seem to consider it self-evident that everyone should pay for health insurance. Everyone should share in the cost as well as the benefit.
Although the Individual Mandate is a necessary ingredient of universal health care, some countries in Europe have a health care system based on private insurance. The Dutch, for instance get health insurance from private companies and there is no public option. The insurance companies are heavily regulated however and heavily subsidized. There is no cherry picking. Insurers who only insure healthy people have to pay a fee and insurers with a lot of high risk people get subsidized, so that there is a level playing field.
Private health insurance system guarantees that there is adequate competition to lower premiums to attract subscribers. Providers are also mostly private (hospitals, doctors, dentists).
Even though the Public option has been removed from the New Health Care Bill it would have been a much better solution than the Individual Mandate. It would have been a natural incentive for private insurance companies to be competitive. It's the health care equivalent of being pro-choice. The excuse given by opponents of the public option say that it would out-compete private insurance companies. But if you look at Germany, for instance, where there is a public option, the insurance companies are thriving. They actually get more money for insuring people with pre-existing conditions because they get subsidized for it.
Contrast that to the purely market driven health insurance system in the US. This drives insurance companies to NOT cover the sick, which Obamacare is trying to change. Obamacare is economically smart. It spreads the risk out so that each individual will eventually pay less.
America was founded on the principles of liberty, equality, and justice for all and proclaimed her shores with the motto: "Give me your tired, your poor, your huddled masses yearning to breathe free.."
I hope the Supreme Court keeps this in mind when they rule on this very important issue. But I am not holding my breath. leave comment here
Wednesday, March 28, 2012
by Madeleine Kando