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Recent Articles
The Mandate Opt-Out Safety Valve
Princeton sociologist Paul Starr in today's New York Times recommends the Democrats add an opt-out provision to the requirement that everyone buy health insurance, which is included in both reform bills. This is a timely reworking of his column in the American Prospect that made the same proposal last December, which I endorsed here.
Why is the individual mandate required in the first place? To force insurers to take all comers despite existing health conditions, which is part of reform, the companies have to be assured that people won't simply wait until they get sick before buying coverage. Starr's proposal would allow Americans who don't want to buy insurance and don't want to pay penalties to avoid those obligations to simply sign a waiver of their right to buy subsidized coverage through the national exchange -- which must be open to all comers no matter what their previous health status -- for at least five years. In other words, Starr writes, they could opt-out and face the same market the uninsured face today when they get very sick -- a market that will not sell them policies because they have a pre-existing condition.
The legislation isn't slated to go into effect until 2014. Should the Democrats push ahead and pass the bill without Republican support, there will be a huge "debate" this election year over its implications for the insurance market. Reformers already have a few arrows in their quiver to argue its benefits: the law will immediately ban some of the worst excesses of the private insurance market like rescissions (claiming policies don't cover major conditions after a person gets sick) and discrimination based on pre-existing conditions.
Being able to point to an opt-out clause on the individual mandate would be another major talking point in favor of the bill. It could be used to refute claims the bill forces people to buy a product they don't want or need.
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Comments
How the heck is the public
How the heck is the public interest served when the folks who opt out of purchasing government insurance get emergently sick and require huge sums of money to care for them? Is not this the reason why most (of not all- not sure) states demand that owners/drivers of vehicles obtain auto insurance? States are beginning to bill people who get lost or injured while playing in the wilderness for the cost of the resources used to rescue them. Why not do the same for the opt-outers?
There are so many problems
There are so many problems with these bills - where to start. Oh YES, the removal of abortion coverage for American women. This borders on insanity. It is completely wrong to use a national health bill (such as it is) to CONTROL women's lives, yet this is what the group of mostly men in Congress, have done. Women of my generation struggled to gain abortion rights because we NEED to CONTROL our OWN BODIES. Now Congress in its selfish, self-centered, blind way, is poised to limit this RIGHT.
Next, the original problems Americans and the USA have with our medical system surely involved the COST of healthcare. I am not clear at all that these bills will reconcile in a way that reduces costs. We pay way TOO MUCH for pharmaceutical drugs when vitamins and other cheaper supplements are not covered by insurance. Surgeries are hugely expensive, in-hospital stays are completely insane.
I am not sure any of the bills will take care of this. The good thing is removing the limitations for people with pre-existing conditions - an ever-larger group of Americans.
Not covering immigrants will prove to be a costly mistake. Yielding to right-wing demands has not won any votes from that side, so why even bother. If this bill will pass by a majority, then use this opportunity to reshape the bill to make sense. Reduce costs, reduce costs, reduce costs.
Include less expensive treatments like acupuncture, naturopathy, homeopathy, etc. Cover massage.
And make sure PREVENTION is a reality not a dream. Eating fruits and vegetables, taking a walk, relaxing each day -this works as shown by a number of studies.