The case for Individual Mandates

Yesterday Mark says: Yeah, that’s a great idea. Make people buy something they don’t want.

Today Clinton says:

First, universal access without an individual requirement would make health insurance less affordable, not more affordable. Under the Obama plan, individuals will have an incentive to remain uninsured and not pay premiums until they actually need care – and then stop paying premiums when that need is gone. This would raise premiums for the fewer participants who stay insured when they are both healthy and sick. As economist and New York Times columnist Paul Krugman recently explained, under the Obama Plan, “people who did the right thing and bought insurance when they were healthy would end up subsidizing those who didn’t sign up for insurance until or unless they needed medical care.”

Second, the policies that will most effectively reduce long-run healthcare costs—like prevention, chronic care management and electronic medical records—can only be effectively implemented in a system where individuals are required to have insurance. Because Senator Obama’s plan does not include an individual requirement, his commitment to these cost-savings policies will be substantially less effective at containing system-wide healthcare costs than Senator Clinton’s plan.

Third, the key reforms necessary to make insurance accessible will be far more difficult without an individual requirement. In a voluntary system where coverage gaps persist, insurers will have a strong incentive to find ways to avoid enrolling sick people if they had to instantly enroll them at the same rates as other enrollees. As a result, Senator Obama’s commitment to insurance reforms that, on paper, would improve access to insurance, are likely to be undermined in practice. As one health writer recently explained, “you can’t make the necessary reforms to the insurance market without putting everyone in the coverage pool. The point of the reforms is not merely to keep insurers from gaming consumers, but to keep consumers from gaming insurers. You can’t have one without the other.”

In short, reforms to make insurance (1) accessible, (2) affordable, and (3) required are like a three-legged stool: if one is removed, the others can’t work. This is why states and past reform plans have included all three elements. And it is why affordability and accessibility for the insured as well as the uninsured can only be effectively secured by guaranteeing coverage through an individual requirement for health insurance, as Senator Clinton’s American Health Choices Plan would do.

I think you just got spread Marky Marky

There’s more at the link below. The Clinton campaign just released an awesome policy brief on justifying Individual mandates.



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