Friday, August 07, 2009

Health Care Mandates

Republicans get all up in arms about the government passing laws that require citizens to do anything, or prevent citizens from doing anything. They are “anti-mandate” to the point that the more wingnutty of them holler, “Keep the government’s hands off of my Medicare.” Really, I swear I’m not making that up.

I’m sort of neutral about individual mandates. I carry a driver’s license with me, and have no real feeling of resentment about the requirement that I do so. I have car insurance, and I would have it even if the law didn’t require me to. I have health insurance, even though there is no law requiring that.

What if there was such a law? Well, I would comply with it, and would comply without resentment because that law, just as is the car insurance law, is consistent with my own self interest. That’s easy for me to say, because I can afford health insurance.

For many years my employees were landscapers, many of them working for minimum wage which was the most we could afford to pay in a viciously competitive business environment. We offered health insurance, but a portion of the premium was deducted from employees’ paychecks and very few of them chose it. It wasn’t that they didn’t want the coverage, they did, but they had to make a choice between that premium and several meals on the table for their families.

That’s a hard choice, isn’t it? Do I gamble with my family’s health, or do I send my kids to bed without supper? Terrible choice; but the government should not make that decision.

We’re being told that adding healthy, presently uninsured people to the insured pool will balance out cost and reduce the cost of insurance, and that to do that we need to mandate insurance, and I have no real argument with that. The reform is purported to offer “subsidies” to people who “have trouble” paying for insurance, and that is more vague than I am really comfortable with. Mandate insurance if you must, but be sure you do it in a manner that does not eliminate freedom of choice.

I’m somewhat less than neutral regarding employer mandates.

During the primary and general election campaigns much was made of the unfairness that employer-provided insurance imposed on our businesses, and how it made those businesses non-competitive in the international market because other nations did not require their employers to do that. It was asserted by all of the candidates that we needed health care reform to remove the unfair burden that is borne by our employers of having to provide health insurance for their employees.

During the discussion of the bailout of the auto manufacturers, it was claimed by Obama that part of the reason that our auto manufacturers were failing was the burden of providing health insurance to their employees, a burden the auto manufacturers of other nations, specifically Canada which now owns a good portion of GM, did not bear. We needed to offer the auto makers this bailout, he claimed, in part because of this unfair burden of providing health insurance for their employees.

Now the health care reform requires all employers above a certain modest size to provide health insurance for their employees. This is, for me, a huge wtf component in the health insurance reform proposal.

After more than a year of prating in his campaign about how unfair it was to employers that they have the burden of providing health insurance; after months of declaiming as President about how the burden of providing health insurance had driven GM and Chrysler (but not, apparently, Ford) out of business; now Obama is willing to mandate that all employers of any significant size be required to be saddled with that same burden.

That is nonsensical and nobody, liberal or conservative, is remarking on it.

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