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Nine alternatives to the individual mandate

While the US Supreme Court considered the constitutionality of this issue today, what’s lost in much of the commentary is that encouraging people to purchase health coverage doesn’t require such a mandate.   Put simply, the health law survives without the responsibility requirement with other mechanisms that make it cheaper and easier to just buy coverage.

After all, think about it – most (80%+) people have coverage already, either through their job or Medicare/Medicaid – so it’s a pretty small percentage affected by the requirement.  And, in Massachusetts, where then-Governor Romney passed an individual mandate as part of their health care law four years ago, almost 98% of people have insurance and the requirement to buy coverage has been supremely uncontroversial.

So what are the alternatives?  The simplest is just to really penalize people who wait to buy health coverage until they get sick or enroll later than everyone else.  You can still buy coverage, but it just won’t cover as much and it will cost a lot more.  We already do that in the Medicare program for physician services coverage and it works very well.   See the GAO report for all the nine alternatives.

 

4 Comments


  1. Doug

    March 29, 2012 at 8:35 am

    You forgot the 10th alternative- repeal the entire legislative mess and throw it out !

  2. Lou Meyers

    March 29, 2012 at 9:13 am

    Right Doug, and then replace it with single payer. All the alternatives listed may or may not help a dire situation. If they do help, to what degree will be a question mark.

    Single payer has proven to cut costs by half and provide everyone care. It is considered a national treasure by those that have adopted it. The longer we wait to solve this crisis of confidence and uncertainty, the longer our economy stays on the mat.

    Let’s protect our most valuable resource — our people — and do it better than anyone else.

  3. Alex

    March 29, 2012 at 10:20 am

    Medicare is single payer, and costs have risen double digits for the last 10 or 15 years, and that’s with private insurers subsidizing hospitals to account for Medicare’s low reimbursement. Reforming entitlements is the only answer given the demographics we are currently facing.

  4. Lou Meyers

    March 29, 2012 at 9:24 pm

    Alex, Medicare is single payer for the elderly. Most medical expense occurs in the last 5 year of life straining the program.

    Medicare is single payer for the disabled. Many of whom have been dumped by their for profit insurance cos. more strain on Medicare.

    We had group coverage at my business. Despite massive premiums, my personal medical costs were peanuts. According to contract with our insurer, to qualify for coverage, each covered employ had to prove a 30 hr work week. When renewing coverage I asked the insurance rep. — if I had a stroke or stricken with cancer and our insurance cos. could prove (shouldn’t be hard) there was no way any human could pull off a 30 hr week with those serious conditions would I lose coverage. Her answer was — of course but then I could get Medicare disability (2 year wait) or the state high risk plan if available. So with tremendous out-of-pocket to prevent us for going for routine check-ups or minor accident treatment, it’s even questionable if we even had catastrophic. This is the scam we call health insurance!

    Alex, when Medicare is single payer for everyone else, including the young and healthy, you’ll get your entitlement reform and we’ll get our health care.

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