The Mandate Debate

Last night Clinton and Obama had a health insurance mandate debate (a mandebate?) Clinton thinks everyone should be required to get health insurance, and fined if they don’t. Obama argues a “mandate” would only further punish those who can’t afford insurance in the first place. If only someone tiny and really well informed could provide some clarity…

Enter Bill Clinton’s diminutive Secretary of Labor Robert Reich. This piece is a few weeks old but really helpful:

“Massachusetts is the only state to require that every resident purchase health insurance. The penalty for failing to do so could reach $4,000 next year, but the state has already exempted almost 20% of its current uninsured from the requirement.

Switzerland now enjoys near-universal coverage, but this reflects only a tiny increase over the rate of coverage before it was mandated, when over 98% of population had mostly voluntary coverage.”

So madates have decreased the number of uninsured, but some people still go uncovered. If those few don’t get insurance because they really can’t afford it, a mandate would only hit them with a penalty they also can’t afford. And if we end up giving them exemptions, that only ads a new bureaucratic wrinkle to the system because it isn’t realistic to mandate coverage. We really want people to have insurance, but for now mandates aren’t looking so good.