Saturday, June 06, 2009

On options and mandates

Okay, two things are going on right now, talking about the "public option" -- a public health insurance program modeled on Medicare that individuals could buy into -- and "mandates" -- forcing everybody to buy health insurance. There's two main problems with this whole discussion:

  1. Most of us have no choice in what health insurance we receive, our employer decides and then says, "this is what you get." So what will happen is that the only employees offered this "public option" will be employees of small businesses who cannot get affordable health insurance from insurance companies that only want to sell via big businesses or which "cherry pick" small businesses to accept only the ones with the youngest/healthiest workforce. What this means is that the most expensive/unhealthiest businesses will get shoved into the "public option" (and remember, the current private health insurance system is a scam that already regularly defrauds their patients, so telling them "don't cherry pick!" would be like telling a cat "don't chase a string!", it just won't work because of the nature of the beast). And thus the "public option" really *won't* be an option. And trusting the private insurance industry to not cherry-pick the healthiest and shove the unhealthiest onto the "public option"... bwhahahaha!
  2. The reason so many Americans already lack health insurance is not because they don't want health insurance. It's because they cannot afford health insurance. The "mandate" system basically will deal with this by forcing them into Medicaid or into the "public option" with a subsidy from a fund created by taxing employers who do not provide health insurance to their employees, with a portion of worker's income taken away to pay into the Medicaid or "public option" fund. This will just worsen the problems of the current Medicaid system, which is already underfunded and provides woefully inadequate care that often kills people because as a "separate but equal" segregation of a despised and reviled population (and the poor ARE hated, despised, and reviled in the United States, all you have to do is read the propaganda "newspaper" or watch the propaganda "news" where you find out that all poor people are lazy, drug users / dealers, or criminals), the notion of providing equal resources to that population simply doesn't pass the laugh and giggle test.
In the end, the combination of the "public option" and mandates would create a "Separate but Equal" healthcare system in America -- one for the upper middle class and wealthy that provides the best healthcare in the world at the cost of being woefully inefficient, and one for the lower middle class and poor that would provide healthcare more similar to a dismal 3rd world hellhole like Haiti. And I'm not joking there. Infant mortality rates in some inner-city neighborhoods of the United States look a lot more like Haiti than like any advanced modern nation. The "public option" and mandates expand that failed system even further to create a "Separate but Equal" system just as immoral, just as wrong, as "Separate but Equal" was in education. And it will not save money either -- it will instead create an all-new government bureaucracy to enforce the mandates, and an all-new government bureaucracy implementing the "public option", further adding inefficiency to the healthcare system.

The only system that will both fix the horrifically wrong separate-but-equal system and the horrific inefficient multiplicity of bureaucracies problem is to extend Medicare to ALL Americans, using the existing Medicare payroll tax (pumped up by 4% apiece on employer and employee side) to pay for it and the existing Medicare processing system to process the claims. This is the only system that will eliminate bureaucracies, not create new ones, and will ensure equal care to all Americans, not just the wealthy and upper middle class. Single-payer Medicare For All is our last, best chance for assuring adequate healthcare to all Americans. When we all have the same insurance system, when we all have a stake in whether it works or not, I have confidence that we as a people in a democracy will make sure that it works. Separate But Equal -- just say *NO*. It was wrong for education, and it is wrong for healthcare too.

-- Badtux the Healthcare Penguin


  1. Amen.
    (or its secular equivalent.)

  2. jeg43, I think the secular equivalent is "yippy-ki-yay, muhfuh." Or something like that.

  3. I hear "no shit" works fine

  4. Makes sense, but when people talk about Medicare, including those political figures who would like to do this, no one really discusses the fact that Medicare doesn't cover everything. It covers 80%. That doesn't cut it these days. Part A is free, you pay a premium for Part B and then more for Part D, plus you really need a Medigap policy - which usually comes from private insurance. So does the Medicare for all plan assume that's fixed as well?

  5. Obama says single payer would be a good option if we were inventing health care from scratch. Instead, he will add layers of programming and new mandates that create an illusion of coverage but leaves the prospect of health insurance profitability untouched. And somehow, he thinks that will work.


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