Thursday, August 20, 2009

Stoddard On Mandates

William Stoddard sparks a heated discussion on mandatory health insurance at Megan McArdle's Atlantic blog.

Here's the letter from him that she is quoting:
I'm not sure I'm in any of the four groups of uninsured people you identify. I'm 59 years old, self-employed, and uninsured... because I can't afford to pay for even catastrophic coverage. I have a touchy gall bladder; I haven't had an attack in several years, but it's a pre-existing condition, so it raises my premiums, which are painfully high anyway for a man my age. I've been self-employed since 2002, when my former corporate job was outsourced. Does that fit any of your categories?

If the House of Representatives proposal passes, I expect that my premiums will be right at the legal maximum of 12% where subsidies kick in... assuming that my income doesn't rise past the threshold where a single man is ineligible for help! It averages around $40K, so 12% is $400 a month. I know I can't afford to pay that; I used to pay that much for Blue Cross, and it left me under chronic financial stress. So I'm planning to pay the penalties; 2.5% is $1K a year, which will hurt me, but it won't completely wipe me out. On the other hand, I can't see how it's supposed to help me maintain my health.

But I'll tell you, I supported Obama over both McCain and Clinton partly because he opposed mandates. Now he hasn't said a word to stop them. I don't know if I could bring myself to vote for a Republican, but if the Democrats inflict this financial injury on me, they can forget about my ever voting for another Democrat. I didn't know if Obama was trustworthy; now I know.
Later in the comment thread, Stoddard elaborates on his views:
In response to Mr. Thacker's question, John McCain's proposals on health care were the single thing that most strongly tempted me to vote for him; they are very close to what I would prefer... though not as close as John Mackey's proposals in the August 11 Wall Street Journal. I was deterred from supporting McCain by cultural issues, and centrally by his endorsement of the Republican Party's intolerable orthodoxy on abortion. Obama's position on mandates was just enough to make him a marginally lesser evil.

If Obama were maintaining his position... which he could do easily, by announcing that he will veto any bill that includes mandates... then whatever proposal Congress came up with, if it cost too much, I could remain uninsured and at least not be made worse off. Mandates take that protection away from me; they allow Congress, or some administrator, to decide what I am supposed to be able to afford, and require me to comply. And without mandates, if a lot of people choose not to sign up, Congress will get the message that their proposals aren't working; with mandates, people who send them that message faces fines. Their willingness to resort to compulsion does not inspire confidence in their ability to devise something that people would willingly choose.

And I'm not in the category where large numbers of people will be hurt. The Democratic proposals will really damage many people in their twenties, by forcing them to spend large amounts of money on insurance for the sake of lowering costs for people my age. All income redistribution strikes me as ethically dubious, but income redistribution from the young and poor to the old and nonpoor seems hard to justify in terms of the values the Democratic Party claims to support. What they actually support seems to be forcing 45 million Americans to become customers of the health insurance industry, whether they can afford it or not... the same industry that has completely failed to control health care costs.
Stoddard is asking the sorts of questions that many Americans are asking.

It will be very interesting to see how our political leaders respond...