Evil Mandates, Part 2

I think I should clarify that I've never been a huge fan of mandates. In fact, I wrote a pretty dramatic Huffington Post item a few months ago in which I made a case for opposing them -- an argument I repeated in further columns.

However, and this is the clarification, I'm not willing to oppose the bill if it includes individual mandates. Especially when the penalty is so relatively small ($750/year maximum). To that point, I think a lot of the outrage about mandates is overblown and skewed by understandable outrage. The current progressive argument against mandates is basically: We're being forced to pay private insurers, and even the subsidies would amount to a taxpayer bailout of the insurance companies. I absolutely sympathize with this, and would prefer to have a public option as an option of good conscience. Actually, I still believe there's a chance to get a public option added into the mix before mandates are imposed in 2013.

But, again, a similar "financing for-profit companies" argument could be made against a public option or single-payer plan, which would force everyone to pay private drug companies, hospitals, physicians, tech, etc. -- in essence bailing them out. The only pure system would be the British NHS.

Furthermore, there's a policy argument (see Ezra Klein, for example) in favor of mandates which suggests that without mandates, healthy people would continue to not buy insurance, and, with more sick people in the system and fewer healthy people, costs would continue to rise in order to provide care for the sick people. This has never been seriously opposed by progressives. As I wrote earlier, individual mandates were components of both the Hillary Clinton plan and the John Edwards plan.

Ultimately, my defense of individual mandates isn't so much an embracing of them, but, instead, an opposition to using them as an excuse for killing the bill. I still believe that while I've had a like/hate relationship with the idea, the more productive course from this point would be to pass the bill, then mobilize around making it better by adding a public option or the Medicare Buy-in and so forth as soon as practicable. In order to do that, it's necessary to put all of these things into proper perspective and to just get this passed.