President Obama on the individual mandate
Letter from President Barack Obama to Senator Edward Kennedy and Senator Max Baucus
The White House
June 2, 2009
Excerpt
The meeting that we held today was very productive and I want to commend you for your leadership — and the hard work your Committees are doing on health care reform, one of the most urgent and important challenges confronting us as a Nation.
I understand the Committees are moving towards a principle of shared responsibility — making every American responsible for having health insurance coverage, and asking that employers share in the cost. I share the goal of ending lapses and gaps in coverage that make us less healthy and drive up everyone’s costs, and I am open to your ideas on shared responsibility. But I believe if we are going to make people responsible for owning health insurance, we must make health care affordable. If we do end up with a system where people are responsible for their own insurance, we need to provide a hardship waiver to exempt Americans who cannot afford it. In addition, while I believe that employers have a responsibility to support health insurance for their employees, small businesses face a number of special challenges in affording health benefits and should be exempted.
http://www.whitehouse.gov/blog/The-President-Spells-Out-His-Vision-on-Health-Care-Reform/
Comment:
By Don McCanne, MD
Numerous media reports are proclaiming that President Obama is now open to an individual mandate - a requirement that each uninsured individual purchase a basic health plan. But what did he really say?
He said that if we make people responsible for their own insurance (individual mandate), then we must grant a hardship waiver to exempt people who cannot afford it. But the primary reason that people have not purchased insurance in the individual market is that the plans are not affordable. Most of these individuals will be eligible for the hardship waiver and will remain uninsured.
What else did he say? He said that small businesses should be exempted from the responsibility of supporting health insurance for their employees since they face special challenges in affording health benefits. But for 80 percent of the uninsured, the head of the household is employed, predominantly by small businesses.
So President Obama has endorsed an individual mandate that would expand coverage to everyone - except those who cannot afford to pay for the coverage, and those whose jobs are in small businesses that cannot afford to provide employee health benefits. That is, we’ll cover everyone except most of those who are currently uninsured, nor those who will lose their health benefits as the rate of employer-sponsored coverage continues to decline, especially with a pessimistic job outlook.
The president’s letter is more than a personal communication to a couple of senators. It is a consensus statement, meant for public consumption, on the agreement between the administration and Congress on the most basic fundamentals of the reform legislation to be completed, as the president stated, in the “make-or-break window” before the August recess. Reading the full letter makes you realize how low the expectations are for the final reform product.
Sen. Baucus has expressed remorse for not giving single payer advocates an audience, but he has also stated that it is too late in the process to do so now. However, on June 10, the House Committee on Education and Labor will hold a hearing, “Examining the Single Payer Health Care Option.”
Although single payer legislation has already been introduced in both the House and the Senate, the logistics of lining up the political ducks before the August recess is nigh close to an impossibility. Nevertheless, do not let up on your efforts. In the next couple of months, while health reform is on the front burner, the flames must be stoked with our loud and clear message that we need reform that actually will accomplish the goal of affordable health care for all.
Though we may miss this one, the “make-or-break window” does not close with the August recess. The 2010 election process is already beginning. Individuals and organizations should begin immediately to use strategies and tactics to be certain that candidates understand that they will not be elected unless they support a single payer national health program. That should be the make-or-break litmus test for the 2010 elections.