Back in August, I made the argument that the individual mandate was the linchpin of health care reform. It wasn’t my idea or anything, I’d just read a lot of blog posts and articles on health insurance that led me to that opinion. I’m still sure that I’m right about it.
In a column Friday arguing that Congress should pass the health care reform bill, Paul Krugman succinctly explains the necessity of the individual mandate:
So what’s the answer? Americans overwhelmingly favor guaranteeing coverage to those with pre-existing conditions — but you can’t do that without pursuing broad-based reform. To make insurance affordable, you have to keep currently healthy people in the risk pool, which means requiring that everyone or almost everyone buy coverage. You can’t do that without financial aid to lower-income Americans so that they can pay the premiums. So you end up with a tripartite policy: elimination of medical discrimination, mandated coverage, and premium subsidies.
The very same trends that are driving Medicare costs upward are eroding employer-funded health insurance. If nothing changes, Medicare will have to be dismantled before it bankrupts the federal government, and employers across the country will be forced to drop health insurance as a benefit. If we allow things to reach that crisis point, any solution we implement will be worse than the partial solution this health care bill provides. The bill isn’t perfect, but it’s a place to build from. The status quo is not.
The other day, Ezra Klein posted a graph created by the Commonwealth Fund that showed how the health care reform proposed by Richard Nixon, Jimmy Carter, and Bill Clinton would have affected the growth in health care spending had they been enacted. All of them would have saved trillions of dollars. Passing this bill now instead of doing nothing will save us trillions of dollars. And tens of millions of people who would otherwise be uninsured will have health insurance. At this point the options are to pass this bill, or to do nothing. The idea of doing nothing is unthinkable.
Update: This Ezra Klein post is worth a read, Who does health-care reform help?