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That's not hard

by ndphilo @, Seal Beach, Saturday, December 02, 2017, 21:11 @ scriptcomesfirst
edited by ndphilo, Saturday, December 02, 2017, 21:16

A mandate is necessary to solve free rider problems that arise if you get rid of, most importantly, pre-existing condition exclusions.

A cash penalty, like is included in the ACA, is the likely the least restrictive means to secure a mandate. Many other countries use a much simpler approach, they sign you up for a basic plan if you don't do so yourself. That seems less compatible with freedom to me, but maybe you would prefer that?

The point of a system of healthcare is not simply to maximize freedom because, well, FREEDOM! It is to balance reasonable competing values in an attempt to ensure the public good. You know, kind of like traffic rules, or contract law, or just about everything else in civil society. What is the better way to provide access to reasonable health insurance to, say, someone born with a condition that requires lifelong medical treatments? Is someone born with epilepsy simply forced to never be able to have insurance through the individuals market? And then what, either we all carry the cost of their care, or we just force them to live without access to healthcare? And even if you reject that principle, there is even an argument that a mandate is, in fact, freedom maximizing if you consider society as a whole because it places modest restrictions on all to open up life saving options for millions. A net increase in freedom, if you further consider the economic avenues opened for those who would have no access to insurance otherwise, to devastating consequence.

And even if you think the mandate has to go, I can respect that, so long as you recognize that getting rid of the mandate alone has a string of predictable economic consequences. Ending the mandate, without making comprehensive revision of the ACA, is horrific policy that will devastate the individual insurance market, and likely have knock on effects for health insurance generally. You can't get rid of the mandate and keep other provisions of the ACA without cratering the market. It might make individual insurance impossible, restricting the ability of millions to buy a product that they would very much like to purchase and which is crucial to their economic, not to mention physical, well-being (yay freedom!).

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