Mandate

Courtesy of MSNBC

Photographer:  Nick Ut/AP

People wait in line for a chance to get free medical care

 after spending the night at the Los Angeles Memorial Sports Arena

on Monday Oct. 17,2011

Mother Jones reports on another kind mandate.  The mandate to provide all people access to quality health care.  From writer, Adam Server:

Marla Tipping's 14-year-old son, Cam, has to have his blood cleaned every two weeks. He has a rare condition that makes his body produce too much cholesterol.

Tipping says her family has had "to be absolutely vigilant in never having a lapse in coverage…because many carriers would never carry you with a preexisting condition again."

That was the case before the passage of the Affordable Care Act. Now, children like Cam cannot be denied coverage because of a preexisting condition. (Similar protections for adults are set to start in 2014.) While Tipping says she and her husband still pay between $20-25,000 out of pocket every year for costs their insurance won't cover, the ACA at least guarantees that they'll be able to find some kind of policy for Cam, even if they are forced to leave their current plan.

Likewise, Stacie Ritter, a mother who participated in protests supporting the ACA's passage, no longer has to worry if her twins, who have a rare form of leukemia, will be denied coverage if they have to change insurance providers.

"This law protects them from being discriminated against if my husband lost his job," Ritter says. "Right now what's protecting us is the fact that my girls can't be discriminated against; we don't have to fear that we don't have access to insurance. That's a really scary thought if the law is repealed."

Although some say that the USSC could eliminate the mandate without "touching" the rest of the legislation,  Don Berwick, former administrator of the Centers for Medicare and Medicaid Services, and "who also helped implement early provisions of the Affordable Care Act," states that this is just not possible.  For one, the legislation is so complex (or convoluted?), axing the mandate creates an administrative nightmare that would inevitably topple other parts of the bill.  Indeed, conservative Justice Scalia seems to have suggested doing so for exactly that reason:  "My approach would say if you take the heart out of the statute, [i.e. the mandate] the statute's gone."

Courtesy of Reuters

Photographer:  Shannon Stapleton/Reuters

People wait in line to enter a free health clinic

at the Wise County Fairgrounds

in Wise, Virginia, July 25, 2009.

Some people are discussing whether axing the mandate - or the legislation - makes single payer more or less "inevitable."  As blogged earlier, AETNA CEO, Chaiman, and President Mark Bertolini asserted that the legislation posed a reckoning for the health insurance industry - with or without the mandate - because health insurance companies will have to accept everyone.  (Though this was stated without the explicit understanding that removing the mandate basically destroys the whole bill.)  Of course, if they don't have to do that (accept everyone), the "inevitability" of their demise seems predicated on the ability of citizens to pressure a Congress controlled by the health insurance lobbyists to expand an improved Medicare to age zero.  Or to pressure them to impose upon themselves campaign finance reform laws adverse to the interests of the lobbyists who maintain them in their jobs.  As health insurance premiums continue to climb, and more people lose their coverage.

IOW, we have the same problem as before, with the real mandate, a moral mandate, still being ignored by many of our lawmakers:

Health care for all, now.

Courtesy of Voice of Detroit