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Part 2 of an ongoing series. See also "Healthcare 101: Don't Eat That Chocolate Bar"

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In Healthcare Part 1, I wrote about the basic factors that create the need for an individual mandate if you want to have a functioning private insurance market; particularly one that doesn't penalize people for pre-existing conditions nor engage in denial of coverage shenanigans. But there's another side of this argument. Conservatives will tell you that this is an unprecedented example of government overreach. That it creates a slippery slope towards government forcing us to buy all sorts of things, and that an individual should not be forced to participate in a market they don't want to.

It sounds like a reasonable argument, but in fact it's highly disingenuous. It's the kind of argument that's promulgated by people who are either ignorant of how healthcare works (which is kind of understandable, since it's so durn complex), or by people who are playing politics with the nation's future (which is much less understandable the more you understand what they're doing). Let's start with the latter group and think about why their argument stinks.

First, it can't be said often nor emphatically enough that the idea of the individual mandate is in fact a REPUBLICAN IDEA. It was championed by the Heritage Foundation and prominent Republicans like Bob Dole, Newt Gingrich, and, of course ,most famously: Mitt Romney. The idea was pushed forward during the "Hillarycare" debate as an alternative to Bill Clinton's proposal that would mandate employers cover the cost of health insurance. Republicans countered with a proposal that "individuals" should be mandated to provide their own insurance, which fit with their ideology of supporting the business community and promoting individual responsibility.

In fact, Republicans thought the individual mandate was such a good idea that then-Governor Mitt Romney made it a center-piece of his Massachusetts healthcare reform initiative and lo & behold it worked! 98% of Massachusetts residents and 99% of children now have coverage. Unlike the Affordable Care Act, the Mass law punted on addressing cost controls (though one could definitely argue Obamacare doesn't do enough on this either), but it did manage to expand coverage and apparently improve health. Romney went on to crow that it should be a model for the nation, which it became under President Obama. Confused that this doesn't sound like what Romney is saying today? That's because it isn't. Romney today hates Obamneycare, because...well, because Obama did it. Call it an Etch-A-Sketch moment...

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The GOP establishment believes healthcare to be a good political issue for them, and so they've switched sides on their own proposal. Craven? Perhaps. Surprising? Not if you've been observing the recent trend towards increasingly partisan politics in this country. But what about the people who are not political salamanders? The ones who are generally worried about their freedom? I saw a Tea Party leader on Hardball Monday night who spoke passionately against the dangers of Obamacare. She repeated again and again that the American people "don't want it." Chris Matthews asked her a question about the uninsured. She responded that she herself had once been uninsured and the doctors and hospitals had worked with her -- that no one would be turned away.

In that moment, she made the other side's argument.

This woman may not realize it, but she's effectively a free-rider in our healthcare system (or at least she was). When doctors and hospitals "worked" with her to reduce her costs, what they wound up doing was one of two things: A) eating the costs themselves or B) passing the costs on to government. Either way, the rest of us wind up paying for her care in the form of higher insurance premiums or taxation. If you don't believe me, just look at the case of Mary Brown. She's the lead plaintiff in the Healthcare lawsuit currently before the Supreme Court. She just filed for bankruptcy, leaving behind a raft of unpaid medical bills. Guess who's now paying for her so-called "freedom?"

People have talked for years about the sense of entitlement in our society, but this takes it to another level. You want to be free not to pay for health insurance, you figure the tooth-fairy is gonna' pick up the tab anyway, so damn Obamacare to heck, right? In the end it seems some conservatives truly love individual responsibility...as long as they don't have to practice it themselves.

derrick ashong

To be fair, there ARE ways to have a viable healtchare system without an individual mandate - conservatives just happen to hate all of them (well, maybe all but one). In the next post we'll take a look at the good, the bad & the ugly alternatives to Obamacare.

Derrick N. Ashong
D.N.A.