Opposition to the Mandate
So, one thing has continually troubled me throughout the health care debate, and this is the consistent polling showing opposition to the individual mandate. It’s taken me a while, but I think that I have finally figured this out.
THIS article reviewing data from the AFLAC Workforces Report shows that we are doing a terrible job in educating our public on health concerns.
six out of ten workers (62 percent) think it’s not very or not at all likely they or a family member will be diagnosed with a serious illness like cancer, and more than half (55 percent) said they were not very or not at all likely to be diagnosed with a chronic illness, such as heart disease or diabetes.
But of course, this is not reality. This fundamental disconnect as the article notes, is more than simply problematic..
Americans may be overly optimistic when it comes to thinking they won’t ever be diagnosed with a serious illness or experience an accident. According to the American Cancer Society, Cancer Facts & Figures 2012, one in three women and one in two men will be diagnosed with cancer at some point in their lives, and the National Safety Council, Injury Facts 2011 edition, says that more than 38.9 million medically consulted injuries occur in a year. The American Heart Association, Heart Disease & Stroke Statistics 2012, show that one in six deaths in the U.S. was caused by coronary heart disease. “The fact that American workers aren’t aware of their medical risks and the potential financial impact of those risks is a very real concern that is only compounded when workers don’t take full advantage of available benefits options or adjust their savings strategies to be more prepared,” said Audrey Boone Tillman, executive vice president of Corporate Services at Aflac. “Now, more than ever, people need to understand that well-being means more than just good health—it’s being prepared for the reality of whatever life may bring and taking the necessary measures to protect themselves and their families.”
I think that this explains this. Certainly some people are fundamentally opposed to government mandates of any sort, but they would hardly constitute a plurality, let alone a majority, but pure ignorance, or a magical suspension of disbelief I think explains it. I cannot think of any other explanation.
Having watched several relatives go through illness that resulted in death, and having a chronic condition myself, I simply cannot help but wonder how people have reached this conclusion. The simple fact that they don’t understand this is likely more troublesome than a rejection of the mandate itself.
It is part of a larger trend were we have created a society that is beyond the understanding of many of its members. Of course the quote is also self serving in that Aflac sells insurance.
In addition perhaps many folks follow the bibiblical injunction to take no thought for the morrow it will take care of itself.
One thing that is important, I think, is the effectiveness of propaganda. A lot of people hear people who supposedly know what they are talking about, perhaps even people that they hold in regard, say that the individual mandate is bad.
Now, I was raised by conservatives, but I was also raised to believe in insurance. You hope that you do not get your money back with insurance. The whole point is to pool your money with other people so that when disaster happens it can be mitigated. Health insurance is broader than that, to include ordinary medical expenses. Maybe that has something to do with the opposition, I don’t know.
But I get the impression that young conservatives today have been taught to believe that insurance is some sort of scheme to rob them.
The mandate is waived if the insurance would cost more than 8% of income.
Plus there’s premium support for everyone up to $46,000 single and $94,000 family, and people under 133% of Federal Poverty Level qualify for full Medicaid (which isn’t that great but it’s better than nothing).
The penalty is 2.5% of gross income, so if you’re 50, making $75,000 and you don’t want to carry insurance, you can pay the $2000 penalty tax instead of the $6000+ insurance.
This is the same idea the Republican moderates floated in 1993 — Dole, Hatch, etc.
It was the institutional preference of the Heritage Foundation as late as 2005.
Opposition to this is just opposition to destroy what their Party failed to create. They know once people like this it will be a feather in the cap for Dems, and also that the $60B+/yr in subsidies are going to have to be paid by somebody (this is what sunk the 1993 plan too, nobody wanted to pay for the subsidy part).
The important question here is: at what age?
We can make sense of the two sets of numbers quite easily:
six out of ten workers (62 percent) think it’s not very or not at all likely they or a family member will be diagnosed with a serious illness like cancer, and more than half (55 percent) said they were not very or not at all likely to be diagnosed with a chronic illness, such as heart disease or diabetes…..before age 65
And
According to the American Cancer Society, Cancer Facts & Figures 2012, one in three women and one in two men will be diagnosed with cancer at some point in their lives, and the National Safety Council, Injury Facts 2011 edition, says that more than 38.9 million medically consulted injuries occur in a year. The American Heart Association, Heart Disease & Stroke Statistics 2012, show that one in six deaths in the U.S. was caused by coronary heart disease……after age 65
And 65 is when Medicare kicks in.
I’m not trying to make a partisan point here: just noting that to really work out whether Americans in general are entirely deluded about the fact that everyone dis of something or not we’d need in fact to have a detailed look at exactly what question was asked and how.
That explains the propaganda, but what about the polls?
“we’d need in fact to have a detailed look at exactly what question was asked and how.”
Yes, the exact wording of polls makes a difference. Ouestions that apparently mean the same thing can have quite different responses.
I’m confused. If less than half think that they will be hit with something that hits less than half, where is the story.
You have been taken in by a sales job.
No Arne, you simply aren’t understanding the relationship between the two categories of “less then half.” They are not correkated halfs, at least we have no measure of any correlation. Think of it this way, less than half of those questioned think that they will end up as one of those in the less than half group that is injured. One insures themself from the cost of being in the injured group because there is no way of knowing who will be one of the less than half. So the less than half that think they will not be in the injured group are ignoring the almost 50:50 chance of being in the defined group.
In addition, the question deals with family units, not individuals. Except for the situation of single people living on their own, ther probabilities for severe or chronic ilness in a family will be considerably higher than indicatd by the statistics for individuals. Furthermore, the big C isn’t the only serious health issue; there are numerous serious medical conditions which are quite common.
Mike Halasy
with respect you have missed the point entirely. forcing people to buy a product in the private market is a serious constitutional issue.
Just the fact that so many people hate the idea ought to suggest that possibility to you. And you do yourself no credit by writing it off to ignorance and propaganda.
Rory K Little, Former clerk to Justice William J Brennan, and Professor of Law at U.C. Hastings College of Law tries to explain it to you in a short letter on page 3 of the May 7 New Yorker.
Tim
hate to say this, but you are right.
yes, you all, it is quite true that each of us has a significant chance of being hit with an expensive illness. that is not the point.
the point is a government mandate to buy a product from a private corporation. this offends people’s sense of their personal freedom from government control. odd but true, it offends them more than a simple tax for the same purpose.
try to think of it as being forced to buy protection insurance from the local mob.
coberly:
No, it is not a serious constitutional issue; but then Coberly, everyone is entitled to a day in court to speak of what they need to speak before whatever court their case rises to. The ACA is covered by the Commerce Clause. Futhemore, masses of people taking issue with something does not make it unconstitutional either. Some light reading on conctitutional law as told by Erwin Chemerinsky:
- http://go.bloomberg.com/health-care-supreme-court/2012-03-21/commerce-clause-jurisprudence-through-the-centuries/
- http://www.youtube.com/watch?v=5cRpSLaG3Nc
- http://www.fcan.org/Health_care/law_professors_ACA.pdf
There is certainly more out there to be read.
Coberly
I’m not saying it is good or otherwise, the mandate that is, but it is not unique. Auto insurance is required in order to register a vehicle. Title insurance is mandated by the banks if you’re seeking a mortgage. We are all mandated to pay for the Medicare program. And as you well know and agreeable to, we are all mandated to participate in a retirement program with a significant insurance aspect in the event of premature disability or death. Some states are mandating draconian invacive measures related to termination of unwanted pregnancies.
Health care is a basic and prevelent need that we all will experience a need for whether for a catastrophic circumstance or just a small stick in the eye. The mandate was one more circuitous route to get to a conclusion that was being obstructed by the same people that now are complaining about the mandate. Single payer or medicare for all supported by a dedicated tax might have been preferable. That was decried as socialized medicine though only the payment mechanism was being socialized in any sense. The provision of care was still via private practitioners. Let the complainers come up with a better solution before we throw out the solution that was already agreed to.
Laltely the only thing we seem not mandated to do by the government is to register guns and ammo. We’re really making strides as a more civilized society.
run
no point in fighting with you. unfortunately the Constitution is what the Court makes it. So when you get to be a Justice you can decide what is a serious issue and I will have to take you seriously.
Jack,
each of the other examples you cite is distinguishable. i would think you would have noticed that since Obamacare is a Republican idea, there might be something wrong with it.
As you know there is a better solution… single payer. Obama care is not “the best we can get”: it is exactly what the bad guys need to prevent us from ever getting single payer. So you will get to do business with organized crime instead, supporting those CEO million dollar paychecks.
Interestingly, there are examples of citizens being required to buy products early in our history: a statute requiring men over 21 to buy rifles and ammunition in case they are required to form a militia (sort of like Switzerland) and another requiring shipowners to buy health insurance to cover their sailors (not unlike modern state statutes requiring employers to have workers compensation insurance).
Arne,
Let’s see here…let’s just keep it small with a nuclear family, mom, dad and two kids, let’s say two girls so the odds of cancer are even lower.
What’s the likelihood that no one in that family will get cancer based on the 1-in-3 and 1-in-2 odds?
It’d be (2/3)*(1/2)*(2/3)*(2/3) = 0.148 or 14.8%. Or, there’s an 85% chance at least one of the family members will get cancer in his/her lifetime.
And we haven’t even factored in cardiovascular disease, diabetes, etc.
Dale, I know that some Americans are opposed to the mandate, but I cannot belief that most of them are opposed from a constitutional standpoint. Most Americans don’t even know whats in the Constitution outside of what they hear on the news. For example, here’s some stats I got off the Bill Maher show one night…The best explanation I can come up with, albeit, rudimentary, is the results of this survey….
Listen to some of these statistics. A majority of Americans cannot name a single branch of government, or explain what the Bill of Rights is. Twenty-four percent could not name the country America fought in the Revolutionary War. More than two-thirds of Americans don’t know what’s in Roe v. Wade; two-thirds don’t know what the Food and Drug Administration does. Nearly half of Americans don’t know that states have two senators. And more than half can’t name their congressman. Did you know only about half of Americans are aware that Judaism is an older religion than Christianity? That’s right. Half of America looks at books called the Old Testament and the New Testament, and cannot figure out which one came first. A Gallup Poll says 18% of us think the sun revolves around the earth.
I made a mistake. The requirement to buy weapons, ammunition and other equipment applied to men, 18-45 (Second Congress. Sess. I. Ch. 33). The insurance for sailors is at Fifth Congress. Sees. II. Ch 77.
Sure Coberly:
The last time a mass of people did not like an outcome which was constitutional, we ended up with the Colfax Massacre of black voters by white voters. Funny how thoe white voters hated black voters and who they voted for in the end.
Your points have little or no foundation supporting your views. You sound no different than a teabagger being led by Rush. What the court decides dos not make it correct and the court has yet to overturn and congessionally legislated tax. If you read the sites I have posted, you can easily see this.
Erwin is the one of the most prominent constitutional expert in the nation today. You would be wise to mark Bev’s words also as her knowledge on constitutional law is not easily surpassed.
Michael
they don’t know what’s in the constitution, but they know what feels like an infringement of their freedom.
and if you say so did integrating the schools, you be right. but some things really are infringements of freedoms that deserve protection.
once more the obama plan is the romney plan. think about it.
and while half of americans have iq’s less than 100, i’d guess that about 18% of americans lie to pollsters.
run
sorry. not a tea partier. maybe what “sounds like” to you is not what “is.”
JackD
if you cite history and particulary previous law, i can’t match you. i would say that courts often find things Constitution that offend the hell out of me… and I don’t mean Brown v Board or Roe v Wade.
I’d be glad if the current Court finds the mandate un-, but I am not expecting it. I don’t have run’s insight into what is “right.”
well, actually, i do. it just isn’t the same as his.
I on the other hand will not be surprised if the court rejects the mandate. This is the most political court in my memory. They are all political to one degree or another but this one is far out, as the kids would say. I too am sometimes offended by their holdings on constitutional issues. Citizens United is a good case in point. So, under a liberal court, was Korematsu v. U.S. holding the wartime internship of the Japanese Americans constitutional.
The math you must go through shows that the article’s numbers are really handwaving with the hope that readers will believe it supports the conclusion.
I don’t have coberly’s problem with the mandate, but lousy argumentation for a good cause is still lousy argumentation.
Tim
I think you are right. And there is also this… the “logic” of the appeal to statistics is flawed. It assumes that illness is purely random and no one has any additional insight into their own likelihood of contracting a particular disease.
This is similar to the argument that “you are more likely to die in an automobile crash than in an airplane crash… mile for mile.
While this is true enough, if I don’t drive drunk or crazy my own “odds”(driving) are better than the “odds” of any person picked at random.
I think those of us near age sixty or over have a pretty good idea whether or not we will get a heart attack, or even cancer, before the age of sixty five.
JackD
sure they are political. and I suspect they will be happy to hand the Republicans the mantle of the Party of PFreedom for the next hundred years, while the Democrats get saddled with “the Mandate,” and the Insurance Companies and Health Care Providers laugh all the way to the bank.
The people can hate the Court all they want… the Court doesn’t have to get re-elected, and folks won’t remember that it was a “Republican” court. And they know it.
Meanwhile Robamneycare will destroy the last chance of getting single payer in this century. Our liberal friends here are all for Robamneycare because they call it Obamacare and think it’s “the best Democrats can do.”
And that is how America is governed.
Just supposing the court were to throw out the Affordable Healthcare Act, are you really suggesting that that would offer a real opportunity for single player? Are you assuming a Democratic Congress and President after the election?
No. there are no real Democrats.
but the health industry cannot survive the way it has been going. it needs the mandate. without the mandate, we will have to have single payer. that might elect some Democrats, but try to remember politicians really do follow the popular voice. they may screw it behind closed doors, but they can’t keep on screwing it if they can’t fool it.
>once more the obama plan is the romney plan. think about it.
right, it’s the only thing DC could vend in 2009, a compromise between the center-right and the center.
And the center — the House version — got lost at the conference.
Everybody wants health insurance. Nobody wants to pay for it. Film at 11.
>forcing people to buy a product in the private market is a serious constitutional issue.
Good thing nobody is forced to do so then. Just pay the penalty tax to go uninsured/underinsured then.
>Obama care is not “the best we can get”
Not through the Pelosi House of 2009, no, but Congress is not Unicameral, eh.
Is the penalty for not getting insurance unconstitutional?
I don’t see how.
along with PPACA is government getting its nose in the tent with the medical loss ratios and putting everyone within 133% of FPL on Medicaid.
Plus the tens of billions of premium support.
Coberly, you’re just all wet on this particular issue.
You hit the nail on the head with ” the health industry can not survive the way it has”. Without this bailout the industry would collaspse. The court will uphold this bill 5-4 and the the Republicians will have supported it private while pointing blame at Democrates. What will be even worse is the way it will be emplemented by a Republican congress. They will ensure it mostly pumps money to the industry while minimizing the public good. The corruption will be of epic proportion.
Good thing nobody is forced to do so then. Just pay the penalty tax to go uninsured/underinsured then.
First off, let’s put to be the fallacy that *only* Teabaggers, Foxnistas and Christian Dominionists are against the private mandate. Many of us would have liked *genuine* healthcare reform and 100% European-style universal coverage, aka “the public option” or “single payer”, which Obama and the Blue Dog Democrats took off the table even without putting up a fight (caving in to insurance company demands, as ususal).
Regardless, to say that being forced to either pay 2.5% of your income as a penalty or buy private insurance (not Medicare-for-all, not single payer, mind you but PRIVATE insurance) is somehow hunky dory and Constitutional is absurd. As coberly has tried pointing out time and time again, a tax for a GOVERNMENT service –Medicare, SS, etc.– is one thing, being forced to buy the equivalent of “cousin Rocko’s insurance” forever or pay a hefty price is something entirely different.
Once again for the slow-to-grasp:
Taxes withheld for Medicare? Perfectly Constitutional
Being forced to buy private policies out of your own pocket from the local insurance mafia or face a stiff fine? Not-so-clear.
Let’s put to bed the fallacy that *only* Teabaggers, Foxnistas and Christian Dominionists are against the private mandate. Many of us would have liked *genuine* healthcare reform and 100% European-style universal coverage, aka “the public option” or “single payer”, which Obama and the Blue Dog Democrats took off the table even without putting up a fight (caving in to insurance company demands, as ususal).
Regardless, to say that being forced to either pay 2.5% of your income as a penalty or buy private insurance (not Medicare-for-all, not single payer, mind you but PRIVATE insurance) is somehow hunky dory and Constitutional is absurd. As coberly has tried pointing out time and time again, a tax for a GOVERNMENT service –Medicare, SS, etc.– is one thing, being forced to buy the equivalent of “cousin Rocko’s insurance” forever or pay a hefty price is something entirely different.
Once again for the slow-to-grasp:
Taxes withheld for Medicare? Perfectly Constitutional
Being forced to buy private policies out of your own pocket from the local insurance mafia or face a stiff fine? Not-so-clear.
Lets’ put to bed the fallacy that *only* Teabaggers, Foxnistas and Christian Dominionists are against the private mandate. Many of us would have liked *genuine* healthcare reform and 100% European-style universal coverage, aka “the public option” or “single payer”, which Obama and the Blue Dog Democrats took off the table even without putting up a fight (caving in to insurance company demands, as ususal).
Regardless, to say that being forced to either pay 2.5% of your income as a penalty or buy private insurance (not Medicare-for-all, not single payer, mind you but PRIVATE insurance) is somehow hunky dory and Constitutional is absurd. As coberly has tried pointing out time and time again, a tax for a GOVERNMENT service –Medicare, SS, etc.– is one thing, being forced to buy the equivalent of “cousin Rocko’s insurance” forever or pay a hefty price is something entirely different.
Once again for the slow-to-grasp:
Taxes withheld for Medicare? Perfectly Constitutional
Being forced to buy private policies out of your own pocket from the local insurance mafia or face a stiff fine? Not-so-clear.
In that case vote Democrats into the Congress.
Tim:
If one were to pick the disease of significance, it would not be heart disease or cancer. Look to Diabetes which impact the young, the middle aged, as well as the elderly. We are fat from eating fast foods, we sit on our asses and do little, and we concentrate on fat and sugar. This gneration born now will not live as long as their parents. Of course this will take care of the Social Security issue.
Harm:
Oh BS. Lets understand one thing here, the hard right and the Blue Dogs killed the chance of universal and single payor with Lieberman single handedly torpedoing Medicare for those in their fifties. Many and nobody faored single payor unless you Harm did it in your mind the same as the Goldwater ploy “In your Mind, you know he is right.”
There was no public out cry even when Kennedy was dying. There was an attitude to settle for whatever they could get and pass in the Senate. JacjD made it pretty clear as to what Congress had legislated in the past (5th Congress legislated that people must have rifles and ammo in hand so as to far a militia.
It clearly was the Repubs, the teabaggers, the Nelsons and the Liebermans who sold the type or mode of insurance we truly need. ACA may not be the best; however, it is a start.
run
sadly, it won’t. the enemies of Soc Sec never rest.
Troy
that is sophistic. on a par with Rodney Kind directing his own beating.
splish splash
Unfortunately, only people in the particular districts and states can do that. In Illinois, we’re doing our part (by and large).
@Arne
I agree that the poll is flawed. Let me quote:
“six out of ten workers (62 percent) think it’s not very or not at all likely they or a family member will be diagnosed with a serious illness like cancer, and more than half (55 percent) said they were not very or not at all likely to be diagnosed with a chronic illness, such as heart disease or diabetes.”
Good Lord! The citizenry is innumerate, yet they are expected to answer a complex question in probability? “You or a family member”. Besides, families come in all sizes. That is a meaningless question. Even if people understood it, it has no single answer.
In addition, they use the phrases, “Likely”, “Very likely”, and others, I am sure. We already know that “likely” elicits wrong answers.
I think many are opposed to a mandate to buy possibly –make that very likely for those who can’t afford good insurance– crap health insurance, especially with that mandate being enforced by Federal muscle in the form of the IRS.
I favored single payer, something like Medicare for All Improved, and I would have no issue with paying for it as people now pay for Medicare. While single payer support was (deliberately) not polled very often, it came in with well over 60% approval numbers. The latest poll I saw was fairly close to the time Obama appeared to be succeeding with attaining passage of his profit protection plan for the Big For-Profit Health Insurers and others in the Big Medical Industry.
The public wanted something like Medicare. Seriously. Obama took it off the table and kept it off no matter what.
Troy
that is sophistic. on a par with Rodney King directing his own beating.
The problem for Obama was that he didn’t have to convince “the public”; he had to convince the Congress. It was not about to buy single payer or Medicare for all. Obama didn’t take it off the table no matter what. There was an attempt to pass Medicare for all and it failed.
JackD:
Correct. There were multiple plans on the table. In each case it was the Nelsons, the Liebermans, the blue dogs, and the repubs who torpedoed each plan. What JohnQPublic favored then and now does not matter. What matters is what tbtf pharma, hospitals, insurance and the AMA wants for us. Each of these groups has significant lobbying taking place in Congress. Congress goes where the money is unless it signs up with Norquist or ALEC.
Troy:
Yes
thanks men for this great opportunity to know what you know! this is a big help!
Affordable Health Plan
Awesome post man thanks for share
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