Howard Dean is just wrong on the Insurance Mandate

Howard Dean has been making the rounds on the news circuit claiming that the Supreme Court should throw out the individual mandate but keep the rest of the law.

Here is the problem. If you keep every other part of the law but toss out the mandate, it cannot work. In order to understand the rest of this post you need to understand the concept of anti selection. If that link is too long for you to read, the simple explanation is this. If there is no reason for an individual to buy insurance when well, people will just wait to buy insurance until they are sick. This would mean that the only people buying insurance would be those making claims and insurance companies would become no more than really expensive discount plans. It would ultimately drive insurance companies out of business, leaving more people uninsured.

Now, the insurance companies previously compensated for this possibility with the preexisting condition clause. It basically protected the insurance companies from people who would just wait until they were sick to buy insurance. Now, these clauses were misused and abused by insurance companies. That is one of the reasons they were eliminated in the healthcare law. However, there needed to be a way to counter anti selection and the way to accomplish this was the individual mandate. With a mandate, people cannot practice anti selection because they are required to have insurance.

Since Former Governor Dean supports the elimination of preexisting condition clauses (because he wants the rest of the law intact), supports the elimination of the mandate, and has not provided us with another way to avoid anti selection, he has proven himself to not understand the issue enough and really should just be ignored on this issue. (And that is pretty sad seeing his background in Medicine, he really should understand this issue much better).

Now, Former Governor Dean is welcome to present another way to prevent anti selection that would be more popular than a mandate and incapable of being abused by insurance companies. If he presents a valid way to do so, we could replace the mandate with his way. However, if the mandate is ruled unconstitutional while keeping the rest of the law intact, until that alternative way is found we will have anti selection and that would just be very bad.

I know Dean wants single payer, but win the argument by convincing enough people that single payer is the right way to go. Don’t completely break the system harming many in the short term.

And you know the worst part of all of Dean’s ranting about this is? He doesn’t even give a legal reason WHY the mandate should be overturned. He just wants it to be. (And that likely because is that there is no legal reason why it should be overturned. It is an amendment to the tax code. Congress has the authority to change the tax code).


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