First of all, it's important that we understand what this "mandate" really is. It is this: starting in 2014, you will be required to obtain health insurance that meets excellent minimum coverage standards if you can find it for 8% of your income or less (or pay a small fine), and people with incomes under 400% of the poverty level, subsidies will be provided on a sliding scale.
Here's the deal about that meme of how the government has never mandated that individuals buy a product from a private company. It's completely, utterly, and provably false. The government does, on a regular basis, mandate the purchase of private products from private companies by the American people. Let's look at a few things that proves this case.
Home and auto insurance:
Your state forces you to buy home insurance if you own a home and auto insurance if you own a car. Who sells you this insurance? Private companies! I know, I know. "But I don't have to own a home," you say. Well, no, you could rent. But if you do rent, your landlord is paying his or her property and home insurance from your rent money. So, you are still being forced to buy property insurance for your landlord, which is mandated by the state. But you don't have to rent either! No, I suppose you could move into your car. But then... yeah.
You also don't have to own a car. In many, many areas of the country, though, it is not an option. Try living in Central Valley, California, without access to a car, for example. Oh but you could move to an area with public transit. How easy! But wait. Let's say you have the means to do so. You move to an area with good public transit. You pay your bus fare. Who made that bus? Not your local government. So now your fare is going to a private company that makes buses and has a contract with your city. What! How dare they force you to buy a product form a private company?
Wait, wait, wait, you ain't gettin' away with it that easily, you counter. You are only required to buy liability insurance for your car, which means it's for the protection of others. Ah ha! Frankly, so is the health insurance mandate. You would be mandated to buy it provided you can afford it so that if and when you get sick or get hit by a car, the rest of us as a society and as a country don't have to foot the bill for it.
Food stamps and food:
Currently, nearly 41 million Americans are getting assistance from the government to buy food in the form of food stamps. Where do people who are on food stamps shop? I haven't noticed a bunch of government run grocery stores or supermarkets springing up in my neighborhood. How about yours? Food stamps are direct subsidies from the government mandated to be spent in the -- you guessed it -- private market, buying food from private companies.
Oh but wait a minute, you say. You don't have to be on food stamps. No, you don't. I suppose you do have that other lucrative option of starving.
But, you say, putting your thinking cap on, you are required to spend only the amount of the government subsidy when it comes to food stamp buying products from private companies. The government doesn't force you to do so with your own money! Right. So where are we buying food without own money these days? At the local "public option" farmer's market? Why aren't we up in arms about how, by not providing a 'public option' for buying food, the government is de facto mandating that we spend money buying products from private entities? Oh, I know. Because of that other lucrative option. You don't have to buy food. You could choose to starve instead.
Couldn't you grow food on your own backyard if you really wanted to? Sure. You've got a backyard? It means you've got a home. So the government is forcing you to buy property insurance now.
Come to think of it, that same argument can be made for all three essentials of life in America: food, shelter and clothing. We are all (except in cases of public housing) forced to buy these things from private entities. There is no "public option" for them. And you do have to buy them, even without a legal mandate. The alternatives, starving, going naked and being homeless are simply not palatable options. Health care, too, is an essential of life. And the way health care is paid for in this country is by health insurance.
Contracts funded by taxes:
There is in fact no greater rebuttal to the idea that the government has never before forced us to buy anything from a private company than the way our tax dollars are spent. A vast amount of tax dollars are spent in federal contracts to private companies. Defense contracts particularly come to mind, but they are not the only ones. Tax dollars dedicated to building highways are spent on private contractors who actually do the building. Public school building projects are likewise handled by private contractors who are paid with our tax money. In FY 2010, the federal government spent $347.5 billion in federal contracts to private corporations. That is our tax dollars going directly to pay private corporations.
Some will hang their hats on the idea that the federal government spending tax dollars on private corporations are not analogous to an individual mandate to purchase health insurance, since the mandate applies to individuals and not the spending of tax money as a whole by a society. That is a preposterous argument, of course. Everyone who can afford to has an individual mandate to pay taxes -- on income, on purchases, on capital gains, on a whole bunch of things -- and it's those tax dollars going to fund these private contractors.
But even if we took that argument to have merit, for those who argue it, intellectual honesty would dictate that they be satisfied with an alternative plan: there would be no individual mandate, but the government would raise taxes to cover the expense of health insurance for everyone, and hand a contract to provide that insurance to one or more private insurance companies. That, according to the logic followed by the ideologues, should really solve the problem. But really, would anyone be happier with that?
This article is not meant to be a knock on the public option in health care reform. I remain a staunch proponent of it. At a recent Facebook chat with Congressman Alan Grayson organized by the group Progress for A More Perfect Union, I asked Congressman Grayson about the status of his Medicare Buy-in proposal and what we could do to help. A public option or a Medicare buy-in is something I remain committed to.
In this piece, I have made the case that opposition to health reform on the basis of having an individual mandate without a public option being an unprecedented idea is simply an inaccurate one. Those perpetuating it are either misinformed, dangerously mistaken, or if none of those, intellectually dishonest.