A health mandate is no remedy

Re “A mandate isn’t mandatory,” Opinion, Feb. 26

Jacob S. Hacker’s defense of the healthcare mandate fails to convince this voter. At both the individual and the employer level, Massachusetts is having great difficulty trying to put the mandate into operation. Businesses large and small resent taking the hit for rising costs while insurers coast on their profits.

Mandate implementation requires the addition of costly administrative layers, to say nothing of the compliance police.

The Lewin Group analysts, cited by Hacker, compared the projected costs of healthcare reform options and stated clearly that only a single-payer plan would save trillions and allow for cost control. Moreover, a taxpayer-funded system will be easy to initiate and oversee.

So we are left with the political feasibility argument. This country is facing a recession. Our leaders must move beyond feasibility foolishness and opt for fiscal common sense.

Harriette Seiler

Louisville, Ky.

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Hacker boasts that he influenced the healthcare policies of both Democratic Party candidates. Instead, he should be embarrassed.

What he has crafted is a confusing hybrid that seeks to serve two masters: those who idolize the invisible hand of the market that is choking patients, and those who want real reform.

The main difference between Sens. Hillary Rodham Clinton and Barack Obama is over who should be mandated to buy insurance, the scheme that helped sink Gov. Arnold Schwarzenegger’s California proposal and that is rapidly collapsing in Massachusetts.

The individual mandate is a scam that only a policy wonk could love. Ordinary people are tired of enriching the insurance companies while the same companies continue to price gouge and deny needed medical care.

Hacker’s mystical belief that an underfunded public plan can compete with the multibillion-dollar insurance industry is also a hoax. And it betrays public demand for a genuine solution, such as an expanded Medicare for all that is the only way to solve our healthcare crisis.

Rose Ann DeMoro

Executive Director

California Nurses Assn.

Oakland

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Hacker has a notion that a key benefit of Clinton’s and Obama’s healthcare proposals is “their pledge of allowing public insurance to compete with private insurance to hold down costs.” This does not exactly square with common sense. Medicare and Medicaid “compete” with private insurance by reimbursing providers below cost, shifting a hidden tax that increases private insurance premiums by 12%. Allowing the government, which has the powers of taxation and regulation, to compete with insurers that must compete for capital will create a death spiral as the bureaucracy tilts the playing field in its own favor, driving up taxes and insurance premiums even more. Eventually, Americans will become dependent on government for healthcare. Providers will be unable to cover their overheads, and the U.S. will suffer the same lack of investment in medical infrastructure and technology now all too evident in Canada.

John R. Graham

Director

Health Care Studies

Pacific Research Institute

San Francisco