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Keith Olbermann is ready to go to jail over it. Markos Moulitsas is prepared to see the health-care bill die over it. Howard Dean is assaulting the White House over it.
It’s the individual mandate, the source of rare cross-ideological agreement in the health-care debate. The provision to force everyone to buy health insurance long labored in obscurity, overshadowed by the more glamorous and controversial public option. No more.
The death of the public option left the individual mandate exposed. Disappointed liberals now confront in the cold light of day a provision that will, by force of law, make people hand over money — and a lot of it, as a percentage of their total income — to the insurance companies. Should they fail to do so, they face fines that could total billions of dollars a year, or even jail time.
Newt Gingrich once blasted Bob Dole as “the tax collector for the welfare state.” As far as the Left is concerned, the individual mandate will make Barack Obama the tax collector for the insurance-industrial complex.
Outside of the income and payroll taxes and Prohibition, the individual mandate might be the most intrusive peacetime measure ever undertaken by the federal government. It will require people to buy a private good or service as a basic condition of living in the U.S. If the Constitution weren’t all but a dead letter on such questions, there’d be a roiling debate over what authority the federal government has for this coercive extravagance.
We’ll have to settle for a right-left pincer movement against it. The Right hates the governmental fiat and thinks — given the regulations and taxes that add to the cost of insurance — the mandate’s a bad deal. As one wag said of the bill, “First, it transforms insurance into a product that few rational people would buy. Second, it forces them to buy it.”
The Left hates that the insurance companies get the proceeds. Instead of cutting out the dastardly “middle man,” the bill ensures that the middle man scoops up even more customers. In his usual carefully reasoned style, Keith Olbermann thundered against “the legally mandated delivery of the middle class into a kind of Chicago stockyards of insurance.” He vowed to defy it, even if he must become the country’s most famous insurance criminal.
Putting aside its irrational animus for insurance companies, the Left has a point. The insurance industry wouldn’t support the bill absent the individual mandate. In fact, the mandate is all that stands between the companies and a death spiral. By requiring the companies to cover people with pre-existing conditions, the bill creates an incentive for people to drop insurance until they get sick — unless the state forces them to do otherwise.
Howard Dean’s constant refrain now is that the bill isn’t reform. He’s right. It is an incoherent grab bag that doesn’t improve on the current system — it just adds to it. As Yuval Levin of the Ethics and Public Policy Center writes, “What’s left of the bill compels universal participation in a system that everyone agrees is a failure without reforming that system, and even exacerbates its foremost problem — the problem of exploding costs.”
The individual mandate is what barely holds the bill together, and tellingly, invokes the ire of both sides. The Right and independents already hated the bill. With the Left starting to hate it, too, it’s almost unanimous. A new Wall Street Journal/NBC poll found support at 32 percent. How long before some poll finds it in the 20s?
Practically the only people who think passing the bill in its current form is a good idea are Democratic congressmen. Much better to take Dean’s advice and dump it. The Left and Right can continue to battle it out over what constitutes true reform, with the voters ultimately deciding. In the meantime, everyone will be spared a more perverse version of the status quo, prominently featuring the hated individual mandate.