Tuesday, October 01, 2013

Could Congress cover "pre-existing conditions": out of public funds to end the individual mandate? (Negotiation under duress?)

Okay, with the mess going on this morning. It’s High Noon (like the movie) and the shutdown is real (or maybe “reel”).  
One thing that is so dangerous is that it is perfectly legal for Congress to package unrelated items together in bills, and hold one constituency hostage to the “needs” of another.  Maybe this is a reflection of the way the patriarchal leadership of many families behave.  Transposed to the individualistic world, it sounds like hostage-taking, forcing one person to make sacrifices for the unrelated needs of another.  In the world outside of politics, it is crime, it is even terrorism.
So the hardliners in the GOP “Tea Party” say they will do anything “legal” according to Congressional rules to protect some individuals from the side effects of “Obamacare”, including job loss, reduced hours to part time, or mandatory premiums they cannot afford.  The sacrifice, them, shifts right now to many federal workers and veterans.  (It looks like military pay has been restored).  If a debt ceiling crash occurs, the “sacrifice” could move to seniors, in some scenarios.  (Boehner calls this “fairness for the American people” – everyone takes his turn with sacrifice, like it was a military draft.) This sounds like a form of combat. This sounds like a breakdown of civilized living, even if somehow it is technically legal. It is a lot like bullying.
I can do a particular thought experiment.  Suppose that there had been a rider on the appropriation gutting Section 230 of the 1996 Telecommunications Act, a downstream liability provision that makes much of the open communication on the web possible, as I’ve discussed on my main blog.  (Actually, a lot of state attorneys general want something like this to happen.)  Or suppose there was rider requiring everyone publishing in “everyone” mode online to have liability insurance (sounds a bit like an extension of mandatory insurance in Obamacare, doesn’t it), or requiring property companies to cover liability (hint, the experience with reputation damage, cyber bullying and revenge porn would be an incentive).  There was a little bit of talk about this in 2008, and it may be that the financial crisis then distracted everyone enough to stop that talk.   I guess the “Tea Party” intransigence, with respect to such a proposal, would be protecting “my” free speech. What if this controversy carried to the debt ceiling debate?  Then I would be pitting my own “self-expression” against my own income and financial stability.
I guess thought experiments are dangerous, they give legislators ideas.  But Congress seems to have run out of them. 

I would like to ask the GOP: suppose someone in your family has juvenile diabetes, probably genetic.  You don’t have employer insurance.  You can’t get private insurance without enormous premiums.   So, whose responsibility is it?  The rest of your family?  Or should others without the genetic disability pay a little more so your child gets care at the same rate – the “public” solution.  It seems that this kind of question only gets harder as there is more that medicine can do about life-threatening diseases – but the luckier always wind up paying for the less fortunate.  Should this be mandatory?  How should this happen?  Most western countries do make this risk a public responsibility. Under “Obamacare” your child gets covered for the same price and gets the care she needs. Obamacare is insuring you a bit against bad luck.  Of course, there are other areas where behavior matters.  The vdieo below does indeed talk about "anti-selection". 
The GOP says that it’s “unfair” for employers to get a year’s break but individuals don’t.  Maybe what Congress can do is indeed postpone the individual mandate for a year, and pay for the premium support for pre-existing conditions out of public funds. That adds to the deficit. In the short term, that’s the best solution I can think of.  So think about “this” thought experiment. But, oh, I’m negotiating with legislative “terrorists”. 
Again, how can fewer than 90 House members control what the House will sign off on.  No one has explained this.


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