Congressman Tom Price, M.D.

10/6/2009
A look at the ugly side of mandates

Politico
Rep. Tom Price
October 6, 2009

As a physician, I’ve long known that there are three things that would destroy quality health care in America: the creation of a government-run plan, giving government the power to decide what qualifies as proper medical care and, last, the imposition of mandates. Each of these ideas is being proposed by the president, and each would be remarkably destructive.

Yet it was not that long ago that President Barack Obama also thought an individual mandate was a bad idea. Many forget that before taking office, he was one of the major critics of forcing Americans, under penalty of law, to purchase health care. What has changed?

The arguments against an individual mandate are many: some straightforward, others less obvious and some rooted in basic common sense.

The recent Senate Finance Committee markup process has been extremely revealing about the ugly side of mandates. First, the bill text flatly contradicts the president’s recent assurances that mandates would not result in new taxes. In fact, the legislation clearly states that families would face an excise tax of up to $1,900 should they not meet the government’s requirements. And late last week, it was uncovered that not only would the plan impose a tax, but also one could be jailed for up to a year for disobeying the president’s new vision of health reform.

Back during the campaign, Obama made a strong case against the individual mandate because, as is still the case, it was the most inartful of solutions. The idea is equivalent to ending joblessness by mandating that everyone find work. Surely unemployment imposes a cost on society, just as the uninsured add a hidden cost to health insurance. But no one suggests a work mandate is the solution to achieving full employment. Instead, we labor to create an environment of job growth so that people can lift themselves up to employment.

The same should be the case for solving the challenge of the uninsured. Common sense would dictate that rather than mandating coverage, we must create the circumstances in which coverage may be achieved.

Still, the most dangerous aspect of an individual mandate is perhaps the least discussed. Often overlooked is the fact that a government mandate means that government, not individuals, defines what health care packages should look like. When Washington mandates something, it must first define what it is mandating. Sure enough, the president’s plan provides for the creation of a new federal definition of health coverage.

When the president says, “If you like your health care plan, you can keep it,” he neglects to finish the sentence, as he should, with, “so long as your plan matches a new federal definition of health coverage.”

The result of giving Washington this power is that, in a very real way, many coverage options would no longer be available simply because the government forbids them. For instance, high-deductible catastrophic plans currently owned by millions of Americans would not be allowed. Those Americans whose personal circumstances dictate that health savings accounts or flexible savings accounts are the most appropriate for them would be out of luck. HSAs, FSAs, catastrophic plans, cafeteria plans, all would not only no longer be available; they’d also be illegal, because they wouldn’t conform to the government definition of a qualified health plan.

This takes us to the root of the flawed approach being taken by Democrats. Rather than empowering individuals to control the system, control is being handed to Washington. No longer are individuals provided the basic freedom and right to make coverage decisions that are best for their families.

There is a positive solution, however, to achieving the full coverage we seek without mandates. Working with fellow members of the Republican Study Committee, I have introduced a comprehensive, patient-centered plan: the Empowering Patients First Act (H.R. 3400). By providing financial incentives, giving ownership to patients so they are empowered instead of insurance companies, breaking down costly regulatory burdens, and addressing the liability crisis, our solution gives individuals control of the system and ensures no bureaucrat — from the government or insurance company — gets in between patients and their doctors.

If our Democrat colleagues have been paying attention this summer, they will have heard a few things loud and clear. The American people don’t want Washington choosing their treatments, picking their doctors or deciding what their health plans look like. The only thing that should be mandated this year is that patients be in charge.

Politico