Health Mandates: A Talk With Obama Health Advisor David Cutler
“I’d like to start with a general comment,” Cutler began. “Two possible reasons why people don’t have health coverage are usually given. One is that the uninsured are gaming the system. The other is that they can’t afford it and don’t know where to get it. Most of the literature suggests that the explanation is mostly the latter. That means the single biggest thing we can do to help the uninsured is to make coverage affordable and accessible.”
“That’s why all the Democratic plans focus on removing excessive profits where they exist, improving information technology, and so forth,” Cutler continued. “All the plans do those things, although I think the Obama plan does the most.”
“The mandate argument is: You must buy something – but I’m not going to tell you what it is, how much it will cost, or where you’re going to get it.”
“It comes down to this,” said Cutler. “You’ll never get someone to buy something if it’s not affordable and not accessible. People just don’t do it.”
That’s an area where the Edwards campaign has taken the lead. They suggest automatic enrollment whenever an American intersects with the health care system or government services.
“You can enroll them,” Cutler replied, “and then forcibly collect the premiums. That’s one way to solve the problem. But it’s not necessary to do that.”
(I realise this is from a 2007 interview -- and didn't Obama oppose mandated insurance back then? -- anyway):
The actual bill dictates what has to be in the insurance, and gives government authority to control premiums.
I don't think it mandates where we go to "get it", but I know where we are all taking it if it passes.