Go ahead, get rid of the individual mandate

If the courts or the Republicans in Congress gut healthcare reform, there may only be one way forward: Single payer

Published February 4, 2011 10:06PM (EST)

President Barack Obama speaks at Rec Hall on the Penn State University campus  in State College, Pa., Thursday, Feb. 3, 2011. (AP Photo/Carolyn Kaster) (AP)
President Barack Obama speaks at Rec Hall on the Penn State University campus in State College, Pa., Thursday, Feb. 3, 2011. (AP Photo/Carolyn Kaster) (AP)

This originally appeared at  Robert Reich's blog

The Republican vote to repeal the new healthcare law is purely symbolic. But there's one provision of the law that Republicans are likely to try to defund, and they may have the public with them on this. It's the so-called individual mandate -- the requirement that everyone purchase health insurance, or pay a fine. According to a recent poll, 60 percent of the public opposes it. They just don't like the idea of government telling them they have to buy something.

The mandate is also particularly vulnerable to legal challenge. So far, two federal judges, one in Virginia and another in Florida, have struck it down. They say the federal government has no more constitutional authority requiring citizens to buy insurance than requiring them to buy and consume broccoli, or asparagus. The Florida judge referred to broccoli; the Virginia judge to asparagus.

Yet the new system can't work without the individual mandate. Only if everyone buys insurance can insurers afford to cover people with preexisting conditions, or pay the costs of catastrophic diseases.

The curious thing is that Americans don't mind individual mandates when they come in the form of payroll taxes to buy mandatory public insurance. In fact, that's the system we call Social Security and Medicare, and both are so popular politicians dare not touch them.

And no federal judge has struck down Social Security or Medicare as being unconstitutional requirements that Americans buy something.

Social Security and Medicare aren't broccoli or asparagus. They're as American as hot dogs and apple pie.

So if the individual mandate to buy private health insurance gets struck down by the Supreme Court or killed off by Congress, I'd recommend President Obama immediately propose what he should have proposed in the beginning -- universal healthcare based on Medicare for all, financed by payroll taxes.


By Robert Reich

Robert B. Reich is Chancellor's Professor of Public Policy at the University of California at Berkeley and Senior Fellow at the Blum Center for Developing Economies. He served as Secretary of Labor in the Clinton administration, for which Time Magazine named him one of the ten most effective cabinet secretaries of the twentieth century. He has written 15 books, including the best sellers "Aftershock", "The Work of Nations," and"Beyond Outrage," and, his most recent, "The Common Good." He is also a founding editor of the American Prospect magazine, chairman of Common Cause, a member of the American Academy of Arts and Sciences, and co-creator of the award-winning documentary, "Inequality For All." He's also co-creator of the Netflix original documentary "Saving Capitalism."

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