From Kevin Drum
Under the Edwards plan, when Americans file their income taxes, they would be required to submit a letter from an insurance provider confirming coverage for themselves and their dependents.
If someone did not submit proof of coverage, the Internal Revenue Service would notify a newly established regional or state-based health-care agency [which] would enroll the individual into the lowest cost health-care plan available in that area….The newly covered individual would not only have access to health benefits but would also be responsible for making monthly payments with the help of a tax credit.
….If a person did not meet his or her monthly financial obligation for a set period of time (perhaps a year, perhaps longer) the Edwards plan would empower the federal government to garnish an individual’s wages for purposes of collecting “back premiums with interest and collection costs.”
Oh, yes. Give the IRS more power. Great thinking Johnny. /sarcasm
diane says
I didn’t support Edwards before – in fact, I don’t like him. But this from the self-styled compassionate guy in the race?
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p>No thanks.
greg says
Do you disagree with the idea of the personal mandate or Edward’s proposed enforcement of the mandate? If it’s the personal mandate you disagree with, then I suppose you would have the same negative reaction to Clinton’s health care plan as well as our own system in Massachusetts, backed by Deval Patrick. Do you have the same reaction to mandatory car insurance?
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p>If you disagree with using the IRS for enforcement of the mandate, how would you suggest the mandate be enforced? The IRS is a federal agency that all Americans are supposed to make contact with on an annual basis. That seems to me the perfect agency to provide the enforcement in a cost-effective way. Who do you suggest should provide the enforcement?
marcus-graly says
Universal Single Payer Health Care is what the rest of the developed world uses, giving them lower costs and, in most cases, better care. The only reason that are the leading candidates are coming up with harebrained ideas like this one is because they’re afraid to take on a multi billion dollar parasitic industry with a strong vested interest in perpetuating itself.
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p>Almost everyone has a story of having to fight for months with their insurance company to get payment for the most simple of procedures. That’s how they make their money: by denying care. It’s time to end the fraud and waste the is health insurance, and replace it with something sensible, not force the existing broken system on millions of Americans who cannot afford to pay hundreds of dollars a month for care that they will most likely be denied if they try to actually use it.
joeltpatterson says
but one raw fact is that our Federal Constitution has a strong anti-majority streak in it–the Electoral College and the Senate, for instance. The Senate especially has stymied progress on civil rights bills and healthcare bills, such as the Clinton plan of the 1990s.
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p>One reason Edwards’ plan is better than Hillary’s and way better than Obama’s is Edwards will give people a choice between a private insurer and a public program modeled on Medicare. So, this is not a direct jump to single-payer, but, Marcus, don’t you believe that given a few years of the option of a Medicare-for-all, most Americans would gravitate to a public program?
joeltpatterson says
So, given the power of the insurance lobby, if we can pass Edwards’ plan, then single-payer gets a foot in the door and those private sector companies get the chance to compete and prove whether private health insurance serves people better than a public program.
joeltpatterson says
IIRC, raj, you’ve stated that the German socialized medicine plan makes more sense than the current American system that leaves 37 million people without insurance (therefore susceptible to poverty if they get really sick).
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p>It’s going to take a lot of work to get everybody covered, and this is a fast way to get every child, woman and man into the system. You may hate the IRS, but it’s childish to think a government can exist without some sort of bureaucracy to collect revenue. Edwards has a common sense idea here to make the bureaucracy work toward the goal of getting every American into the system.
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p>BTW, another idea Edwards has supported is giving the IRS a new power: making brokers & investment bankers report income to the IRS the same way employers report wages on a W-2 form. This should get more revenue from people who cheat by lowballing their investment income–and help lower the deficit and pay for things like hospitals, roads, trains, housing, and schools.
progressiveman says
John Edwards and Paul Krugman on this issue…
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p>How do you expect to enforce an individual mandate? Edwards’ plan gives people lots of chances (and subsidies) to get on board before any enforcement. And without enforcement, to Krugman’s wise point, there is no incentive for the young and healthy to get involved driving up costs for everyone else.
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p>Plus the introduction of a single payer choice.
kbusch says
Edwards was responding to Obama and reading Krugman (now on the required list as it no longer takes a special New York Times library card) makes it quite clear.
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p>And what the heck is going on with Obama?
tedf says
I will run the risk fo disagreeing with Raj two times over.
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p>1. First, IRS enforcement and audits over the last decade are way down, due mostly, I think, to demagogery in Congress when the Republicans ruled the roost. We lose billions and billions of dollars that the IRS could recover given a more robust audit and enforcement program. So as a general proposition, I’d say that the IRS needs more power, not less.
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p>2. Also, granted that single-payer is a more efficient option but is not on the table for tawdry political reasons, why isn’t Edwards’s proposal (mandatory and automatic enrollment, with penalties administered in some respect by the tax authorities) better than what we now have in Massachusetts (enrollment required on pain of a tax penalty, but people not actually involuntarily enrolled in plans?)
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p>TedF
amberpaw says
I absolutely disagree with you. You are taking one part of a comprehensive plan out of context. To get the whole plan, go to:
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p>http://johnedwards.com/issues/…
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p>And, Raj, you do receive health care “whether you like it or not”, right?
stomv says
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p>Does “regional or state-based” mean public? I don’t mean to seem obtuse, but it isn’t explicit enough for my tastes. Is he proposing a state/regional version of medicare, only neither means nor income tested?
mr-punch says
Supporters of a government-run single payer system (which apparently includes most of us) believe that the IRS should take money from everyone to enroll them in a health insurance plan — and SEND THOSE WHO DON’T PAY UP TO JAIL. So it’s hard to see how we can possibly object to Edwards’s proposal, which is indeed mild and flexible by comparison.
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p>Pending the withering away of the state, I’m afraid that the power of the IRS is the bedrock of progressivism.
sabutai says
This is a remarkable way to:
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p>1> Get public money to enforce a private industry’s model
2> Get private information about health and medicine
3> Have the IRS collect moneys according to a private industry’s whims
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p>This pro-business trampling of personal freedom is downright Republican.
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p>Looks like it’s either Dodd or Richardson for me.
greg says
It is proof that you have insurance from some provider, not necessarily a private industry provider. It many cases it will be a public provider like Medicare.
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p>How else do you propose enforcing the mandate?
sabutai says
If the government is going to go into the health business, do it all the way — an expanded public health system accessible to citizens and landed immigrants. This service would be funded through tax dollars.
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p>This is forcing people to patronize private businesses, because Medicaid wouldn’t be able to handle this large an increase suddenly. Edwards is trying to get to say that people will be covered under his plan, without actually making the changes necessary for a true national health care system.
greg says
Edwards plan would greatly expand the role of Medicare-like health care plans and have them competing directly with private insurers. Because private insurers will be incapable of competing successfully with public insurance, many believe (myself included) most would opt for the public program, and the whole system would evolve towards a single-payer Medicare-for-all system.
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p>I agree with the single-payer system you propose, and John Edward’s plan seems to be the most realistic step in that direction.
sabutai says
I lived in a single-payer country for 6 years, so I’m in no hurry to see it here. As for the idea that a more strongly funded Medicaid will beat all comers, I’d say that’s not as guaranteed as you imply. There are plenty of cases where the public sector bests the private, and plenty of cases where it doesn’t. I’m not willing to bet the chunk of my income that Edwards wants to take from me that he’s right on this one.
raj says
The issue isn’t whether everyone should be insured. The issue is–as I have made it clear through numerous comments over the last year–is how to provide insurance (or some reimbursement plan) for those who cannot otherwise afford the level premium regime that currently reigns in the US. I seriously do not understand why people here cannot–apparently–distinguish between the two issues. I have given you an example that I am familiar with–that in Germany. There are other examples that I am not familiar with (UK, France and Canada, for example), and that’s why I haven’t mentioned them.
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p>Why in heck would Edwards want to use one of the most feared agencies in the US–the IRS–to enforce a level premium mandate, even against those who might not be able to afford it? That is about as dumb as using the Treasury Department’s paramilitary operation–the BATF–to enforce federal firearms laws. Oh, yes (strikes hand to forehead) that’s what happened at Waco in Feb 1993.
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p>…why isn’t Edwards’s proposal (mandatory and automatic enrollment, with penalties administered in some respect by the tax authorities) better than what we now have in Massachusetts
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p>I suppose that if people can afford the automatic enrollment it would be fine. In point of fact, there is something similar to automatic enrollment in Germany (see above) but the “premiums” are not level; they are similar to the American Social Security tax: the employer automatically pays the relevant sickness fund the employee’s and employer’s contribution, both of which are based on income and (this is the important thing) their equivalent of the IRS (das Finanzamt) does not come hounding the employee. That last is the important issue.
centralmassdad says
Taxing authorities are likely the only ones in our government’s beauracracy that have the infrastructure to do this in anything like a cost-effecient manner. Otherwise, there is much wheel invention to be done. I agree that empowering the IRS is politically toxic, but perhaps it is less politically toxic than Harry and Louise have proved to be.
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p>I suppose that it could be argued that the proposal gets everyone into the risk market and subjects private carriers to competition. It therefore could be an opportunity for those of us who are skeptical that the government can assume the role of insurance carrier in an effective manner to be wrong, while preserving a safe haven for us in the event that we are proven right.
will says
If you want universal healthcare, you have to spoonfeed it somehow. If you don’t like the IRS taking attendance, then how do you want it done?
raj says
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p>What else would you give the IRS the power to enforce, that that apparently does not relate to taxation? It is bad enough that the IRS has access to all of your financial records for purposes of taxation enforcement, but unless you are going to bite the bullet and admit that the health care mandate is a form of taxation and adjust the mandate accordingly, it is completely inappropriate for the IRS to have any power of the issue
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p>Taxing authorities are likely the only ones in our government’s beauracracy that have the infrastructure to do this in anything like a cost-effecient manner.
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p>Not exactly. As was mentioned above, IRS audits are down. Is there any reason to believe that empowering the IRS to enforce this mandate would lead to much of anything, except window-dressing for those who know better, and fear among those who do not? Or among those that are being paid “under the table” and do not file income tax returns. One problem, though, is that–as my contracts professor told us 35 years ago–you can’t get blood out of a turnip. So, if the IRS starts enforcing the mandate on a bunch of turnips, it will discover that eventually there will be no blood. What then? Force the turnips to leave the country, even if they are citizens?
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p>I suppose that it could be argued that the proposal gets everyone into the risk market and subjects private carriers to competition.
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p>Hardly. It provides a revenue floor for private carriers. That is true of virtually every government mandate.
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p>It therefore could be an opportunity for those of us who are skeptical that the government can assume the role of insurance carrier in an effective manner to be wrong, while preserving a safe haven for us in the event that we are proven right.
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p>Actually, your last is wrong. See above regarding not filing income tax returns. The Edwards proposal would only effect those who actually file income tax returns. I know that there is a penalty for failing to file, but if people are paid “unterm Tisch” there isn’t a lot of likelihood that they’ll be caught, is there?
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p>Note to Will: I have given you an example as to how another country has done it for well over a century. If you wish to not learn from how others have done it, that’s your option. The problem that you have is that the American system of providers and payers has become so bastardized and gerry-rigged that shortly you aren’t going to have any options.
will says
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p>You have not given me any example. If this is something you wrote in a previous diary, link to it.
raj says
…do a search on my many comments here regarding the German health care financing system. I apologize for the fact that I don’t save every URL for every comment that I enter here. If I did, my hard drive would be full. BTW, I do lots of comments, but not very many posts (what you call “diaries”).
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p>Do your homework. If you are suffiently uncurrious to do your homework, don’t bother letting me know.
greg says
You are the one criticizing Edward’s health care plan. You are the one criticizing his proposal for enforcing the mandate. If you think there’s a superior alternative, the burden of proof is on you to describe it. I’m not about to wade through your admittedly many comments to find the ones where you talk about the German health care system, just to piece together the evidence for the argument you posted.
raj says
…I have made my points here on this web site over the last year. I am not going to repeat them. Don’t consider yourself worth my time of me repeating them or citing them for you.
will says
No one else on this site presents the conceited viewpoint that others should be willing to search their comment history so as to be aware of all past comments they have made in the context of a current discussion.
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p>I do not really think you hold that viewpoint. I think you are just desperate to always sound smarter than others and always have a snappy putdown, and you will say anything to that end, even when it destroys any respect others have for you.
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p>Or you could just be that conceited. It’s a loser’s game either way.
raj says
…If you are sufficiently incurious to do website searches, it isn’t my problem. I’m not going to waste time to recreate my earlier comments that were posted here.
pitt-the-younger says
Get used to it Raj. How do think the individual mandate in Mass. is going to work and be enforced? Pretty much just as the senator lays out in “his” plan.
bolson says
It’s not a personal mandate, it’s a guaranteed revenue stream for the insurance industry. This is the worst thing since cities someone decided that eminent domain was a good idea for building stadiums and shopping malls and other developments that profit a few and aren’t actually in the public good like it’s supposed to be.
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p>Yeah, Edwards has the gov’t option health care provider, but until that’s a shiny superior option and not just the lowest cost catch all, I won’t buy it.
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p>I refuse to be satisfied with the surrender politics that says getting something passed is always better. I think all of these insurance industry coddling plans are more harm than good and should be mercilessly beaten back until we can get something actually good.
jconway says
Much like the state has no power to mandate individuals sexuality, morality, it also should not have the power to mandate their personal financial choices.
joeltpatterson says
Go on. I’m sure the IRS would love to hear your arguments about mandating “personal financial choices.”
raj says
…putative “independent contractors” do not interact with the IRS at all.
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p>BTW, just to remind you, indpendent contractors are supposed to pay taxes quarterly. The returns are filed in April.
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p>Another of my little stories. We have lost track of them, but several years ago we were in contact with an elderly German couple. He was a pensioner of the German government, and at one point he was the German ambassador to Nato. They owned an elegant home in northern Italy, Suedtirol, specifically Oberbozen (Suprabolzno? I don’t do Italian). They placed the home on the market. Most of the sale price went to accounts in the Cayman Islands, less than one tenth was reported to the Italian government. As has been relayed to me by more than a few people, das Finanzamt braucht nicht zu wissen–the government taxing authority doesn’t need to know. That was the couple who told us that Italy was poor, but the Italian people were rich.
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p>There’s another little story. When we went to that little section of Italy, we would stay at an excellent little hostelry. Once, we wamted to pay by credit card. Of course that would leave a record for the Finanzamt. We quickly learned the game, and brought lots of cash (if you would have considered 2000Lira a lot of cash for a week, including room and board). The hotel manager was pleased that we had learned the game (das Finanzamt braught nicht zu wissen) but she complained that the Finanzamt would tax them on the number of chairs in their dining room. It was hilarious. The Finanzamt is going to get their money, one way or another.
jconway says
There are compelling arguments that the federal income tax is unconstitutional, was never ratified, and that individuals do not have to pay them.
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p>On the other hand as Thomas Hobbes once pointed out if the government has the monopoly on the legitimate use of force and the individual violates his duties to the state then the state will use that force against it as that poor elderly couple in NH found out, or the people at Ruby Ridge and Waco.
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p>That said there is also another difference. The only person whose best interest it is arguably to purchase health insurance is me the individual, yet its in the interest of the state, my neighbors, and my community at large that I pay taxes. So the government has a more legitimate reason to use force to enforce its tax policy (by the way it only clamps down on the little guy, CEOs and Senators get away with tax evasion all the time) than to mandate that I get health insurance.
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p>Using that logic we should mandate that people stop smoking and make McDonalds illegal. This plan is the worst of both worlds not only is the government not covering me or providing me with a choice of public and private options, it is forcing me to pick a private option that is expensive for what it offers in terms of coverage. So in the end we do get government mandated health care except its poor quality and expensive but you definitely have no choice. I say this was a smart move by Romney whos distanced himself from his plan to entrap Democrats into endorsing it.
david says
There are compelling arguments that the federal income tax is unconstitutional, was never ratified, and that individuals do not have to pay them.
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p>Utter bullshit. Don’t be fooled, please. There are numerous websites debunking this “tax protester” nonsense; this one is pretty good.
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p>This too is wrong (as well as ungrammatical):
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p>The only person whose best interest it is arguably to purchase health insurance is me the individual
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p>The whole point of individual mandates is pooling risk. That’s how insurance works — you have to get the healthy people into the risk pool to make the economics work out. So it’s in lots of people’s “best interests” for you to be forced to buy health insurance that you don’t want. I don’t like the individual mandate, but there actually is a principled argument that it’s necessary in order for a non-single-payer system to work. Don’t ignore it.
greg says
First, you misrepresented Edward’s plan. It doesn’t include an option for a “gov’t health care provider”, it includes an option for a gov’t health insurance provider. That is a HUGE difference, so you need to exercise more caution when describing it.
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p>As for gov’t health insurance providers, your “shiny, superior option” is already available. It provides superior insurance to most private health care plans and costs much less. Edward’s plan would expand the role of Medicare-type publicly-funded insurance providers.
raj says
it includes an option for a gov’t health insurance provider.
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p>It includes an option to assign the individual to what basically sounds like a shared pool assigned risk private insurance plan.
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p>I’ll give you an analogy. If you have a mortgage, and if you do not maintain property insurance, the mortgagee (the bank) will acquire property insurance merely to protect itself. Similar to the assigned risk auto insurance plan: they’ll get you insurance, but you will pay through the proverbial nose.
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p>That is what the Edwards plan sounds like. The problem is that the “assigned risk” plans are much more expensive than other plans.
will-seer says
Isn’t Edwards’ plan just the Massachusetts health plan with enforcement by the Internal Revenue Service rather than Massachusetts Department of Revenue? Somebody gotta do the dirty work if you want health insurance. Otherwise, line up for the free lunch!
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p>And, I’d rather deal with the IRS any day. They’re professional and try to resolve the problem rather than just take the money. The only way to resolve something with DOR is to move out of state.
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p>(Psst! There is no free lunch.)
melanie says
program then I have absolutely no problem with this.
lasthorseman says
will bring out the fact that most of his career has involved sucking up to and cavorting with globalist oriented organizations which makes his attempt to portray himself as a champion of the common man the ultimate hypocrisy.
greg says
I have no idea what a “globalist oriented organization” is. Amnesty International, the UN, the WTO, and Walmart are all very different organizations that could be said to have “globalist” orientation.
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p>Moreover, it’s only arguably “hypocrisy” if he is currently promoting organizations that are against the interest of the common man while portraying himself as their champion. If he supported those organizations in the past and has since renounced those views, then that is not hypocrisy, that is changing his mind.
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p>Now we can debate about whether his change in mind is genuine — I happen to think it is — but it’s nothing that can be defined as hypocrisy.