Without a mandate for everyone to carry insurance, we have one industry footing the bill for what should really be paid by the government.
Instead, the indigent have insurance (in theory), and they can get healthcare other than at the emergency room, hopefully at lower cost.
The alternative is to end the mandate for hospitals to treat everyone.
Prior to 1986, hospitals were not required to treat the uninsured, but most nonprofit hospitals did anyway.[1] For-profit hospitals tried to dump them on nonprofit and charity institutions. The 1986 law makes all hospitals that take any Federal funding treat uninsured people with emergency conditions.
[1] https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_an...
> ... "if the bill remains what it is now, I will not be able to support a cloture motion before final passage." In other words, Lieberman will support a filibuster. "I can't see a way in which I could vote for cloture on any bill that contained a creation of a government-operated-run insurance company," Lieberman said.
[0] http://www.slate.com/articles/news_and_politics/prescription...
As an aside, I agree that Medicare expansion would have been a better policy. Good luck getting that through congress, though.
Because you do get fined for not buying health insurance.
We can argue the semantics of the word 'mandate' all day, but your analogy is upside down.
You are being fined for not paying mortgage interest. You are being fined for each kid you don't have. Buy your house and have your kids or you will continue paying more in taxes!
Person B -- the renter -- will pay more income tax, because Person B does not get to deduct mortgage interest while Person A does.
In much the same way, if Person A carries insurance all year and Person B doesn't, Person B will pay more income tax.
So yes, you do get "fined" for not buying a house. We just spin it as "encouraging the dream of home ownership" instead of as a "fine", a "penalty", as "the government holding a gun to your head and forcing you to buy a house", etc.
How would a renter feel if their rent increased because their landlord was unable to take a mortgage deduction?
I countered that the home mortgage interest deduction doesn't apply to rental properties. Renters and homeowners are thus currently unequal from a tax standpoint, since renters effectively pay a higher tax rate than homeowners. Removing the deduction would thus not create a new inequality; it would remedy an existing one.
If I choose to live rent-free in my parents' basement, I will not get fined for doing so. I keep ALL of my cash. But I'll STILL get fined for having not buying myself insurance.
I'm not sure what logical fallacy you're throwing here, some form of "Denying the antecedent" or something along those lines, but it's not the same situation.
Why people insist the two cases are conceptually different (i.e., that one and only one of them is a "fine" for not doing the thing), I do not know.
I don't mean this as a rhetorical question, so I apologize if it comes across as snide, but from the point of view of economics, what is the difference? I'm trying to understand why one kind of tax incentive is objectionable and not the other.
If I have $1000 in my pocket right now, I will still have $1000 in my pocket if I choose not to go after an incentive.
But if I have $1000 in my pocket right now, I will not have $1000 in my pocket even if I choose not to buy any health insurance.
In my eyes, being punished for peacefully doing absolutely nothing is as anti-American as it comes. That's another argument, but my point is that the analogy is off the mark.
There is a tax penalty for not having a home mortgage, so it's mandatory in exactly the same sense that health insurance under the ACA is.
You have to spend money on interest to have a portion of that reduced in taxes. It's not a penalty.
It's not a 'tax penalty'. You're keeping more of your money by not paying interest, and pay normal taxes on those. It's not a penalty.
That's really bizarre (although unfortunately, common) thinking.
There's an incentive for having a home mortgage under certain conditions only, and you do not owe anyone additional money if you have no outstanding mortgages on properties.
The same is not true for the ACA. You are fined for not owning something - e.g. if your net worth was $0, you could go into the negative for not having insurance.
If you don't own a mortgage, you cannot be fined into the negative.
There is no difference between a tax penalty and a tax incentive (more precisely, a tax incentive is exactly identical to a general tax cut plus a tax penalty for everyone who doesn't qualify for the incentive, and a tax penalty is equivalent to a general tax increase plus a tax incentive for everyone not subject to the penalty; so, except as concerns the general level of taxation, penalties are exactly the same as incentives.)
> If you don't own a mortgage, you cannot be fined into the negative
Since having a mortgage or not can make the difference between owing net income taxes or not, if you have $0 net worth before a particular year's taxes are considered, you absolutely can be "fined into the negative" for not paying interest on a mortgage (lenders, not borrowers, own mortgages.)
The healthcare mandate is a tax. What many people object to here is that most taxes tax an activity (making money, buying things, owning things, etc.), such that one does not HAVE to do any of those things, but if one CHOOSES to, they become subject to the tax. Here on the other-hand they are being TAXED for NOT doing something.
Using your analogy, the healthcare mandate is the same as taxing people for not owning a home.
It is being talked about but there is significant opposition from those that don't want to raises taxes to the level that would be required to finance such a proposal.
Many doctors don't take Medicare. Over a situation where say there are 3 doctors for a specialty in a town... the two better ones do not take it, and the new less good one will take it. So if that flat answer is let everyone take medicare, I think there are some serious quality of care problems.
(I have no better solution though, every angle seems bad).
But continuing with your theoretical environment: no, they would consider adding new patients until they had a critical mass and then stop accepting new patients.
No we wouldn't, we'd be in a much better position and we'd be paying much less for healthcare. Medicare has far less overhead than private insurance and it'd be the logical move to establish a far more effective and cheaper system of socialized medicine.
Except that Medicare more like ACA with a public default option than true single payer.