More than 80 clinicians and health policy experts have signed a statement noting the importance of health reform, noting the similarity across Democratic health reform plans, and noting the ways that one issue—the individual mandate—has taken on undue prominence in the presidential and health policy debate. Several of us associated with RBC are signatories.
A money quote about mandates and coverage.
The necessary outreach will not be easy, and it will be fruitless unless health insurance is made affordable and accessible to all. Some believe that an individual mandate to buy health insurance should be part of this effort; others hold that a mandate would be paternalistic or too onerous for families at the margins of affordability. Regardless of our feelings on this issue, what is clear from the evidence is that mandates alone, without strong incentives to comply and harsh punishments for violation, will have little impact on the number of uninsured Americans.1 Indeed, as the Massachusetts experience illustrates, non-compliance with mandates is a large problem, absent harsh sanctions. There is simply no factual basis for the assertion that an individual mandate, by itself, would result in coverage for 15 million more Americans than would robust efforts to make health care more affordable and accessible.
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