Missed Opportunities and the Mandate Dilemma

Recently, I had the opportunity to write a post for the esteemed website, Disruptive Women in Health Care.  I shared my concerns about the number of states – Virginia being the most recent – that are moving legislation or introducing constitutional amendments to prevent the federal government from requiring their citizens to acquire health insurance.

The concern here is that erecting barriers – be they legal or political – to prevent an individual health insurance mandate makes essential health reform impossible.  Everyone wants to ensure that every citizen can purchase health insurance regardless of whether they have a pre-existing health condition.  We can’t take that step, though, unless everyone – young and old, high and low healthcare spenders – are in the system. 

If only those with high healthcare costs are in the insurance system, and the healthy low-spenders can hold off on purchasing coverage until they actually need it, then premiums are too high for everyone.

A major problem is that policymakers have done too little to engage in a dialogue with the American people on why a mandate is essential and on the value of having health insurance coverage.  That’s what I discussed in the Disruptive Women piece.  Let’s hope it’s not too late to correct this omission in the health reform process.