If Private Health Insurance Companies Are Evil, Why Are You Forcing Me to Be a Customer?

A big part of the final push for this health care reform effort is focused on how terrible the private insurance companies are. On the White House blog, communications director Dan Pfeiffer is attacking the huge premium increases and monopoly power of some private insurers. HCAN is doing a “mass citizens' arrest of the insurance companies.” On the stump, President Obama is hitting the terrible practices of the private insurance corporations hard. From Washington Post:

Obama and his health secretary staged a two-pronged attack Monday in a stern letter to health insurance chief executives and a speech in which the president castigated insurance companies 22 times. "How much higher do premiums have to rise," he demanded, "before we do something about it?"

The messages are part of a strategy that Obama and those around him have begun to employ lately, to ratchet up the pace and the populist appeal of their rhetoric against the health insurance industry. The barbed tone moves far beyond that of the 2008 presidential campaign, when Obama began to say that medical coverage should be accessible and affordable for more Americans.

I agree with the message. I can't decide if I dislike the industry more for its morally reprehensible practices or its bloated, inefficient, and completely unnecessary nature. Attacking the private insurers is smart politics and should have been done months ago.

The big problem is that the messaging is incompatible with pushing for Obama's official health care proposal. That program will use the IRS to force Americans to buy insurance from the same, terrible, private insurance industry everyone is now rallying against.

If the private insurance industry is so evil, why would you ever possibly force me to be their customer?

The messaging would make sense of Obama were pushing for a Medicare-for-all system that would completely marginalize or eliminate the private insurers. It would make sense even if the bill only had a simple public alternative, like a public option or Medicare buy-in. I could understand the message even if the bill had a broad state waiver provision that would allow for states to possibly create single payer plans. I might even except the messaging if Obama was pushing for what Switzerland did by forcing all private health insurance companies to become highly regulated non-profits. It might even be accepting if there were only the new consumer protections but no individual mandate.

The issue is that Obama's health care proposals don't do any of those things. It places a few good, new regulations on the private insurance companies (which will probably see a very spotty record of enforcement because that function is left up to the states), but it will now force you to buy insurance from these same, terrible, private insurance companies Obama is now attacking, or you face a fine.

To me, this sounds like pushing for a bill that would force factory farmers and slaughter houses to treat livestock 15% more humanely, but in exchange, the laws would require every American to buy triple the amount of meat.

If everyone pushing for health care reform is pointing out how awful the private insurance companies are, why is Firedoglake the bad guy for saying it is therefore immoral to force people to be customers of these admittedly terrible companies (especially when health care reform could be done without an IRS-enforced individual mandate to buy private--and only private--insurance)?