While the White House publicly eschewed any concrete “guiding principles,” the People Who Mattered, it appeared, had already long ago settled on theirs. Those principles seem to have been: no single-payer system, no meaningful public option, no meaningful employer mandates and a very meaningful mandate for individual consumers. In other words, the only major reform with teeth would be the one forcing everyone to buy some form of private insurance, no matter how crappy, or suffer a tax penalty. If the public option is the sine qua non for progressives, then the “individual mandate” is the counterpart must-have requirement for the insurance industry.
“That was their major policy ‘ask,’ and it looks like they’re going to get it,” says Dr. Steffie Woolhandler, a Boston physician who is a prominent single-payer advocate…
If things go the way it looks like they will, health care reform will simply force great numbers of new people to buy or keep insurance of a type that has already been proved not to work. “The IRS and the government will force people to buy a defective product,” says Woolhandler. “We know it’s defective because three-quarters of all people who file for bankruptcy because of medical reasons have insurance when they get sick — and they’re bankrupted anyway.”
Sick and Wrong : Rolling Stone