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Peanut butter jelly time

Posted by: Ella Hushagen on Apr 23, 2009

Some things just work best all put together, like a peanut butter jelly sandwich, or the cast of Friends. New polling data published in Health Affairs indicate that an individual mandate requiring everyone to obtain health insurance is like that too: just okay on its own, far more appealing when combined with other reforms.

The polling results show that,

an individual mandate alone is supported by less than half of the population, [while] a shared-responsibility plan that includes this type of requirement is supported by a majority.

What is shared responsibility? It's the sweet spot lawmakers must achieve by balancing responsibilities and costs among consumers, employers, the government, and the health care industry. The researchers at Harvard and MIT who conducted the survey described it this way in their survey:

This proposal would place requirements on individuals, employers, the government, and insurance companies so that everyone shares in the responsibility. Individuals who don't already have insurance would be required to buy it or pay a fine, with financial help from the government for people with lower incomes. Employers would be required to cover their workers, or pay money into a pool that helps people buy insurance. Government health insurance programs would be expanded. Insurance plans would be required to take anyone who applies, even if they have a prior illness.

 Many health policy wonks insist that an individual mandate is the only way to get to universal health coverage, and point to Massachusetts as an example of a state that has successfully used such a requirement. As our representatives on Capitol Hill work to fairly distribute costs and responsibilities among stakeholders, consumer advocates must ensure that

• Low- and middle-income people are protected from high premiums and out-of-pocket costs;

• Consumers are guaranteed a good benefits package, not bare-bones health insurance;

• Effective mechanisms exist to help people get signed up for appropriate coverage, especially people with limited income, limited English, and disabilities or chronic illnesses;

• People can get an exception to the mandate if coverage is unaffordable for them.

Shared responsibility is, indeed, a nebulous concept, and consumer voices are necessary to help create that perfect PB&J.