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A long-term care insurance scheme, similar in nature to other social insurance systems in Germany (pension, employment and health insurance), was introduced by the German Parliament in 1994. 2 All employees earning less than the social security earnings ceiling (Pflichtversicherungsgrenze) for the German social insurance system (3,937.50 euros per month in 2006) are members of this system. Contributions are paid equally by employers and employees and are calculated from gross income up to a social security contribution ceiling (Beitragsbemessungsgrenze) which is fixed every year. Employees who are not covered by the social insurance system (i.e. civil-servants, self-employed etc.) are usually. | All the President s Mandates Compulsory Health Insurance Is a Government Takeover by Michael F. Cannon No. 114 September 23 2009 Executive Summary The most hazardous health reform measure before Congress is not the so-called public option but proposals to make health insurance compulsory via an individual or employer mandate. Compulsory health insurance could require nearly 100 million Americans to switch to a more expensive health plan and would therefore violate President Barack Obama s pledge to let people keep their current health insurance. In particular the legislation before Congress could eliminate many or all health savings account plans. Making health insurance compulsory would also spark an unnecessary fight over abortion and would enable government to ration care to those with private health insurance. Obama adviser Larry Summers writes that mandates are like public programs financed by benefit taxes meaning that compulsory health insurance would also violate President Obama s promise not to increase taxes on the middle class. Under the House Democrats legislation some middle-income earners would face marginal tax rates over 50 percent before state taxes . The experience in Massachusetts belies the claim that compulsory health insurance brings down health care costs. The shared responsibility ruse allows Massachusetts politicians to declare success for a compulsory health insurance scheme whose actual costs reveal it to be a failure. Massachusetts also demonstrates that compulsory health insurance enables and ultimately requires politicians and government bureaus to control nearly all aspects of health care and medical practice. Rather than make health insurance compulsory Congress should make it more affordable by letting individuals control their earnings and choose their own health plan from any state in the Union. Michael F. Cannon is director of health policy studies at the Cato Institute and coauthor of Healthy Competition What s Holding Back .
