I think Marcy Wheeler makes the single most compelling argument here about the precedent of a private health insurance mandate:

And for those who promise we’ll go back and fix this later, once we achieve universal health care, understand what will have happened in the meantime. The idea, of course, is to establish some means to get people single payer coverage (before Lieberman, this would have been through a public option or Medicare buy-in) and, over time, expand it.

In fact, this bill will move toward single payer, too–though not the kind we want. For the large number of people who live in a place where there is limited competition, this bill will require them to get health care through the oligopoly or monopoly provider. It’ll work great for the provider: they will be able to dictate rates. But the Senate bill allows these blossoming single payer providers to keep up to 25% of the benefit in profits and marketing costs, and pass little of that benefit onto citizens. If we make private corporations our single payer, how are we going to convince them to cede control when we ask them to let the government be the single payer?

The reason this matters, though, is the power it gives the health care corporations. We can’t ditch Halliburton or Blackwater because they have become the sole primary contractor providing precisely the services they do. And so, like it or not, we’re dependent on them. And if we were to try to exercise oversight over them, we’d ultimately face the reality that we have no leverage over them, so we’d have to accept whatever they chose to provide. This bill gives the health care industry the leverage we’ve already given Halliburton and Blackwater.

It’s the 9.8% tithe that bothers me the most. But for those who think we can fix it, consider this, too. If the Senate bill passes, in its current form, it will mean that the health care industry was able to dictate–through their Senators Joe Lieberman and Ben Nelson–what they wanted the US Congress to do. They will have succeeded in dictating the precise terms of legislation.

Now, that’s not the first time that has happened. It certainly happened on telecom immunity. It certainly has happened, repeatedly, on Defense contracting (see also Randy Cunningham). But none of these egregious instances of corporations dictating legislation included a tithe–the requirement that citizens pay corporations to provide their service, rather than allowing the government to contract the service.

This is a fundamentally different relationship we’re talking about–one that gives corporations vast new powers. And the fact that–with one temper tantrum from Joe Lieberman–the corporations were able to dictate the terms of this new relationship deeply troubles me.

When this passes, it will become clear that Congress is no longer the sovereign of this nation. Rather, the corporations dictating the laws will be.

I understand the temptation to offer 30 million people health care. What I don’t understand is the nonchalance with which we’re about to fundamentally shift the relationships of governance in doing so.

We’ve seen our Constitution and means of government under attack in the last 8 years. This does so in a different–but every bit as significant way. We don’t mandate tithing corporations in this country–at least not yet. And it troubles me that so many Democrats are rushing to do so, without considering the logical consequences.