The Employer Mandate Delay: A Path to Single-Payer
Elizabeth Lee Vliet, MD
The Employer Mandate Delay: A Path to Single-Payer

By Elizabeth Lee Vliet, M.D.,

Obamacare is a hodgepodge of new regulations, requirements, and penalties. The big three are the health insurances exchanges, the individual mandate, and the employer mandate. Only the last is to be delayed by one year.

The employer mandate requires that businesses with more than 50 full time employees must provide health insurance for all employees, and that insurance must meet the new standards set forth in the new law. Businesses that do not comply must pay a financial penalty for each employee, which for large companies can run into the millions of dollars annually.

To understand the reason for this selective enforcement, we must first understand this fact: Barack Obama wants a single-payer healthcare system in the U.S. This is not a secret: In 2003, he said: “I happen to be a proponent of a single payer healthcare system for America, but as all of you know, we may not get there immediately.” In 2007, he said: “But I don’t think we will be able to eliminate employer-based coverage immediately. There is potentially going to be some transition time.”

Single payer is also the admitted goal of many Obama advocates.

In 2009, Rep Jan Schakowsky (D-IL) said:“Next to me was a guy from the insurance company who then argued against the public option. He said it would not let private insurance companies compete. A public option would put the private insurance companies out of business and lead to single-payer. My single payer friends, he was right.”

Single-payer proponents no longer use the term “public option,” since the public has clearly and consistently opposed it. It is now called “Medicaid expansion,” which avoids the use of the unpopular term “single payer” to describe taxpayer-funded healthcare.

In 2008, Yale professor Jacob S. Hacker said: “Someone once said to me this is a Trojan Horse for single payer. It’s not a Trojan Horse, right? It’s right there! I am telling you. We are going to get there. Over time. Slowly. But we are going to move away from reliance on employer based health insurance, as we should, but we will do it in a way that we are not going to frighten people into thinking they are going to lose their private insurance. We will give them a choice of public or private insurance when they are in the pool. We are going to let them keep their private insurance as long as their employer continues to provide it.”

Hacker nicely sums up the underlying goals of Obamacare: not to increase competition or patient choice, but to drive people out of private insurance, as a stepping stone to a government-run, single-payer system.

Once we know the ultimate goal, the purpose behind the delay of the employer mandate seems clearer: to hurry the “transition time” away from employer-based health insurance and to a single-payer system.

By forcing individuals to purchase compliant healthcare plans but not forcing employers to provide those plans, Obama is creating a swell of 10-13 million workers that must enroll in health insurance, but cannot obtain it from their employers. These workers thus have no choice but to use the government-controlled health insurance exchanges, or else pay a financial penalty. This will double the number of workers forced to get health insurance on the exchanges.

Importantly, the IRS has ruled that if workers have access to affordable health insurance through their employer, their dependents are not eligible for taxpayer-funded subsidies on the Obamacare health insurance exchanges. Now that businesses will not be required to offer health insurance until 2015, workers and their dependents will be eligible for the subsidies.

Community organizers are already being hired around the country to sign people up for the health exchanges. There are no penalties for failing to verify eligibility, and no penalties for signing up people who cannot afford to pay the monthly insurance premiums. It is set up for disaster, much like the “liar loans” that helped topple the mortgage industry when people were not required to verify their income to qualify for a mortgage.

The transition time to single payer may be much shorter than Obama and his supporters thought. What better way to speed a transition to the new than to wreck the old! And how clever to accomplish the goal under the cover of accommodating your opponents!

But patients continue to lose under these clever manipulations by the power elite: higher premiums, longer wait times to get into a doctor, and fewer treatment options allowed. Single-payer, government-controlled healthcare never serves patients well.

Dr. Vliet will be a featured speaker at the IHS 2013 International Health Strategies Conference to be held October 6-10 in Tucson, AZ. Learn More at

Elizabeth Lee Vliet, M.D. is a preventive and climacteric medicine specialist with medical practices in Tucson AZ and Dallas TX that take an integrated approach to evaluation and treatment of women and men with complex medical and hormonal problems. Dr. Vliet is also President of International Health Strategies, Ltd., whose mission is twofold: liberty and privacy in treatment options and preservation of the Oath of Hippocrates focus on the individual patient.

Dr. Vliet is the 2007 recipient of the Voice of Women award from the Arizona Foundation for Women for her pioneering advocacy for the overlooked hormone connections in women’s health. Dr. Vliet received her M.D. degree and internship in Internal Medicine at Eastern Virginia Medical School, then completed specialty training at Johns Hopkins Hospital. Dr. Vliet is a Director of the Association of American Physicians and Surgeons.

Dr. Vliet has appeared on FOX NEWS, Cavuto, Stuart Varney Show, Fox and Friends and syndicated radio shows across the country addressing the economic and medical impact of the new healthcare bill.

Dr. Vliet's books include: It’s My Ovaries, Stupid!; Screaming To Be Heard: Hormonal Connections Women Suspect-- And Doctors STILL Ignore; Women, Weight and Hormones; The Savvy Woman's Guide to PCOS, The Savvy Woman’s Guide to Testosterone.

Dr. Vliet’s medical and educational websites are and For more on healthcare, go to

DISCLAIMER: Dr. Vliet speaks as an independent physician. Dr. Vliet has no financial ties to any health care system, pharmaceutical company, or health insurance plan. Her allegiance and advocacy is to and for patients.