One of the hottest topics in the 2008 election campaigns is whether the government should require everyone to have health insurance.[1] Advocates say that's the only way to achieve universal health coverage, but opponents say the high cost of insurance is the real problem and should be addressed first.
Who is right?
While universal coverage is an important goal, an individual mandate for health insurance has far-reaching consequences for individuals, businesses, and the health sector overall.
When political leaders pass a law requiring everyone to have insurance, they must decide what qualifies as acceptable coverage. That means that government decides what will – and will not – be covered.
We saw what happened in Massachusetts, which enacted an individual mandate in 2006 and kept all of its coverage mandates and regulations in place, driving up costs for citizens, businesses, and taxpayers.[2]
Further, an individual mandate immediately becomes an employer mandate as political leaders decide how much employers must pay for the new health insurance that's now prescribed by the state.[3]
An individual mandate would inject much more government control into our health sector and would require onerous enforcement provisions, like garnishing people's wages.[4,5] Americans are struggling to afford decent housing, child care, and other necessities. Requiring them to buy health insurance before we address its high costs would further burden the workers and families we're trying to help.
Political leaders should foster a more competitive market for insurance by freeing companies to offer more flexible, affordable policies. That means rolling back expensive mandates and regulations that have made health insurance so expensive in the first place – including community rating, guaranteed issue, and a tightly regulated insurance market that has dried up competition[6] – and they should immediately advance initiatives that provide new subsidies for the uninsured to purchase this more affordable private insurance.[7]
That's my opinion. I'm Grace-Marie Turner, President of the Galen Institute.
Footnotes
Reader Comments on: Should the United States Mandate Health Insurance…or Not? See reader comments on this article and provide your own.
Readers are encouraged to respond to the author at gracemarie@galen.org or to George Lundberg, MD, Editor in Chief of The Medscape Journal of Medicine, for the editor's eyes only or for possible publication as an actual Letter in the Medscape Journal via email: glundberg@medscape.net
References
- 1.Sack K. Coming soon: health care debate, part 2. New York Times. March 2, 2008. Available at: http://www.nytimes.com/2008/03/02/weekinreview/02sack.html?scp=7&sq=%22mandate%22+AND+%22health%22&st=nyt Accessed March 31, 2008.
- 2.Sack K. Massachusetts faces a test on health care. New York Times. November 25, 2007. Available at: http://www.nytimes.com/2007/11/25/us/politics/25mass.html Accessed March 31, 2008.
- 3.Turner G-M. An individual mandate is not the right choice for health insurance reform. National Association of Realtors Public Policy Debate Book. Winter 2008. Available at: http://www.realtor.org/policyconf.nsf/files/public_policy_debate_book_08.pdf/$FILE/public_policy_debate_book_08.pdf Accessed March 31, 2008.
- 4.Edwards statement on health care mandate. John Edwards 08. November 28, 2007. Available at: http://www.johnedwards.com/news/headlines/20071128-health-care-mandate/ Accessed March 31, 2008.
- 5.Sack K. In health debate, Clinton remains vague on penalties. New York Times. February 4, 2008. Available at: http://www.nytimes.com/2008/02/04/us/politics/04checkpoint.html?pagewanted=print Accessed March 31, 2008.
- 6.Bunce VC, Wieske JP. Health insurance mandates in the states 2008. Council for Affordable Health Insurance. January 31, 2008. Available at: http://www.cahi.org/cahi_contents/resources/pdf/HealthInsuranceMandates2008.pdf Accessed March 31, 2008.
- 7.Turner G-M. Toward free-market health care. The Heritage Foundation. March 26, 2007. Available at: http://www.heritage.org/Research/HealthCare/hl1019.cfm Accessed March 31, 2008.
