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April 22, 2008

The Truth About Mandatory Health Insurance

Hillary Clinton's supporters attacked Barack Obama [in January] for not proposing a federal mandate that every American buy health insurance. Mr. Obama's health insurance plan, they said, is a "Band-Aid" for the nation's gaping wound: 47 million people without health insurance. Mrs. Clinton would require all Americans to get coverage. Presidential candidate John Edwards and Christopher Dodd say they would, too. Not Mr. Obama.

Imposing a federal mandate is a hot issue on the campaign trail. It's also a burning issue in Congress, where Democratic Sen. Ron Wyden and Republican Sen. Bob Bennett are pushing the Healthy Americans Act, which would require everyone not in Medicaid or another government program to get health insurance.

'Shared Responsibility'

But is mandatory health insurance really a good idea? Requiring catastrophic coverage (our parents called it major medical) probably is smart. This would ensure that a person who is hurt in a car accident or diagnosed with a costly illness can pay his own medical bills, instead of being a burden on society.

But catastrophic coverage is not what the mandate advocates want. They would require that everyone have comprehensive health insurance, covering preventive and routine care.

The rationale for this mandate is not personal responsibility but "shared responsibility," a polite way of saying shared costs. Requiring comprehensive coverage, the argument goes, will make it affordable for the sick, by pulling the young and the healthy--neither of whom use these health services very much--into the insurance pool. Advocates also argue that requiring this type of coverage will cure overcrowded emergency rooms and help tame skyrocketing health care costs.

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Posted by healthinsurance at April 22, 2008 02:34 PM