— Paul Krugman, “Broccoli and Bad Faith”
WHEN PEOPLE CHOOSE NOT TO BUY BROCCOLI, they dont make broccoli unavailable to those who want it. But when people dont buy health insurance until they get sick which is what happens in the absence of a mandate the resulting worsening of the risk pool makes insurance more expensive, and often unaffordable, for those who remain. As a result, unregulated health insurance basically doesnt work, and never has.
There are at least two ways to address this reality which is, by the way, very much an issue involving interstate commerce, and hence a valid federal concern. One is to tax everyone healthy and sick alike and use the money raised to provide health coverage. Thats what Medicare and Medicaid do. The other is to require that everyone buy insurance, while aiding those for whom this is a financial hardship.
Are these fundamentally different approaches? Is requiring that people pay a tax that finances health coverage O.K., while requiring that they purchase insurance is unconstitutional? Its hard to see why and its not just those of us without legal training who find the distinction strange.
http://www.nytimes.com/2012/03/30/opinion/krugman-broccoli-and-bad-faith.html?_r=1