Why affordable health insurance for all has to be mandatory insurance for all

There is nothing wrong with the arguement - if you accept the idea that is it alright to force people to purchase insurance coverage. Given the fact that we supposedly live in a free country, I believe that is one very large "IF".

I also don't see anything wrong with the argument -- if you accept the notion that the current problems with the US healthcare system are more related to a lack of coverage for everyone and less around the inefficiencies that the various insurance companies bring to the proverbial table. If and when everyone is forced to sign up for their HMO/PPO/FSA/HSA plan of choice, does that mean that our rates will finally stop going up at double-digit rates?

Me, I'm not really holding my breath on that.

Now I get that mandates might be hard to enforce, and unpopular with voters.

Well Social Security isn't optional either and it hardly seems unpopular with voters, nor is enforcement a big problem. Ditto for collision insurance in most states. I think you're right on the merits. On the politics, it's a matter of how it gets sold and how it gets covered by the media.

Justin, OT, but any thoughts on whether the FairTax as championed by Huckabee is realistic? My sense is no, and with Huckabee's statement that "it will be like waving a magic wand" I'm tempted to dub it the "FairyTax", but do you have a take? For a critical assessments from the right, see Richard Lowry at NRO or Bruce Bartlett at the WSJ.

I am a strong supporter of universal healthcare, but I object to mandated coverage because it achieves universal health care in the most inefficient way possible.

The truth is, I don't like Obama's, Edwards, or Clinton's plans, as I understand them, because they leave the insurance companies in the middle, and that is the one major difference between our health care and everyone elses - well, that and the cost of our health care. The outcomes are all the same, interestingly enough...

Chuck:
The outcomes are all the same, interestingly enough...

Actually, no. Believe it or not, the US actually gets materially worst outcomes by most measures than other major countries, even the UK which spends less than half per capita on health care than the US does. That's right the US spends more and gets less.

I recommend Ezra Klein's Health of Nations series for details.

Health care isn't for everyone.

Crust,

I have read EK's health of nations and he's done a lot not just to win me over to universal coverage as an achieveable good, but to viewing universal coverage as part of a package to control healthcare spending and be a fiscally rewarding good as well.

But when I look at the various charts showing things like longevity and infant mortality and other metrics of healthy-ness, I don't see a huge difference between the US and the rest of the world - sometimes better, sometimes worse, but always part of the normal distribution. That, combined with not being able to separate out how much of that difference we say for sure is due to our health care system vs. our life styles, culture, etc, is why I view our outcomes as basically the same.

But the cost of our health care - that is clearly greater than all others, a statistically significant outlier that we should make us feel like losers (in that arena, anyway).

Chuck, I think the best single summary measure is Potential Years of Life Lost. If you look at Chart IV.9 in this post, it shows a PYLL of 5766 per 100,000 for the US vs. an OECD median of 4431. So the US is 30% worse than the median and also 12% worse that the second worst such country (New Zealand at 5156). Wouldn't you agree that's a pretty material difference? (Admittedly, those are 1997 stats, but I don't think the trend has changed much.)

But, as you say, even if you were to concede for the sake of argument that the US system produces equally good outcomes, it still sucks relative to the rest of the world because it costs so much more per person.