I have argued before that the focus on the public option, while necessary, missed the key defect in Democratic health care restructuring plans. The problem is the health care mandate, which by the way, Barack Obama opposed during the campaign.
The mandate that every individual carry health insurance under threat of punitive taxes is a corrosive tool which changes the way we understand taxation. For the first time, we will tax people not on their economic activity, but on their failure to engage in economic activity. While arguments over whether such a tax is constitutional are interesting, the real issue is political.
Do we want to empower the government to use its taxing powers to force people to take action? If the right to be left alone is a foundation of our liberty, are we willing to jettison that foundation? If taxation is the means to achieving a health care mandate, are we prepared to have the IRS play the role of health care enforcer?
There is no current equivalent. While many states impose mandatory auto insurance requirements in order to drive, individuals have the alternative of not driving. With the health care mandate there is no alternative. If you exist, you either obtain “acceptable” health insurance coverage or you are taxed.
The public option merely is necessary to make a mandate work. Many people will not be able to afford private insurance, particularly once the government defines acceptable insurance to include so many benefits as to raise the cost prohibitively.
The public option, which inevitably will be subsidized, provides the catch basin for the mandate runoff. As more and more employers opt for taxation instead of coverage, and as the ranks of those facing individual taxation rise, more and more people will be forced into the public option.
The debate over the mandate is a debate we need to have. It goes to the very heart of who and what we are as a nation. If we can mandate health insurance under threat of taxation, then there is no limit to what else can be mandated under the threat of taxes.
It is time to get rid of the disease, not just treat the symptom. It is time to get rid of the mandate from the Democratic health care restructuring plans.