The economic rationale for a mandate (individual, employer-based or a hybrid) is based on avoiding adverse selection: consumers will logically opt out of the system if they feel their personal health (past predicting future) is better than average and insurance companies will overprice the product, expecting only the highest-risk customers to enroll. In the absence of some mandate, the individual insurance market devolves to the current state: many individuals rationally choosing to be uninsured, not because they don't value health insurance, but because they refuse to overpay for the offered product.
But beyond the economics of this mandate, there is a cultural change that might follow. Perhaps if everyone knows that they will always need to be insured (rather than planning for that day in the future when they anticipate the "need"), they will become more informed consumers. Perhaps they will also take health preservation and illness prevention more seriously. Perhaps our health-care providers will find greater motivation to incorporate preventive measures in their day-to-day delivery of care. And with more healthy risks in the insurance pool, perhaps we will actually stand a better chance of truly preventing disease and/or detecting it at a stage when we can affect positive change.
While some of the narrative bears proof-of-concept, there is little risk and a huge potential reward. Mandates are a necessity if we can make this work.
But why stick with a system that is fundamentally wrong?
Every other industrialized country in the world gets better health care as measured by all the bottom line public health statistics (there are 16), and they do it at less than half the cost per person as we spend? And they all have government run systems, mostly single payer.
We could give a super Medicare to everyone and it would not cost a penny more than we are now spending because of high overhead and enormous compliance costs of private insurance and high drug prices caused by vast expenditures on Marketing. A public option would not use these savings.
Why not support HR676?