What Mandatory Health Insurance Really Means

When talking about health insurance, "mandatory" is an increasingly popular term among politicians of both major parties, including presidential candidates. What do they really mean by it? Put simply, being uninsured would no longer be a misfortune or a choice, but a crime. And for the insured, the issue is much more complicated.

No politician is going to use the force of law to require you to buy insurance without going further to specify in detail exactly the kind of insurance and what it must cover. Many states now have a long list of requirements for all insurance policies, and that list is sure to get longer if insurance becomes mandatory. And sure to follow will be regulations governing who the insurance companies may, may not or must sell to, and when. A mandate forcing millions more to buy these policies with so many things requiring coverage will create a tremendous magnet for any special interest with an agenda to pile on even more requirements. Then, as costs of such policies go into orbit, more government intervention will be called for to subsidize those increasing costs.

Once all of the regulations are in place, there is plenty of opportunity for regulators or politicians to expand on what mandates can really mean. For example, Senator John Edwards says that his plan for national mandatory insurance would require every individual to take regular physical examinations. What kind of examinations? That would not be left up to you either. After all, if you cannot be trusted to go see a doctor, you cannot be allowed to decide which ailments and which body parts you should be examined for. Women would not be urged but required by law, says Senator Edwards, to get regular mammograms.

It is fascinating to speculate about how the federal government would enforce these mandatory examinations. Perhaps all of your newly computerized medical records will be regularly forwarded to government officials for inspection. Or perhaps you will have to attach the results of your mammogram or prostate exam to your IRS tax return every year.

Senator Edwards would also mandate dental and mental health care as a part of his plan. Then a policeman would be able to give you a ticket if you don't go in for your root canal. How often would you have to see your psychiatrist so he can certify to the government that you are not going nuts? Indeed, that might become more difficult as the mandates expand.

What kind of thinking or what political principles can justify such proposals? One is tempted to believe that the most heartwarming aspect of these proposals for Senator Edwards is the millions of additional opportunities they would create every day for some trial lawyers to bring litigation on behalf of patients being forced into their doctor's office. But it is probably worse than that. Senator Edwards says he wants to impose these mandates on everyone because "what child, what woman, what man in America is not worthy of health care?" They all obviously are worthy. That is not the question. The question, Senator, is: what child, what woman, what man in America is not worthy of freedom?

Perhaps it is a good thing that Senator Edwards is being so threateningly explicit with his proposals. It is not a stretch to reach the conclusion that politicians that want to make all of your health decisions for you and mandate every detail of your health care, no matter how personal, are really after ownership of your body. They think that if they pay for the care of your body (with money that they take from you), then they own it. Don't worry; they may let you keep the other stuff.

We all owe a debt of gratitude to candidates like Senator Edwards for making absolutely clear just what mandatory insurance really means.

Richard E. Ralston is Executive Director of Americans for Free Choice in Medicine.