The so-called individual mandate in Mr. Obama’s health-care law is a mechanism used to require all uninsured residents, including the young and the healthy, to buy health insurance. One of the key concepts of insurance is to spread risk among as many people as possible by getting them all into the same “risk pool” – the healthy and the sick, the young and the old, and, more important, those with pre-existing conditions.
Contrary to some of the current political rhetoric, the concept of an individual mandate was proposed by the conservative Heritage Foundation, and even endorsed in earlier times by Republican presidential candidates. If the Supreme Court rules that the individual mandate is unconstitutional, the entire health-care reform program will be in jeopardy, because this idea of spreading risk and its associated costs is the underlying foundation (and intent) of the law.
Our current system is unsustainable because it is just too costly. The upcoming demographic tsunami of baby boomers will undoubtedly overwhelm our existing system capabilities and drive costs up even higher. As the global economy continues to accelerate, it appears America’s industrial competitiveness will only further diminish.
The best argument to implement universal health care through an individual mandate, other than the national embarrassment that the wealthiest country in the world does not provide basic health care for all its citizens, is that America already provides universal health care – by default. It’s called EMTALA.