Rhetoric surrounding the healthcare debate in Massachusetts has been largely shaped by plans to extend coverage to the poor. But two of the major initiatives under consideration by the Legislature would also, for the first time, require everyone who is able to afford it to buy private health insurance. Massachusetts would be the first state to impose such a requirement, a shift being hailed by many observers as forcing a new personal responsibility in the national debate over how people should get insurance.
But such a requirement, which would be aimed largely at the 200,000 or so people in the Commonwealth who are young, single, healthy, and without coverage, is setting off resentment among the uninsured.
The opposition to mandatory health insurance tends to be of two types.
1. "It's my money, and if I decide to spend it on something other than health insurance, that's my business."
2. "I shouldn't have to pay for health insurance. Someone else should have to pay for my health insurance."
I support mandatory health insurance because I believe that in the public at large, group (2) outnumbers group (1) by a wide margin. Thus, if we don't have mandatory health insurance, what we will have will not be the libertarian alternative favored by group (1) but the socialist alternative favored by group (2). Also, I think that mandatory catastrophic health insurance could wean people away from the comprehensive insurance that we have today, which encourages overconsumption of health care services.
Did I just say that I think that the majority of people favor socialized health insurance? No. Many people already live with private health insurance, so they are in neither group (1) or group (2). However, it would not surprise me to find that the majority favor socialized health insurance. No matter how many people are in favor of it, they are misguided.