Cato Institute
Policy Analysis
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No. 565
April 5, 2006
Individual Mandates for Health Insurance
Slippery Slope to National Health Care
by Michael Tanner
Executive Summary
with insurance. In practice, however, an individ-
Proposals for achieving universal health insur-
ual mandate is likely to be unenforceable because
ance coverage are once again receiving serious
it would involve a costly and complex bureau-
attention. Among the ideas attracting bipartisan
cratic system of tracking, penalties, and subsi-
support is an individual health insurance mandate,
a legal requirement that every American obtain ade-
More important, an individual mandate
quate private health insurance coverage. People
crosses an important line: accepting the princi-
who don't receive such coverage through their
ple that it is the government's responsibility to
employer or some other group would be required
ensure that every American has health insurance.
to purchase their own individual coverage. Those
In doing so, it opens the door to widespread reg-
who failed to do so would be subject to fines or
ulation of the health care industry and political
other penalties.
interference in personal health care decisions.
Proposals for an individual mandate respond
The result will be a slow but steady spiral down-
to a legitimate concern about "free riders," the
ward toward a government-run national health
uninsured who nonetheless receive treatment
care system.
and pass the costs on to taxpayers or individuals
Michael Tanner is director of health and welfare studies at the Cato Institute and coauthor of Healthy
Competition: What's Holding Back Health Care and How to Free It (2005).