Massachusetts Governor Mitt Romney's solution to the health care crisis, an individual mandate -- or "a legal requirement that every American obtain adequate private health insurance coverage" -- represents an "unprecedented expansion of government power," according to Michael Tanner, director of health and welfare studies at the Cato Institute.
In his newly released critique, "Individual Mandates for Health Insurance: Slippery Slope to National Health Care," Tanner warns that an individual mandate opens the door to widespread regulation of the health care industry and political interference in personal health care decisions.
While universal coverage schemes may sound desirable in theory, Tanner argues, "in practice, none are likely to reach all Americans, and all carry significant price tags -- both in terms of dollars and in terms of unintended consequences for the health care system as a whole."
Enforcing mandatory health care laws would be problematic, Tanner argues, pointing to the government's weak record of enforcing existing mandates. Significant numbers of Americans already ignore existing state laws mandating auto insurance, and furthermore, "the Internal Revenue Service spends more time, money and effort than any other federal agency in tracking Americans who fail to file tax returns, but millions consistently slip through the cracks."
Individual mandates for health insurance would also be vulnerable to pressure from special interest groups to expand benefits -- adding to the cost of the proposed mandate. Tanner explains: "...[D]isease constituencies (whose members naturally have an urgent desire for coverage of their illness or condition) will always have a strong incentive to lobby lawmakers for inclusions in any minimum benefit package."
While Tanner concedes that there is no easy answer, he finds that the health care debate must shift away from its single-minded focus on expanding coverage to the bigger question of how to reduce costs and improve quality. This, he states, "will require the introduction of market mechanisms to give consumers more control over and responsibility for their health care decisions."