The most hazardous health reform measure before Congress is not the so-called "public option," but proposals to make health insurance compulsory via an individual or employer mandate.
Compulsory health insurance could require nearly 100 million Americans to switch to a more expensive health plan and would therefore violate President Barack Obama's pledge to let people keep their current health insurance. In particular, the legislation before Congress could eliminate many or all health savings account plans. Making health insurance compulsory would also spark an unnecessary fight over abortion and would enable government to ration care to those with private health insurance.
Obama adviser Larry Summers writes that mandates "are like public programs financed by benefit taxes," meaning that compulsory health insurance would also violate President Obama's promise not to increase taxes on the middle class. Under the House Democrats' legislation, some middle-income earners would face marginal tax rates over 50 percent (before state taxes).
The experience in Massachusetts belies the claim that compulsory health insurance brings down health care costs. The "shared responsibility" ruse allows Massachusetts politicians to declare success for a compulsory health insurance scheme whose actual costs reveal it to be a failure. Massachusetts also demonstrates that compulsory health insurance enables, and ultimately requires, politicians and government bureaus to control nearly all aspects of health care and medical practice.
Rather than make health insurance compulsory, Congress should make it more affordable by letting individuals control their earnings and choose their own health plan from any state in the Union.