In his April 8 Op-Ed article on the individual mandate, the aspect of the federal healthcare reform law that requires everyone to have coverage, William Voegeli advances a false dichotomy. He states that while it may be legitimate to require people to carry health insurance that would cover the costs of their care were they to be hit by a bus, it is illegitimate to require them to carry insurance coverage that will cover substance abuse treatment or dental care for their children.
Voegeli acknowledges that the requirement that people have coverage is consistent with John Stuart Mill’s dictum that limiting the freedom of some (in this case the uninsured) is only appropriate when it avoids their harming others (in this case through making others pay for the cost of covering their care). This requirement that others pay is called the “cost shift,” and it is borne, in particular, by California businesses that pay thousands more than their international competitors on health coverage for their employees. Voegeli concludes, though, that “under the guise of preventing cost shifting … Obamacare commits cost shifting” by requiring people to pay for more of the care or protection of others than is absolutely necessary. Continue reading