As the senate health bill lumbers toward passage, leaving tracks of slime behind it, it is obvious that it will contain the "individual mandate," requiring individuals to purchase health insurance, on pain of heavy fines.
I thought I would take this opportunity to repost an entry I put up in September, which got virtually no attention at the time. Maybe it will be of more interest now:
It's okay for the government to force you to buy auto insurance. So why can't they also force you to buy health insurance? What's the difference between the two cases?
You often hear this argument as a response to another one, which says that the proposed "individual mandate," represents the government moving into a completely new area of coercive interference: forcing everyone to buy a specific commercial product.
The shortest answer to this argument is that they don't force you to buy car insurance. What they do is prohibit you from driving without insurance. You are perfectly free to avoid the premiums by avoiding driving.
That is exactly what I did when a car insurance law was passed in my state while I was a student. I couldn't afford insurance, so I shifted my transportation activities from driving to walking, biking, and hitchhiking.
Further, there is a principled reason for linking insurance -- keeping in mind that it is liability insurance that we are talking about here -- to driving in this way, and the principle involved does not apply to the case of health insurance.
Requiring liability insurance is the only way to prevent massive, widespread injustice: people being hurt or maimed by automobiles without being compensated for it.
To drive a car is to knowingly subject others to risk that you will, perhaps in a moment of negligence, injure or kill them. What could render this just? Putting yourself in a position to fully compensate your (surviving) victims would certainly help.
The liability insurance mandate can be justified by the principle that it is wrong to subject others to heightened risk that you will injure them unless you can compensate them if you do.
No such principle is applicable to the health insurance mandate, and that is a huge ethical difference between them.
[Note than I am not justifying the liability insurance mandate, I am only arguing that is is morally different, and in a way favorable to it, from the health insurance mandate.]