Proposals for achieving universal health insurance
coverage are once again receiving serious attention. Among the ideas
attracting bipartisan support is an individual health insurance
mandate, a legal requirement that every American obtain adequate
private health insurance coverage. People who don't receive such
coverage through their employer or some other group would be required
to purchase their own individual coverage. Those who failed to do so
would be subject to fines or other penalties.

Proposals for an individual mandate respond to a legitimate concern
about "free riders," the uninsured who nonetheless receive treatment
and pass the costs on to taxpayers or individuals with insurance. In
practice, however, an individual mandate is likely to be unenforceable
because it would involve a costly and complex bureaucratic system of
tracking, penalties, and subsidies.

More important, an individual mandate crosses an important line:
accepting the principle that it is the government's responsibility to
ensure that every American has health insurance. In doing so, it opens
the door to widespread regulation of the health care industry and
political interference in personal health care decisions. The result
will be a slow but steady spiral downward toward a government-run
national health care system.