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August 13, 2009

The French Cowboy agrees with Monsieur Ponnuru that, rather than continuously concentrating fire on the “public option”, opponents of Obamacare should begin emphasising the imposition of individual mandates which would require every American to buy health insurance whether he wants it or not. Ponnuru gives five reasons for why he thinks this is a good tactic:

First, the basic outline of Obamacare can survive ditching the public option. It can’t survive ditching the individual mandate. You can’t, for example, have a ban on insurers’ taking account of pre-existing conditions without such a mandate.

Second, the polling on an individual mandate suggests that it’s less popular than the public option — and just plain unpopular. I keep pointing out that Obama was able to win the Democratic presidential primaries without embracing a mandate, which ought to tell us something about the politics of the issue.

Third, my impression from talking to Republican congressmen about the issue is that to the extent they support this idea, that support is an inch deep. It rests on misunderstandings that are easy to clear up (notably the notion that a mandate would reduce insurance premiums by making the uninsured pay their fair share).

Fourth, we have already made our case on the public option, and we haven’t made it on the mandate.

Fifth, there are interest groups willing to keep making the case on the public option — but most of these interest groups are for the mandate since it would improve their bottom lines (at least in the short term).

Let me add that Americans don’t like the idea of an individual mandate (aka forced insurance) for good reasons. It is a restriction of the freedom of contract. All citizens will be forced to enter a contractural relationship – this spits into the face of economic liberty which is the very bedrock of capitalism and a free society.

“But that is part of being a citizen”, you say, “you already are in a contractural relationship with the federal government by being American – you have to obey the laws, pay your taxes etc, while the government provides infrastructure, military protection etc in return.” Oui, oui, ça c’est vrai, the French Cowboy tells you, But purchasing health insurance is first of all an economic contract and has nothing to do with the basic social contract you have entered the moment you became a member of society. If the individual mandate becomes law, being alive as an American will oblige you to purchase health insurance. Imagine you had to buy and maintain a car by government decree.

There is also the aspect that, health care will be the (high) fixed cost of your very existence even if you manage to live on what you find in garbage cans. That means that if you cannot afford health insurance you will have to officially apply for financial help.  You can bridge every financial stretch through cutting down your personal living expenses, but if you are forced to pay for health care then you will also be forced to apply for public subsidies if you cannot afford it. To the French Cowboy this is contrary to the spirit of an individually independent and self-reliant people.

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