The Individual Mandate

Last Thursday, Republican presidential candidate Rudy Giuliani psuedo-announced his national health care proposal on the Sean Hannity radio program. According to the Long Island Newsday, Giuliani made "no mention of covering everyone" in the U.S. during the interview. Meaning no individual mandate, popular in most Democratic candidates' plans (not particularly surprising, but still...).

Obama received quite a bit of criticism for his health care proposal, which makes health insurance a requirement for children but not for adults. A Boston Globe editorial states:

Senator Barack Obama came out yesterday with his plan, which comes close but doesn't cover everyone, though he implies it does. ... without a broader mandate, he can't be sure adults will buy insurance."

An opinion piece in the Chicago Sun-Times writes

Obama proposes mandating coverage of children but not adults, opening the question of whether his plan will lead to Obama keeping his first pledge, to sign a universal health care law by the end of his first term.

Apparently Obama felt a bit threatened by the criticism and wrote in a letter to the editor in the Boston Globe that

The major reason that 45 million Americans don't have health care is not that they don't want it, it's that they can't afford it. If we require people to purchase insurance before we bring down its cost, we'll make a bad problem worse.

He added that the editorial was "inaccurate" when it "stated that my universal health care plan would not cover everyone," adding, "My plan will cover every American."

I agree with Obama in that requiring people to purchase insurance right away will most likely create significant problems for a lot of lower-income people. Massachusetts is having problems with that right now ... the only age group for their new insurance law that has affordable coverage is young people ages 19 to 26. The state is going to have significant growing pains come July 1, the date set for the law's enforcement, which maybe could have been lessened if the state slowly implemented the mandate.

In the long run though, the individual mandate is necessary to balance the risk pool for insurance companies. If 19- to 26-year-olds -- the healthiest age group and the one least likely to purchase insurance -- don't buy insurance because it's going to cost them $150+ per month (I personally fall into this age range and would find it difficult to come up with the extra $150, in addition to my student loans, credit card debt, and overpriced rent), then insurance companies are going to be over-burdened with health care costs for the sick. If a mandate is what it takes to get healthy people to buy insurance, then it's necessary in order to lower premium costs across the board.