Ezra Klein says that Barack Obama will ask Congress to include a mandatory participation clause when he spells out the broad strokes for his proposed health care plan:
Administration officials have been very clear on what the inclusion of “universality” is meant to communicate to Congress. As one senior member of the health team said to me, “[The plan] will cover everybody. And I don’t see how you cover everybody without an individual mandate.”
A mandatory federal health care plan is troubling on several fronts. First, it would destroy the private coverage system that we have now and effectively eliminate choice for virtually all Americans. For many this is not an overwhelming problem because they have relatively few choices now. Under the tenative Obama plan participation will be mandatory. The only way to opt out would be to accept the coverage, then pay cash for your choice on the side.
Second, the very idea of mandatory government plans is repugnant to people like me who see government as a problem rather than a solution. That Social Security and MediCare have been financial train wrecks is well-documented. The former has historically under-performed on its investments and will go negative in a couple of decades because of larger-than-intended payouts. The latter will quite frankly bankrupt this country sometime this century unless it is drastically reformed. That’s the effect. The fact that they are mandatory government programs is the cause. (No, you don’t have to take MediCare. But who refuses?)
Third, it goes without saying that the only way to offer subsidized coverage or the more expensive “universal” coverage that first Hillary Clinton and now Barack Obama have embraced is to tax the money out of the hands of those who have it and give it to those who do not. The taxation might come in the form of a payroll tax ala Social Security or as an increased federal income tax rate. Either way the effect is the same: a massive redistribution of wealth to fund another expensive liberal program.
That’s change you can believe in. More precisely, you have to believe in it. OK, you don’t have to. But we’re going to tax you as if you did, so you may as well.