A hospital emergency room entrance. Photo by M.O. Stevens via Wikimedia Commons

The Republican-led Congress is trying hard to kill the individual mandate, the heart of Obamacare and perhaps the last gasp for common-sense, market-oriented healthcare in America.

The individual mandate is a very simple and effective idea for dealing with the skyrocketing cost of healthcare. Every American is required to obtain health insurance or pay a penalty.

That mandate forces young people into the insurance market, which lowers the cost for older, sicker Americans. But more importantly, it’s a market-oriented attempt to insure everyone against catastrophic medical costs that can bankrupt a family.

The logic is similar to auto insurance, the Social Security tax, motorcycle helmets and vaccinations for school children. All infringe on our personal freedom and have a cost, but all also offer important societal benefits.

No young person expects to get cancer or be in a horrible accident. But it does happen, and having insurance prevents such an accident from bankrupting them and their family. The individual mandate protects people while lowering insurance costs for everyone.

The healthcare industry is nearly unanimous in supporting the individual mandate. On Nov. 15, the American Medical Association, American Academy of Family Physicians, American Hospital Association, America’s Health Insurance Plans, Blue Cross and Blue Shield Association, and Federation of American Hospitals all called on the GOP to preserve the mandate.

Sadly, in today’s contentious political climate, Republicans are likely to disregard such professional organizations, perhaps lumping them in with what the right wing calls “the swamp.”

But these organizations know that if the mandate goes, and people stop buying insurance, the uninsured sick and injured will just show up at emergency rooms seeking the public’s mercy. For-profit hospitals may turn them away, but the nonprofits will treat them, with local communities picking up the tab.

Longer-term, eliminating the mandate will finally start that downward spiral in the insurance markets that Republicans have publicly warned about (and perhaps secretly sought). Once that happens, and millions of Americans decide to go without insurance, the pressure for a new healthcare solution will mount.

The individual mandate is a way to make the private healthcare insurance market work for everyone. Once it stops working, it will be hard to ignore calls for a government-run, single-payer insurance system.

One irony of the GOP effort to eliminate the mandate is that it was the idea of a forward-thinking Republican, 2012 presidential nominee Mitt Romney. As governor of Massachusetts, he supervised a healthcare initiative that required every state resident to obtain insurance. It was such a good idea that President Obama appropriated it as Obamacare.

The Republicans in Congress may well achieve a short-term win by ending the individual mandate. Fox News, Breitbart and conservative talk radio will surely cheer. But the long-term result will be a government health insurance system that the Republicans never wanted.


Chris Jennewein is editor and publisher of Times of San Diego.

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Chris Jennewein

Chris Jennewein is Editor & Publisher of Times of San Diego.