Health Care Mandates: We Already Have Them

A blog about business and economics.
April 2 2012 3:13 PM

Financial Penalties for Not Buying Health Insurance Are the Foundation of U.S. Health Care

The hidden health care mandate doesn't seem to bother the Tea Party
The hidden health care mandate doesn't seem to bother the Tea Party

Photo by Mladen Antonov/AFP/Getty Images.

I published a column over the weekend about the fact that financially penalizing people for not buying health insurance is already the core of the American health insurance system. It's just that instead of saying "you pay a fine if you ask your employer to give you higher wages instead of subsidizing your insurance premiums," we say that "if your employer subsidizes your insurance premiums instead of paying you higher wages, you don't need to pay taxes on that." But the impact on your pocketbook and the system as a whole is identical.

It turns getting insurance into a smart decision even for customers for whom it's not an actuarially savvy decision, and the presence of those customers keeps the entire risk pool viable. As a legal matter, the slight difference in how it's organized may be crucially important, but as an economic matter these are very similar policies, and if you're interested in the broad implications for human liberty of penalizing people for not getting insurance, you have a much bigger battle on your hands than the war on Obamacare.

Matthew Yglesias is the executive editor of Vox and author of The Rent Is Too Damn High.



The Ebola Story

How our minds build narratives out of disaster.

The Budget Disaster That Completely Sabotaged the WHO’s Response to Ebola

PowerPoint Is the Worst, and Now It’s the Latest Way to Hack Into Your Computer

The Shooting Tragedies That Forged Canada’s Gun Politics

A Highly Unscientific Ranking of Crazy-Old German Beers


Welcome to 13th Grade!

Some high schools are offering a fifth year. That’s a great idea.


The Actual World

“Mount Thoreau” and the naming of things in the wilderness.

Want Kids to Delay Sex? Let Planned Parenthood Teach Them Sex Ed.

Would You Trust Walmart to Provide Your Health Care? (You Should.)

  News & Politics
Oct. 22 2014 9:42 PM Landslide Landrieu Can the Louisiana Democrat use the powers of incumbency to save herself one more time?
Continuously Operating
Oct. 22 2014 2:38 PM Crack Open an Old One A highly unscientific evaluation of Germany’s oldest breweries.
Dear Prudence
Oct. 23 2014 6:00 AM Monster Kids from poorer neighborhoods keep coming to trick-or-treat in mine. Do I have to give them candy?
  Double X
The XX Factor
Oct. 22 2014 4:27 PM Three Ways Your Text Messages Change After You Get Married
  Slate Plus
Tv Club
Oct. 22 2014 5:27 PM The Slate Walking Dead Podcast A spoiler-filled discussion of Episodes 1 and 2.
Oct. 22 2014 11:54 PM The Actual World “Mount Thoreau” and the naming of things in the wilderness.
Future Tense
Oct. 22 2014 5:33 PM One More Reason Not to Use PowerPoint: It’s The Gateway for a Serious Windows Vulnerability
  Health & Science
Wild Things
Oct. 22 2014 2:42 PM Orcas, Via Drone, for the First Time Ever
Sports Nut
Oct. 20 2014 5:09 PM Keepaway, on Three. Ready—Break! On his record-breaking touchdown pass, Peyton Manning couldn’t even leave the celebration to chance.