The Democrats have essentially cleared the way for the passage of a health reform bill that is poised to become the largest overhaul to social welfare in this country in more than half a century. The plan to cover more than 30 million uninsured is the result of the individual mandate inherent in the bill’s language which is meant to spread the risk pool which also shares (spreads) the cost of coverage.

For the young and “invincible”, as many wonks and health plan actuaries like to call them, the decision to participate in an insurance mandate is as individual as the potential patient considering the decision. Why should a young, healthy patient buy insurance (even if mandated by the government) if he/she feels perfectly healthy? It’s that point that has many healthcare economists concerned. Opting to pay a penalty is just another another mechanism by which compliance with any mandate is not guaranteed.

There are many imperfections in the reform bill; engineering social norms in such a way that perfectly healthy people feel just as determined to purchase health insurance as they do when they are required to wear seatbelts — well, that pill may take a while to go down. | LINK

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