Colorado Progressive

Via Jon Caldara, Ari Armstrong argues that comparing mandatory health insurance coverage to mandatory car insurance coverage is flawed:

It is simply not true that states “require you to carry auto insurance.” Rather, you must buy auto insurance (or face fines) only if you drive an automobile on politically operated roads.

For example, Colorado’s statute 10-4-619 states that “compulsory coverage” applies to “every owner of a motor vehicle who operates the motor vehicle on the public highways of this state or who knowingly permits the operation of the motor vehicle on the public highways of this state.”

In other words, if you don’t own a motor vehicle, or you don’t drive your vehicle on “public highways,” you aren’t required to buy auto insurance.

This is valid yet still misses a larger criticism. Comparing health insurance to auto insurance is like comparing apples to giraffes. Auto coverage comes with an opt-out, while health insurance will not.

The administration points to what it hopes makes sense: most states require drivers to carry compulsory coverage on their vehicles. Armstrong makes a fair point that this applies to public roadways; what you do with your vehicle on your property may indeed be up to you, as far as the state is concerned.

Where conservatives and Libertarians are fundamentally miffed–and perhaps correctly, at least logically speaking–is that auto insurance comes with an out: don’t drive (on public roads) and the state won’t force you to buy auto insurance. Further, there are plenty of alternatives to the car to get where one must go. The personal automobile may be the most efficient transport for millions of Americans, but it is by no means the only transport option.

To follow Armstrong’s argument, patients who forgo publicly funded health centers should have the choice to skip mandated health coverage. And if there were a provision to that effect, Libertarians might ease up. (Conservatives, I’m convinced, still would not, because opposing the president is a matter of political sport as much as ideological battle.) Of course there is no such provision, because providing an out would reward the wealthiest Americans, weaken the insurance pool, and create an enormous loophole wherein millions of Americans could say they won’t use publicly funded health centers but when the rubber meets the road will turn to emergency rooms and pass the costs on to the taxpayers.

More crucially, however, is that the opt-out to mandatory auto insurance is, simply, don’t drive. But what’s the equivalent when discussing mandatory health insurance? There isn’t one. Anyone who lives will be insured. Of course, I think this is great, and a step to universal health care and (hopefully) a single-payer system. My ideological outlook suggests that government-funded health care would work better than the current system. None of that prevents me from seeing, though, that the president’s comparison is flawed on account of the presence and absence of this fundamental characteristic.