Below is a comment on a Washington Post article on mandated coverage, http://www.washingtonpost.com/wp-dyn/content/article/2009/10/25/AR2009102502607_Comments.html
Great movie, poor reform—at least that’s my take on how poorly the current healthcare legislation will actually work regarding a mandate. There are probably more federal judges with gangsta rap on their iPods than congressmen who have actually read the reform bill.
I call the idea of the mandate “must carry”. The only option of the public option and must carry provisions is the option to “opt”. Individuals can “opt” and so can firms. “Opt-in”, “Opt-out”—like clap-on clap-off.
However well intended it may be, as structured, the mandate will not work; neither for individuals or for firms. The individuals who will be required to carry, can opt out for a $750 annual fine and “opt” in when they are sick or injured. The fine will be less than the cost of the insurance premiums. That way, their out-of-pocket costs are actually paying co-payments not premiums.
It appears that firms may be able to pay the fines on a per person basis rather than opting to pay for healthcare insurance for their employees.
Hence, mandated coverage may only apply to those who haven’t figured out that it doesn’t apply.
Pale Rhino Consulting 
Mandated coverage could work with a public option (expanded Medicare-type coverage) for those who can’t afford or obtain other medical insurance. I’m speaking as someone on Medicare due to becoming disabled and broke while seeking competent care while insured by Cigna. The reason is that the cost of services under Medicare are a mere fraction of the fees I was charged while insured in an HMO and are far lower than the fees I was charged as self-pay. What I don’t have a grip on is that my Medicare coverage is handled by private medical insurers just as if I was insured by my employer. How can private medical insurers afford to and even seek to handle Medicare covered patients and say that this is infeasible? The reason is that the numbers of Medicare patients is huge. I think I just came up with a rationale for single payer systems because the business model just doesn’t work if private medical insurers can’t gouge or throw out insurers costing their business.
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Thank you for your comment. I fully agree with the idea that it could work. I do think there are a number of ways for people not acting on good faith to circumvent the upside.
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