You know what I haven't seen one right-winger here do yet? Admit that the mandatory purchase is a REPUBLICAN plan, made to counter the Clinton plan.
It's an interesting question about the constitutional issue - and the threat of expanded mandatory purchases.
It's not clear how much the government would want to make mandatory - just a lot of being afraid by people, as the ridiculous scenarios show - and you show little confidence in democracy, that the elections can't elect people who would not require a lot of mandates.
But it's still a question about the danger and constitutionality.
Look at mandatory fire department subscriptions - that's in effect insurance. We've had 'private, voluntary' fire department businesses and people mostly prefer mandatory.
The healthcare insurance is even more compelling though, because of unequal risk and cost. Do we want people with high medical costs to get care, or not?
We could avoid this issue - by going with the single-payer system other wealthy countries - and some not that wealthy - have. But Republicans oppose that, too.
How about the 'voucher' system the right, unfortunately, wants for schools? They make it mandatory for your child to get an education - what if the voucher doesn't cover it, especially in these 'cost cutting' times? Could the Republicans then have 'mandatory purchase of education' instead of the liberals' 'free schools'?
A few things to consider along with the constitutional issue.
Just a couple of friendly points.
1) Personally, I do have what you would typify as "little" confidence in democracy as it pertains to the issue as you have presented it. My lack of confidence is manifest in the fact that when it comes to spending, an issue closely tied to the one at hand, I believe it is quite true that you can't elect people who would not require a lot of spending.
My view is that whether you vote D or R or other you're always voting for higher spending, it just differs in what that spending is used for. On this issue if mandates are deemed legal the voters
will encounter a long-term scenario where they will be forced to vote for mandates and the way you vote will only affect what mandates occur. Voting for no mandates will not be an option.
2) I would say using fire service isn't the best analogy. Fire service is a mandate (in most areas), but it is a State/local issue, not Federal. Fire service taxes go directly to funding the service whereas the health mandate penalty "tax" will not. Additionally, fire service is typically mandated for the (love-it or hate-it) reason of externalities. Refuse to pay your tax and we'd be happy to let your house burn down, but because your house aflame threatens others' property, livelihoods, etc it's in society's best interest to protect us from you.
Indeed, the same is true for something like auto insurance in most states. Not only is auto insurance under the purview of States (which any health mandate should be) but typically the auto insurance mandate only exists to the degree that you cause harm to others. If you want to drive, you need insurance to cover damage and injury to others but you're not required to cover yourself.
Take it one step further: if you don't want to fulfill the auto insurance mandate you can ride a bike or the bus. If you don't want to fulfill the fire service mandate you can rent. If you don't want to fulfill the health insurance mandate you can what, kill yourself?
Mandating health insurance has no direct externality effect. If I refuse to cover myself and get cancer I do not endanger you with my cancer. It is purely a first-party risk for all direct consequences.
Indirect consequences exist in the form of cost. If I choose not to cover myself somehow the cost of that burden has to be borne. Yet society bears the burden of these indirect consequences all the time. If I refuse to save for retirement, society bears the burden through welfare. If I refuse to plan for old age society bears the burden through Medicare (after I shed all of my assets so Medicare will pay for my nursing home). If I refuse to plan for the costs of raising children society bears the burden through welfare, WIC, child tax credits, etc.
What comes next? A mandate to get a job or pay a penalty? A mandate to save for retirement or pay a penalty? A mandate to purchase an annuity (to provide retirement income) or pay a penalty? All these have indirect costs that are just as onerous as the indirect costs of health care.
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