Taking away choice is hard to enforce. The only real way to do so is to have a default enrollment. If you are alive, you are in plan X unless you opt out and here is the cost and we’re adding it to your tax bill. The Mass. way – take away the standard deduction is pretty toothless.

The auto and home insurance analogies are poor ones. The home insurance mandate arises out of private contract, not government mandate, but one can always rent and avoid the mandate. In other words, there is choice.

Auto insurance is only mandated to the extent of third party liability insurance, ie., protecting innocent third parties against the cost of the insured’s negligence. Health insurance has no function to protect innocent third parties against acts of the insured, unless you think it is meant to protect the provider from financial loss for services and medicine rendered – Hardly as compelling a justification for compulsion. We could do the same by simply repealing laws that forbid providers to turn uninsured patients away if they want federal reimbursement.

As to auto and health insurance, the insured does not trigger them voluntarily. However, depending on the scope of coverage, health insurance can be triggered voluntarily as to elective treatments — that’s what elective means after all — so the health insurance payout is more certain and higher in amount. Thus, auto and home insurance cost a small fraction of what health insurance costs.

Moreover, both home and auto insurance are priced according to risk and loss experience – a vital difference from the universal health proposals.