I just came across an excellent article by Karl Manheim and Jamie Court. It presents some compelling explanations of how the idea of making private health insurance mandatory for American citizens may not be constitutional. At the Colorado Health Insurance Insider, I've come out in support of mandatory health insurance, and also very much in support of a single payer universal health insurance program for all Americans. Manheim and Court's article raised some interesting questions for me, and absolutely reinforced for me that the ideal we should be working toward is government-funded health care for everyone, rather than mandatory (or not) private health insurance for most of us.
It's popular to compare mandatory health insurance to mandatory auto insurance (I've made the comparison myself several times). But you can get around the auto insurance law by just choosing to not own a vehicle. People who walk, bike, or take public transportation are not required to purchase auto insurance. Mandatory health insurance would not have a similar out. And since the health insurance carriers are private companies - most of which are for-profit enterprises complete with shareholders and extremely well-compensated upper management - any law that would require people to buy private health insurance would essentially be akin to taxation without representation.
Can you think of any other situation where the state or federal governments require us to purchase something from a private company in order to live here? Sure there are lots of rules and regulations that we all must follow. We have to drive within the speed limits, obtain permits to built a house, and keep our dogs on leashes. There are lots of rules that we might not like but have to obey anyway if we want to stay on the good side of the law. But I can't think of anything that I have to buy from a private firm just to be able to live here, with no option to decline the purchase.
The somewhat obvious answer here is government-run universal health care. Although it may be unconstitutional for the government to make us buy a product from a private company, it's very much within the law to levy a tax in order to provide government-funded services to all Americans. We already have such a system in place to pay for public education, national defense, police, fire-fighters, national parks, roads, and even health care - in the form of Medicare and Medicaid. If we expand the current government-run health care systems to include everyone, the government would be able to constitutionally raise taxes to fund the program. And people would not be forced to purchase health insurance from private companies where they have no representation.