As you’re planning a night out with friends, you start to feel strange. Your throat is sore, your muscles are achy, and you start feeling so bad that you call the night off.
After a few days, a new rash scares you into visiting Student Health where they diagnose you with a mild case of measles. You don’t how this happened, because you know you got vaccinated. But according to the doctor, only a minority of students got immunized, and now measles is spreading throughout classrooms and dorms.
On the way home, while thinking about missed assignments and getting roommates sick, you’re rear-ended by some jackass in a yellow Hummer. He gets out and apologizes for trashing your car.
“Sorry,” he says. “I wish I could get that fixed, but I didn’t buy car insurance this year.”
Welcome to an America without individual mandates. Without vaccine mandates, groups of unvaccinated people spur measles outbreaks that shut down entire schools or businesses. Without car insurance mandates, irresponsible drivers can total your car and leave you with the bill.
Such a dystopia is a reality in health insurance markets. This could change in June, when the Supreme Court determines the constitutionality of features of the Affordable Care Act — “Obamacare” — which includes the individual health insurance mandate. A ruling to keep the mandate will restore some order to our country’s messy health care system.
The controversy of the individual mandate is only rivaled by its importance. The provision imposes a financial penalty on those who do not purchase health insurance in order to bring younger, healthier people into the new insurance exchanges.
Adding healthier people to the mix should lower the average price of monthly health insurance premiums. Financial assistance will be provided to those Americans who still can’t afford premiums — including many young, out-of-work college graduates.
The mandate would also reduce the problem of uncompensated care. In 2010, UNC hospitals took the hit for nearly $300 million of unpaid care. The biggest chunk of this care goes to the uninsured — at some UNC clinics, 40 percent of patients have no health insurance.
