Sould individuals be required to purchase health insurance? Recently I debated Len Nichols of the New America Foundation on this point (PDF), with Nichols arguing that individual requirements to purchase health insurance are necessary to make the private health insurance market both efficient and fair.

But an individual mandate has far-reaching consequences for individuals, businesses, and the health insurance market. When political leaders require everyone to have health insurance, they must define what qualifies as acceptable coverage. The insurance market can quickly turn into a government-regulated utility as politicians, rather than the marketplace, determine the terms of the coverage and regulate how much people must pay for the policies. Further, an individual mandate almost immediately turns into an employer mandate as political leaders determine how much employers will be required to pay for their employees' coverage.