If you are forced to buy health insurance, politicians must determine what qualifies as insurance, what you must pay, and ultimately what treatments will be available. Now we learn from Mr. Edwards that he wants to force you to get the care that he decides you should have -- another step toward political control of the health care economy.

Eventually, there will be penalties, as we learn from across the Atlantic: In the government-run health system in the UK, the conservatives have proposed that "patients who refuse to change their unhealthy lifestyles should not be treated" by the National Health Service.

People could earn "points" if they lose weight and quit smoking. But they also would be penalized if they don't. A Tory panel said people should not "expect that the state will underwrite the health implications of any lifestyle decision they choose to make."

In the US, some employers are using carrots and sticks to encourage better health habits among their workers, as are some public programs, such as West Virginia's Medicaid plan. Clearly people need better incentives to make healthy choices. But it becomes Orwellian when big brother is watching, especially in a federally-controlled health system.

Wouldn't it be so much better for people to have incentives to take care of themselves and their health spending? Evidence shows that this can work.