The Patient Protection and Affordable Care Act (PPACA), signed into law by President Barack Obama in 2010, contains a provision that will require Americans not already covered by healthcare plans to purchase plans for themselves by 2014. The alternative is not the freedom to use one’s own judgment to make health-related decisions, but to face a fine which would be the larger of $695 or 2.5% of one’s income per year, by 2016. This part of the PPACA is known as the individual mandate. It is based on the premise, as espoused by President Obama, that “everybody should have some basic security when it comes to their health care.” Proponents of the law, including Professor Charles Fried of Harvard Law School, argue that since healthcare is “a market that everyone must at some time enter”, all citizens should participate in the “whole scheme designed to protect by health insurance the largest part of the population.” Though such action would be proper among individuals voluntarily associating in order to ensure “basic security” to all members, such is not what President Obama and Professor Fried are advocating; they instead advocate the use of force to provide “basic security”. As such, the PPACA, and particularly the individual mandate, represent a gross violation of individual rights, and should be immediately, unequivocally, and guiltlessly repealed.
Before discussing which rights the individual mandate would be violating, I will briefly discuss how it would function in practice: how would requiring individuals to purchase a service ensure that “the largest part of the population” enjoy “basic security”? Since everyone, including individuals who infrequently or never use the service they will have paid for, would be participating in the healthcare market, the cost incurred by those needing healthcare would be spread across a much larger population. Supposedly, then, those who actually would receive care under their healthcare coverage would always enjoy lower prices. The supposed (overall) reduction in healthcare costs is used to justify and apologize for the initial use of force.
Though the question of whether the individual mandate can or should work in practice is certainly worth further consideration, my focus will now turn to how, specifically, it violates individual rights.
Let us suppose that President Obama is correct in assuming that the inclusion of an individual mandate in the PPACA will provide everyone with “basic security”, and that Professor Fried is correct in assuming that everyone will need healthcare at some point and that the individual mandate will help satisfy that eventual need. Both argue that since there is a need and a conceivable government solution, action should be taken to satisfy the need. Such an argument presupposes that there is a “right” to healthcare. The problem with this assumption is that a “right” to a good or service would require that somebody provide it, i.e., that somebody be forced to provide it. Benevolent intentions and pragmatic arguments aside, any attempt to promise a right to a service such as healthcare falls short when one considers what “rights” actually are. According to Paul Hsieh in The Objective Standard:
Rights are not entitlements to goods or services produced by others; rather, they are prerogatives to freedom of action, such as the right to free speech, the right to contract, or the right to use one’s property. Any attempt to enforce a so-called “right” to healthcare necessarily violates the actual rights of those who are forced to provide or pay for that care.
As such, just as one cannot kick down a neighbor’s door and hold a family hostage until all members pay a small fee toward his healthcare costs, or invade every house in a neighborhood in order to mitigate the payment of each individual being forced to pay, a large number of citizens cannot properly hand the role of hostage-taker to the state or federal government in order to exact indirect but forced payments from all fellow citizens. In principle, all such actions are the same, since they violate the freedom of action by initiating force against innocent people in order to provide “basic security” to those who “need” it.
Having considered what one does not have the right to do, one should also bear in mind what rights consumers do have. To refer back to a previous passage, one has a right to enter into a contract, and to use one’s property – including money. By the same token, one has the right to not enter into a contract, or to refrain from using one’s property in certain ways. Since, according to Damon Root of Reason.com, “American contract law rests on the principle of mutual assent,” in cases in which two parties do not agree to the terms of a contract, i.e., if it is not mutual, then there is no proper contract. Individuals forced to purchase healthcare, which they otherwise would not purchase or for which they would otherwise pursue different terms of contract for, effectively see their right to contract negated. Furthermore, if the health insurance provider is forced to provide a certain amount or type of coverage to certain or all people, their right is also violated. If an individual is forced to accept the insurance plan of a provider which is forced to insure them in a certain way, the rights of both parties are violated. In all such cases, there is no mutual agreement. In all such cases, somebody is being forced to spend their own money, and as such their right to use – or not to use – their own property as they see fit, is also violated. All this being said, whether or not the individual mandate would provide everyone with “basic security” within “a market that everyone must at some time enter” is patently irrelevant, since it violates rights – namely those of a contract of mutual agreement and of the ability to spend or save one’s own money.
A less frequently considered but no less important subject of the healthcare debate is that of the rights of health insurance providers. As Richard Salsman explains in Forbes, health insurance is:
a valuable service provided by intelligent, hard-working professionals with years of painstaking education and training; people who, like other Americans, deserve equal protection under the law, people who, like other Americans, have a right to their own life, liberty, property and the pursuit of their own happiness. Doctors, nurses, hospitals, drug-makers, and health insurers are no more “servants” of the masses, or even of those in need of health care, than are businessmen, bankers, teachers, journalists, or truck drivers servants of those who need their services.
If healthcare were truly a right, members of the medical field would by default be rendered the servants of those who have the “need” to obtain, but not the expertise to create, health insurance. In the event that there were not enough insurance providers, somebody somewhere would have to be forced to enter the medical field in order to be able to satisfy the right of his fellow citizens to a service which requires effort on somebody’s part. Failure on the part of the mystically inexhaustible supply of health insurance providers would thereby constitute a violation of the rights of all uninsured people. However if we recall the forgoing discussion of the right to contract and to spend one’s own money as one sees fit, we can properly regard the “right” of uninsured people to the gift of insurance by somebody to be nonexistent, since it would violate the right of providers to their terms of the contract and to spend their money as they see fit. If the end of “basic security” justified the means of forcing a minority of the population to provide it, one could properly force healthcare providers to stand guard over gated, sanitized cities populated by their customers.
The content of health insurance plans approved by the PPACA should also be considered. While it does not make private insurance in itself illegal, the PPACA “does establish federal insurance requirements, enforced by the government, which will make many private plans illegal and will force many out of business.” Under the individual mandate, millions of people would have to purchase government-approved insurance, which almost certainly would include “benefits” they would not benefit from. “For example,” writes Hsieh, “Massachusetts currently requires insurance plans to include…in vitro fertilization, blood lead poisoning treatment, and chiropractor services—whether or not customers want them. Residents must purchase alcoholism therapy benefits, even if they are teetotalers.” This example is relevant because “ObamaCare” is based on Massachusetts’ “RomneyCare”, and they are alike in principle. Being forced by the individual mandate to choose from a limited number of government-approved plans (all of which would include any number of “benefits”) is neither beneficial nor right, since those purchasing such plans would be forced to spend money against their will in accordance with contracts they would be forced to accept. Providers would similarly be forced to spend money to provide “benefits” and to offer contractual terms outside the realm of their preference – all to maintain government approval and to not be run out of business for non-compliance.
Some would argue that having to choose between private plans is an identical situation to that described above, since there is a necessarily finite number of options when choosing health insurance plans. Many feel the “need” for health insurance, so they feel “forced” to purchase it. While it is true that customers of private plans are ultimately limited to what their insurers offer within a given plan, it is not so that they are victims of force, since they are not being compelled to purchase, or not purchase, anything. Even in cases where limited options or high costs for private insurance would at face value seem prohibitive, people would still be able to devise alternatives without government interference:
In a free society, caregivers would still be able to provide free services, innovative payment options would arise, and charity organizations and mutual aid societies would be free to fulfill their missions. There is no role here, however, for the forceful hand of government.
Having considered several of the many ways that the individual mandate violates individual rights, we can make a strong moral case for its repeal. To review, the individual mandate would force millions of Americans to purchase a service they may neither want nor need, regardless of the specific needs which may or may not be addressed in a given plan, on pain of a fine; it would violate the freedom of action to enter (or stay out of) contracts or to spend (or not spend) one’s own money; it would violate the rights of insurance providers by forcing them to set contractual terms and spend money against their will; it would violate the rights of companies whose voluntarily offered services would not gain government approval; it would violate the rights of charities to provide their own version of healthcare if they too fell short of government approval; it would ultimately grant tyrannical power to the government to set the terms for the healthcare – and the lives – of every American. If America remains a free country where the rights to life, liberty, property, and the pursuit of happiness are still unapologetically upheld, such heinous violations of these rights will not be permitted, and the individual mandate along with all of the PPACA will be and properly ought to be repealed.
 Kliff, Sarah and Ezra Klein, “Individual mandate 101: what it is, and why it matters,” Washington Post, March 27, 2012
 Sheryl Gay Stolberg and Robert Pear, “Obama Signs Health Care Overhaul Bill, With a Flourish,” New York Times, March 23, 2010.
 The Constitutionality of the Affordable Care Act (2011) (testimony of Professor Charles Fried). Print.
 Dentzer, Susan, “What is the individual mandate and what if it’s declared unconstitutional?” March 27, 2012
 Hsieh, Paul, “Healthcare and the separation of charity and state,” The Objective Standard, 2011.
 Root, Damon W, “The four best legal arguments against ObamaCare,” Reason.com, March 24, 2012
 Salsman, Richard M, “Note to the Supreme Court: health care is not a right,” Forbes.com, April 2, 2012
 Lewis, John David. “What the ‘Affordable Health Care for America Act,’ HR 3962, Actually Says”. The Objective Standard, 2009.
 Hsieh, Paul. “Mandatory health insurance: wrong for Massachusetts, wrong for America”. The Objective Standard, 2008.
 Rhoads, Jared M. “Two more encouraging things from the oral arguments on the individual mandate,” Center for Objective Health Policy, March 28, 2012