Cost: Yes of course any of these plans will cost money. But what everyone seems to ignore is the fact that we are ALREADY paying for “universal” healthcare! We are paying for emergency help for those who have no insurance, we are paying for illness in those who are not covered, and most of all, we are paying for profit for the insurance companies! As everyone knows, we pay more for healthcare thanany other developed country. I personally would rather pay more taxes for a sure thing, than pay in many hidden ways for this patchwork system we have now that is not working.

As a fellow health economist, I disagree with you and Obama on the issue of an individual mandate. The private health insurance market, in particular the individual market, can’t work well without a mandate. If there is guaranteed issue–as there must be–and no mandate, relatively low-risk people will wait to buy coverage until they expect to need expensive medical care, since there is essentially no penalty for waiting. They will not be paying their fair share, and their absence from the insurance pool will cause premiums to be much higher. Someone has to pay that higher price: either the higher-risk people who remain in the pool, which will make coverage unaffordable for many, or government through subsidies to make coverage affordable for higher-risk people. Neither of those is fair. Everybody has to be in the pool to make the system workable and fair.