JAMA? ?
July 11, 2012, Vol 308, No. 2
http://jama.ama-assn.org/current.dtl
Viewpoint
The Moral Duty to Buy Health Insurance
Tina Rulli, PhD; Ezekiel J. Emanuel, MD, PhD; David Wendler, PhD
Extract [Free full text]
The 2010 Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance coverage in the United States. Its most controversial feature is the requirement that US residents purchase health insurance or pay a financial penalty.??? Although debate focuses on the constitutionality of this individual mandate, the central concern is a moral matter?is it morally appropriate to require individuals to purchase health insurance?
Proponents argue that a mandate could lower insurance premiums for everyone by pooling individuals with varying health risks. Opponents respond that requiring people to contribute to the collective good is inconsistent with respect for individual liberty. Appeal to the collective good could justify requiring individuals to buy gym memberships or eat broccoli.1
Rather than appeal to the collective good, this Viewpoint argues for a duty to buy health insurance based on the moral duty individuals have to reduce certain burdens they pose on others. Because physicians and hospitals have a duty to rescue the uninsured by providing acute and emergency care, individuals have a corresponding duty to purchase insurance to cover the costs of this care. Requiring individuals to meet this obligation is consistent with respect for individual liberty and does not imply that they must buy gym memberships or eat broccoli?.
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