People do not want to pay for medical insurance when they are young and healthy. The Democrats want to force the young to take the insurance and pay for it (the infamous “mandate” under Obamacare), because somebody has to pay for it (not to mention overpaying for it, to partially pay for the old and the unhealthy, too) and the Dems secretly recognize the absurdity of allowing people to wait until they are ill before they buy the insurance, and the Dems would rather avoid the appearance of criminalizing a refusal to take the damn insurance. The Republicans are waiting and hoping for the Supremes to bail them out. False dilemma.

Medical insurance should be priced the same way as life insurance and other insurance: you pay more if you present a greater risk. Just as you can lock in a lifetime of guarantied coverage and pre-set rates if you buy life insurance when you are 21 and healthy, but it costs you a lot more if you wait until you get older or sicker, the choice is yours and the market is pretty rational in terms of pricing the product based on the risk – only the nutjobs complain because women pay less than men, Asians pay less than Blacks, and the young and beautiful pay less than the old and the infirm, and you can shop anywhere in the country to buy a policy from any carrier you like; policies are readily available to individuals as well as company employees, and no one gets favored tax treatment. You want medical insurance that protects you from changing jobs or losing one or from developing a condition that is ‘preexisting’ forever after, be smart and buy young. If we want to grandfather-in all the people who today are already stigmatized by being not-young or not-healthy, fine, have the taxpayers foot the bill for a one-time voucher to allow these people to buy an affordable policy that will last for the rest of their lifetimes (or at least until Medicare) – surely that would be a whole lot cheaper than the projected costs of Obamacare. Moreover, if we want ongoing subsidies for the non-rich (however defined), same solution: subsidize as much of a voucher as the societal conscience may require. In any event, this keeps the system private, fully-incentivized, rationally priced in a free market, and fully paid-for; if people want to pay for a less-comprehensive policy, or for none at all, that is their privilege.