For a time in the past, I supported mandating everyone in every American state have insurance to cover emergency room care, since not even the penniless uninsured are turned away from in an emergency. However, I've since changed my mind. One distorted incentive, like free emergency health care, should not alone advance the argument for the government to fix the distortion. Often, a government intervention will distort other incentives enough to produce in a net negative for society. What I've learned from Massachusetts is that a mandate to purchase insurance for emergency care is just not going to happen. The real choice is between no mandate for health insurance and a mandate for coverage that comprehensive in a government-defined way.

Besides, if one distortion justifies another, then when do we stop? For example, ethanol fuel mandates have made many foods more expensive; should basic foods now be subsidized (more than they already are) to compensate? And what if those subsidies lead to less healthy diets that increase Medicaid & Medicare costs? Should we make up for that by subsidizing gym memberships and taxing fatty foods?