Helping out Hiaasen.

The distinction he misses here, in comparing mandatory purchase of automobile insurance with mandatory health care insurance, is the opt-out provision.

If I don't want to buy the mandatory auto insurance that accompanies the privilege of driving a car I own, I can opt out and do neither. It's the economy activity of owning and driving that car -- a definite "activity" -- that makes the one mandatory purchase of a private insurance product permissable.

It's not like we've got people knocking on doors (yet!) and forcing folks to pay for something they don't participate in. You don't want to buy it? Fine. Just no driving legally on government roads, streets and interstates.

You don't participate in the high-priced medical games? Prefer to practice preventative maintenance in maintaining your health, and pay out of pocket for the minimal medical treatments you do incur?

Sorry, the gov't. says. We need you to carry the costs of all those who overconsume, taking more from the system than their own insurance premiums can pay for. And... get this, there's no way of opting out!

No being able to prove that it's not you who's run up medical bills and foisted them off on others. No doctor's note to show that indeed, you've been a model "patient", being careful not to incur medical risks and instead fostering the genetics that allow you a family history of minimal medical treatment.

Nope, if you breathe, you're on the hook for the medical needs of others.

That's unconstitutional. Forcing those who don't consume to buy a product they don't need, don't want, and cannot opt out of.

Spare me the "you might get hit by a bus!" scenarios. Stacked auto insurance policies would help pay for that, as even as a pedestrian, coverage from a motor vehicle accident would draw from there first. Plus, there's going to be plenty of subrogation back to the bus company's insurance, if they're liable for hitting me.

(Funny thing is: it's a pretty decent personal insurance policy to keep you in good health -- not walking around busy streets with your headphones on, or skiing recklessly off trail down mountainsides -- knowing that you alone bear the costs of your ill health and personal risk choices, and not that "you won't feel a thing" in terms of the final bill, because your insurance company has you "covered"...)

What really gets my goat, if we want to improve our national health, is we ought to be looking to the people in the best health who AREN't running up big medical bills and who are able to take care of their health without the latests tests, pills and procedures as role models.

Instead, we look to what is often our sickliest, though most well insured, to decide what the rest of us need to pay to pick up their slack.

No thanks. The Constitution is clear. You can't regulate "non-activity" -- or punish someone because they don't purchase a private product they don't use or need.

The sooner the Courts rule that this mandate is a no go, the sooner the wise policymakers can get back to the drawing board in tackling the skyrocketing rates of medical consumption that will not be fixed by forcing healthy non-participants into a sick system. It's no solution if it's ultimately found to be illegal, afterall.

(And before you ask? Massachusetts also has an opt-out for their mandatory insurance policies: you can move out of state. But federally forcing everyone in? That won't fly.)

ps. Before you ask me what to do about all the uninsured's who DO treat medically, under government guaranteed Medicaid for poor and disabled people? Above my pay grade. Perhaps, some of those "guarantees" ought to be altered, now that they system shows we can't afford such generous impulses without illegally trying to pick the pockets of others -- non-insured non-consumers -- or perhaps some of our most affluent will set up private charity programs, akin to the Catholic hospitals of the last century, where those who choose to can privately step up to pay for the medical needs of others.

That's permitted under the Constitution, and the Commerce Clause still. And surely folks like Mr. Hiaasen would voluntarily divest of a bit of their personal wealth if poor people were dropping dead outside the emergency room doors? If there's not enough charity to cover them, perhaps the problem isn't as big as we're pretending, and there's a reason we continue to liberally maintain extravagant lifestyles -- see the Obama administration -- while crying for the poor and pressing hard to push medical bills onto non-participating others.

(HT: Law Professor Randy Barnett.)