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A recurring theme in the discussion of this week’s major case before the United States’ Supreme Court (Florida v. United States Department of Health and Human Services) has really annoyed me.

The government likes to claim that everyone is already in the market for health care and so they aren’t requiring anyone to enter the market but simply regulating how they behave within it.

This claim is completely wrong — not everyone is in the market for health care.

I don’t mean just those who, for religious reasons, refuse to participate in marketed health care — though I suspect that the government’s attempt to require people to buy health insurance would largely trample such conscientious objectors, especially if they are not registered members of some large and legally incorporated religious body with explicit doctrines forbidding participation in modern medicine.

I mean also normal, everyday, consumeristic Americans who, because of unusual circumstances, never enter the market for health insurance or health care.

Most of the uninsured are young people. Most young people don’t get sick enough to need medical care, so many of them don’t feel a need to buy health insurance.

The idea that everyone is in the health care market assumes that all these young people will eventually become old people, since old people always end up needing medical care. But the fact is that many young people never become old people. They die instead. And many of who die young never need medical care along the way. They go from young and healthy straight to dead. It happens to thousands of young people every year.

Those people are never naturally in the market for health care. Never, ever. But they’d be forced into the market by a universal mandate just the same.

That’s the problem with justifying the universal mandate by saying that health insurance really is no gamble because health care is never optional. It is a gamble. Some people could never use health care, and any young person might end up being one of those people.

Certainly most Americans get sick enough that they would benefit from medical care at some point. But because not all do, the specious claim that all are eventually in the health care market must be rejected. With a universal mandate, some people would be forced to buy health insurance and never have the opportunity to use it.

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