May a government mandate more comprehensive health insurance than citizens want for themselves?

Voorhoeve, A.ORCID logo (2018). May a government mandate more comprehensive health insurance than citizens want for themselves? In Sobel, D., Vallentyne, P. & Wall, S. (Eds.), Oxford Studies in Political Philosophy (pp. 167-191). Oxford University Press.
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I critically examine a common liberal egalitarian view about the justification for, and proper content of, mandatory health insurance. This view holds that a mandate is justified because it is the best way to ensure that those in poor health gain health insurance on equitable terms. It also holds that a government should mandate what a representative prudent individual would purchase for themselves if they were placed in fair conditions of choice. I argue that this common justification for a mandate is incomplete. A further reason for mandated insurance is that it helps secure social egalitarian public goods that would be underprovided if insurance were optional. I also argue that rather than mandating what a representative individual would choose for themselves, we should design the mandatory package by appealing to a pluralistic egalitarian view, which cares about improving people’s well-being, reducing unfair inequality, and maintaining egalitarian social relations.

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