From the journal of the American Medical Association: NIH: Buying health insurance is now your "moral duty"

http://www.ncbi.nlm.nih.gov/pubmed/22782412

JAMA. 2012 Jul 11;308(2):137-8.

The moral duty to buy health insurance.

Rulli T, Emanuel EJ, Wendler D.

Source

Department of Bioethics, NIH Clinical Center, Bethesda, MD 20892, USA.

"The 2010 Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance coverage in the United States. Its most controversial feature is the requirement that US residents purchase health insurance or pay a financial penalty. Although debate focuses on the constitutionality of this individual mandate, the central concern is a moral matter—is it morally appropriate to require individuals to purchase health insurance?


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Physicians and hospitals have a moral duty to provide acute care and emergency care to those who need it. The burdens of providing such care to the uninsured are very high, while the cost of purchasing insurance to cover these costs is not excessive for many. It follows that individuals have an enforceable moral duty to buy sufficient health insurance to cover the costs of acute care and emergency care. This moral duty provides grounds for an enforceable legal duty because the state has an interest in limiting individuals' imposition of substantial burdens on others. Although the Supreme Court will decide the constitutionality of the ACA insurance mandate, this analysis suggests that requiring individuals to buy health insurance is consistent with respect for individual liberty because individuals have a duty to mitigate the burdens of rescue they pose on others."