The Coach wonders why I'm "convinced that health care mandates are good politics (taking [my] argument that principles and politics trump policy in health care at this point)." Fair question. The political reply is that I don't think mandates are bad politics. In fact, I think universality in health care is good politics! It passed, after all, in Massachusetts, and I don't think it would require the world's greatest politician to sell the idea that everyone should have health care, and no one should be able to game the system and pass costs onto the rest of us. But I think the Coach's question is important for another reason: The argument I've been making is not that politics always trumps policy, but that we have to strike the right balance between the two. Covering just children, for instance, is very good politics, but it's utterly inadequate policy in a health system that desperately needs real reform. Similarly, universality is, I believe, a prerequisite to actually reforming the insurance industry (you cannot tell them to cover everyone at one price, then tell the healthy they need not buy in until they fall sick), and actually reforming the insurance industry is necessary if reform is to be worth the effort. Mandates, in other words, strike an acceptable balance between good policy and good politics. I'd prefer some form of tax-based, government enrollment, but that sort of upheaval looks politically implausible to me. I can see the argument that a non-universal system is an easier sell, but that's not a policy compromise I'm willing to make. So mandates it is, unless something better, like automatic enrollment, comes down the pike. For more thinking on how mandates affect insurance markets, see Len Nichols.