Our health is in many ways in the hands of for-profit corporations. The Affordable Health Care Act seeks to make health care available to everyone. It does so, for example, by requiring insurance companies to accept everyone who applies and disallowing rejection based on pre-existing conditions.

To make this provision possible, a necessary individual requirement provision will be implemented by 2014 requiring all Americans to purchase health insurance. This mandate to participate in commerce or be penalized has come under fire.

Last week, a federal judge ruled that the Affordable Health care Act’s provision requiring the purchase of health insurance to be unconstitutional. Judge Roger Vinson of the Federal District Court in Florida is the second federal judge to rule the law unconstitutional.

However, two other federal judges have ruled that the law is constitutional and 12 other judges have dismissed it outright.

Constitutionality aside, is it fair to require people to buy a product that they may not be able to afford? In a word, yes. But this requirement should come with sweeping health care reform that cuts out the profiteering middleman, the for-profit American health insurance industry.

The individual mandate is an example of the General Welfare Clause. The GWC provides for congress to enact laws for the common good, in this case, spreading the burden of health care and lowering the cost. While this is troubling on some levels, it should be pointed out that drivers are required by law to obtain auto insurance in 49 states, including Wisconsin. And operating a motor vehicle without insurance can result in a fine of up to $500.

This ensures a level of protection for people whose property or person you may damage or injure while operating your vehicle.

The parallel then in requiring the purchase of health insurance, is that you are effectively providing a level of protection, not just for yourself, but for others as well. When contributing to the health care system, you are providing a level of protection for the people who you would burden with your debt should you become sick or injured while uninsured.

Individuals who currently choose to forego insurance or cannot afford to purchase health insurance still routinely take advantage of the health care system. The problem extends to the rest of us when those individuals default on their hospital bills.

The cost, for example, of a perfectly normal childbirth without complications averages between $9000 and $17,000. A broken wrist will set you back roughly $2,500 and a trip to the emergency room can easily add an additional $1000 or more to the bill according to Costhelper.

In addition, according to a Centers for Disease Control report from Aug. 2010, the most common visit to the emergency room in 2007 by males 15 years and older was chest pain. Cardio vascular disease costs this country an estimated $475.3 billion in 2009, according to the American Heart Association. Some per-incident estimates reach the hundreds of thousands.

When the median household income in the United States is roughly $50,000, these uninsured health care costs can represent an enormous burden on individuals. When these people are unable to pay, this burden is shifted to the premium-paying insured and the taxpayers. This shifted burden amounts to a hidden tax. That isn’t fair. It increases the cost of health care for those left footing the bill.

The Affordable Health Care Act’s provision that prevents insurance companies from rejecting people based on pre-existing conditions had bipartisan congressional support. An individual mandate is required to prevent abuse of this situation.

Eliminating the pre-existing condition rejection could encourage people to wait to purchase health insurance until they are sick or otherwise in need of medical care. This increases the cost for all people who have health insurance. To put it another way, the cost of health insurance would be even more prohibitive if it was only the sick that were purchasing it.

The problem with insuring only those who need it is a fairly straightforward supply and demand problem. An insurance provider will not survive if they are paying out more money than premiums are bringing in.

Health care is a shared responsibility that an entire society should shoulder. When that responsibility is spread out over a greater number of people, the burden on the individual lessons. In other words, the more people paying health insurance premiums, the smaller the premiums will become.

The fact remains that the United States does not have a government-run insurance program and has, historically, struck down attempts at “public options.” This contributes to questions about the constitutionality of the law to leech into the conversation.

Having a government-run health care program has shown in other countries that administrative costs, among other things, are greatly reduced and care is streamlined. It also makes mandatory universal enrollment much more feasible.

Taiwan’s government-run health care program costs the country roughly six percent of its gross domestic product as opposed to the United States’ 16 percent. Administrative costs in the Taiwan model are less than two percent of program costs. American health insurance companies incur administration cost upwards of 20 or 30 percent.

The small Asian country of 23 million has approximately 99 percent of its citizens covered under the plan, which has a public approval rating of 80 percent. And the average Taiwanese family pays just $650 per year.

Affordable health care is a right and should be available to everyone regardless of age, race, health, or economic status. The individual requirement seeks to make this possible by strongly encouraging individual responsibility.