The Nov. 30 New York Times column by Paul Krugman offers a taste of the bitter debate ahead should a Democrat retake the White House and launch a long-overdue campaign to reform the U.S. health care system, which has more holes in it than Swiss cheese. The hardest nut to crack, however, as Mr. Krugman indicates, will be whether to mandate that everyone must buy coverage. My response would be an emphatic yes!

Insurance only works if the spread of risk is wide enough to make coverage affordable for all. Thus, as long as healthy (at least for now) or downright foolish folk keep opting out, the pool becomes much smaller (and unaffordable) for all.

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