“When Senators Hillary Clinton and Barack Obama spar over health mandates, they’re dealing with only one piece of an intriguing policy dilemma: how to achieve meaningful health reform. Unfortunately, presidential debates invite mainly sound bites on this broad, complex issue. For instance, it’s unclear which types of ‘mandates’ are really being opposed or supported. Mandates figure into many government policies. In Medicaid for the poor, the program benefit must be spent on public health insurance. Some poor people might prefer to spend the money on other goods, but that’s not an option. That’s one type of mandate. How about Medicare? You and I must pay a Medicare tax on our earnings. We really can’t opt out of the program. The tax mandates our participation.” (02/28/08)