There’s one element of healthcare reform legislation on which many liberals and conservatives agree – the mandate.  Both the Senate and House versions of the healthcare reform bill contain a mandate requiring that all Americans be insured – whether it is through their job, the government or the private market.

From the right, there’s criticism from Michael Cannon, a health policy analyst at the libertarian Cato Institute, who says “The federal government does not have the power to force you to purchase a private product.”  From the left, Jim Dean, chairman of Democracy for America, notes that “We’d like to see the individual mandate stripped.  It was fair given the presence of a government entity that could provide competition and control the cost.  It’s not fair if people are required to buy insurance from the same insurance industry that caused this problem.”

The reasoning behind the mandate reflects the basic concept that underlies all insurance.  A large pool of people pays fairly small premiums to create a fund large enough to take care of people who need help.  The idea that people of all ages participate is of particular importance in healthcare, because costly medical conditions are found primarily in Americans who are middle-aged or older.  When younger and healthier people don’t have insurance, the others pay higher premiums.

The insurance industry has a totally different reason for disliking the mandate – they think it’s too mild.  Robert Zirkelbach, spokesman for America’s Health Insurance Plans, believes that “We think there’s more that (the bill) needs to do.  There’s still a strong incentive for people to wait until they are sick to purchase insurance.”  Zirkelbach is referring to one of the legislation’s hallmark features – the requirement that insurers treat those with pre-existing conditions the same as all other patients and bans denying coverage.