How Big is the Health Care “Free-Rider” Problem?

One of the most common arguments for an individual mandate is that “free-riders” – the uninsured who consume emergency room care with no way to pay for it – are jacking up health care costs for everyone else.

The argument begins by pointing out that sickness and emergency can strike anyone at any time, and therefore people don’t have an active choice about whether or not to participate in the health care market. Inevitably, they have to. Thus, so the argument goes, it isn’t fair for people to “free-ride,” charging higher costs to everybody else. A mandate ensures that everyone will pay their fair share.

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