The proposed health insurance reform includes a "mandate" requiring people buy insurance or pay tax penalties. This incenses people from both the right and the left. On the left, it's annoying to be forced to buy insurance from a profit-making company, thereby subsidizing corporate jets, bonuses and the wimpy corporate boards that protect CEO interests above shareholder interests. However, most liberals/progressives support the mandate if there is a competitive public option health program. On the right, the opposition isn't about the type of insurance, but a more fundamental opposition to any government incursion on our independence - in this case, the idea that the government can force you to buy something you don't want or don't need. Arguments from the right make it seem that the proposed health insurance mandate is both unprecedented and unreasonable.
Is a health insurance mandate unprecedented? Let's consider car insurance. I suspect that every state has a mandate that every licensed vehicle must carry car insurance or pay a fine. We consider driving a "privilege" rather than a "right," so the mandate seems fairly unobtrusive. The argument could be made that one doesn't have to drive, so one chooses to drive and therefore chooses to abide by the laws requiring insurance. But as a practical matter, how independent is an American that chooses not to drive? Either you must live close to your place of work and walk, risk your life on a bike, or take public transport that is subsidized by the taxpayers. For the vast majority of Americans in urban, suburban, ex-urban and rural areas, driving a car is not optional - its a necessary part of our life due to the way our infrastructure has developed. Thus, the requirement to buy car insurance is a de facto "mandate," and is a precedent for a health insurance mandate.
Is a health insurance mandate unreasonable? The reason for the car insurance mandate is fairly obvious: through stupidity, carelessness, or simply a bit of bad luck any one of us can cause an accident that leads to another person being financially harmed. Insurance compensates those harmed by any accident we cause. On the face of it, this seems different than health insurance - after all, if I don't carry health insurance how do I harm you? Aren't I just putting myself at risk? Shouldn't I be allowed to be stupid - and wouldn't the gene pool be ultimately improved by allowing this choice? Unfortunately, my choice not to carry insurance does harm you. We have a network of public and private hospitals that receive subsidies based on providing emergency care to any and all who come through the door. If I fall into a seizure in the middle of the street, I will be picked up by emergency medical services, taken to a hospital and treated, even if I do not have any ID or insurance card on me. When I recover consciousness, if I cannot pay and don't have insurance I will still be released from the hospital - we don't have debtors prisons anymore. The cost of my choice to be uninsured doesn't fall on me, it falls on the taxpayers and on those who have insurance that will pay the higher overhead of the hospital that treats the uninsured.
Thus, the argument for the health insurance mandate is fairly simple - we do not have an "opt out" mechanism for emergency treatment, therefore a choice to be uninsured is not a choice for independence, but is a choice to rely on a socialist emergency treatment network. As the ultimate provider of that socialist network, the citizens, must pay the costs themselves through general taxes, recoup the costs by targeted taxes on the uninsured, and/or reduce the number of uninsured by mandating insurance. Oddly enough, the consistent conservative point of view should be payment through targeted taxes and mandates, i.e. individual responsibility. The consistent progressive point of view should be payment through general taxes, i.e. the dreaded single-payer system. However, conservatives, presently arguing against the mandate and tax penalties, are actually arguing for emergency health care that is subsidized by general taxes - while the liberals are arguing for tax penalties for those who don't take individual responsibility to get their own insurance.
There could be a compromise (warning - sarcasm follows). We could allow people to avoid the taxes for not buying health insurance if they post an undertaker's bond of $2000 and have a tattoo on their wrist that says "DO NOT TREAT". We would then tell EMS workers just to leave such people where they lie. Once they're dead the undertaker can pick them up and collect the bond. The uninsured by choice could have their independence and our only inconvenience would be having to step over the dead and dying on the sidewalk.
The proposal to tax people for not having insurance is very similar to what happens with people who rent houses. You aren't required to buy a house, but if you don't buy one you will pay higher taxes than someone who does - and yet no one talks about a "home-owning" mandate in the tax code.