Making health reform work without employer mandates

Requiring employers to furnish health insurance may be a politically expedient way to expand coverage to the uninsured, but it will surely undermine economic competitiveness and contribute to greater unemployment at a time when the U.S. is struggling to regain its economic strength. In the present environment, a wiser course of action would require that individual households, not employers, become the entity responsible for obtaining health insurance. Under such a scenario, limits would be established on the percentage of after-tax income devoted to health insurance, subsidies would be granted to low-income individuals to purchase insurance, and a basic benefit package would be developed that limits payments to services meeting efficacy and cost-effectiveness criteria.