How About a 'Do Not Treat' List? At least some members of the Supreme Court seem to be persuaded by the idea that the government does not have the power to force us to buy health insurance. The whole idea seems specious and anti-free-market to me: If the government could legally enact Medicare for all, and tax all of us to pay for it, why is mandatory insurance not legal? It accomplishes the same thing, while minimizing government control of the health system. But I am not a lawyer, let alone a constitutional scholar. The Times, in an editorial today, responds to a question by Justice Antonin Scalia about how this differs from forcing us to buy broccoli: "Congress has no interest in requiring broccoli purchases because the failure to buy broccoli does not push that cost onto others in the system." The answer, it seems to me, is simple. Let the health plan continue as enacted, with government subsidies and rules to assure access to health insurance for everyone. But if someone is morally offended by the idea of buying health insurance, he or she should be given counseling about the risks but then allowed to decide. Persons who decline insurance would be allowed to provide details of how they intended to pay for care otherwise, if they wished to do so, and to name a person who would be responsible for paying for the care if the patient were unable to direct payment, much as many people now have health care proxies. Anyone who chose not to have health insurance, and not to indicate how they would otherwise pay, would be put on a "Do Not Treat" list. Hospitals could simply refuse to offer any treatment, respecting the person's wish to make his or her own decisions free of an intrusive government trying to keep them alive. I doubt many people would sign up for such a system, but it would certainly overcome the alleged constitutional flaw in the current health care law. Some people might be concerned that such a system would amount to voluntary euthanasia or assisted suicide. But surely they would put aside such qualms when they understood this was necessary to preserve our freedom not to be forced to buy something we do not wish to purchase.