A Mandate to Have Healthcare 'Liability' Insurance would be something like this

This is Robert Brook (RAND), describing his vision for the next phase of health reform [gated], in JAMA:

• What if to obtain and keep health insurance, individuals had to pass something like a driver’s license test?…What skills should be demonstrated?
• Should insurance be more costly, or even withdrawn, not because individuals become sick but because they do not use preventive services or evidence-based care in a manner that both protects their health and reduces health care costs for others?
• Consider a health system in which individuals who have health insurance and are competent to care for themselves would be required to take medications and have procedures known to be necessary and would do so; and a severe penalty would be imposed if they do not.

What if individuals were required to receive vaccines for which they were eligible, as soon as the vaccines became available — and were penalized if they contracted an illness the vaccination could have prevented?

• What if individuals with hypertension or hyperlipidemia who did not take their medications became responsible for some of the costs of future cardiac care?
• Should parents be expected to maintain their young children’s weight-to-height index at the 50^th percentile or less? Should sedentary workers be expected to participate in an exercise program provided at the workplace?