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It was bouncing about in the back of my head and it popped out today, but the question on employers being the gatekeeper for enforcement of mandatory universal health converage has been addressed in Massachusetts.
As of July 1, 2007, Massachusetts requires all residents to carry health insurance (I disagree with their logic that being uninsured necessarily unfairly passes your health expenses to society at large, but so be it).
The method of reporting is as I suggested above. When residents file their state tax returns they'll also have to include their insurance policy numbers. I'm not sure how this guarantees enforcement among the poor and dependent where it most likely to be an issue but that is how they do it. And there are civil penalties for failure to have health insurance. The first year it is loss of the personal tax exemption and then gets much more expensive in subsequent years.
While I wouldn't really support the Massachusetts law, if such is going to exist, that is the enforcement model I'd support. Between the person and the state, not the state putting a private bureaucracy in place as a private police force. The state also has requirements for employers related to health care, but in meeting those that is also a direct relationship between the state and the business (the state doesn't tell the electric company that they have to get proof of compliance before they can turn the power on in the offices).
By the way, it was Mitt Romney that signed this into law.
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