A refusal to purchase healthcare insurance can have an effect on interstate commerce, because in shrinking the risk pool of insured the premiums would incrementally rise. In 2007, healthcare expenditures amounted to $2.2 trillion, or $7,421 a person, and accounted for 16.2% of the gross domestic product. These statistics leave no doubt that regulating health insurance is synonymous with regulating interstate commerce.(10)  Not engaging in economic transactions is a form of commercial behaviour that Congress can regulate. The Supreme Court held that Congress could require that hotels and restaurants provide services to African-Americans. Their refusal to engage in commerce still was deemed to be within the scope of Congress's commerce clause power.(10)  The likelihood is that everyone will require medical care at some point. An uninsured person in a car accident will be taken to the emergency room for treatment. An uninsured person with a communicable disease will be treated; indeed, it is necessary for the health and welfare of the general population to provide treatment to individuals suffering from infectious diseases. Congress can ensure that there is an adequate fund to pay for everyone's medical needs.