Mandatory health insurance is not analogous to car insurance. Car insurance requirements impose a condition on the voluntary activity of driving; a health insurance mandate imposes a condition on life itself.  States do not require non-drivers, including passengers in cars with potentially bad drivers, to buy auto insurance liability policies -- even though such a requirement undoubtedly would lower the auto insurance premiums for those who do drive. The auto insurance requirement is linked to driving and to the possibility that bad driving may cause injuries to others, including passengers in the driver's car, not to those who benefit from roads generally.(2) The primary purpose of the auto insurance mandate was to provide financial protection for people that a driver may harm, and not necessarily for the driver himself. And the auto insurance mandate is a quid pro quo for having the state issuing a privilege: in this case a driver’s license.(6)  Regarding the claim that Medicare tax provides a justifying precedent for the individual healthcare mandate, it is worth noting that the architects of Medicare harboured grave doubts about its constitutionality, which was ultimately settled on the taxing power of the United States government. However, in contrast to an individual mandate, federal benefits are attached to Medicare taxes and there is a specific “contract” involved between the current payment of taxes and future government benefits. No such relationship would exist with the individual health insurance mandate. Additionally, while one can “opt-out” of receiving Social Security and Medicare benefits, although one must still pay Social Security and Medicare taxes, none of the individual mandate proposals provide for an “opt out”, other than for yet undefined religious objections. Interestingly, a suit being led by former House Majority Leader Richard Armey is challenging a federal regulation that suggests that opting out of Medicare will put a person’s Social Security benefits at risk.(6)