By a 5-4 margin, the Supreme Court upheld the health care mandate.
I've always been puzzled by the legal issue. If it is legal for the state to conscript someone into the Army to work for below-market wages that is clearly an onerous and harsh tax—for which you could pay with your life. Despite the teeth-gnashing, a health care mandate is much less draconian than a draft.
The Supreme Court majority agreed with this perspective, saying a health mandate is an implicit tax for which the federal government has legal authority.
Some Christian Scientists will have their religious preferences impinged and I would prefer some type of deferment for members of these religious groups, just as we have had for the draft.
I am more concerned, however, because no law is workable unless the moral justification for it is widely accepted. If a sizable minority of Americans mount a campaign to refuse to buy insurance, that protest could threaten the legitimacy of other tax collections.
The health mandate is not about paternalism (caring for those who don't want to care for themselves). The issue is about personal responsibility. To pretend we are living in caves as isolated individuals is dysfunctional. We live as part of society, and that means contributing into a fund for national security and – now – for health care.
This is not the end of the world for capitalism. In fact, many health insurers like the idea of capturing 40 million new subscribers. It is also interesting that people who quote Hong Kong as the freest country on the planet somehow forget to mention that Hong Kong provides public health care for all.