Yet I would not necessarily be opposed to a mandate if it were accompanied by reforms that enabled my employees to get decent insurance on their own. Frankly, I would prefer to pay 8 percent of my payroll to the government and get out of the business of providing health insurance, which after all has nothing to do with my real business.

This is actually one of the central quandaries of health care reform: If you make it possible for people to get reasonable insurance individually, you create an incentive for employers to drop their plans. That, in turn, threatens to increase dramatically the cost to the Treasury of any plan that aims at anything approaching universal coverage.

But the fact remains that there is little economic logic in forcing companies to provide health insurance. It distracts them from their principal mission, it gives large companies a big advantage over small companies (big companies can leverage economies of scale to reduce their per-employee costs), and it introduces friction in the job market by creating an external incentive not to change jobs.

At the same time, the bitter Republican opposition (which includes at least some small-business groups) to a "public option"—i.e., a government-backed health insurance program that would compete with private insurers—seems to be based less on economic logic than ideology.

"It's just too easy to imagine we'd end up with a healthcare system run with the efficiency of the Post Office and the compassion of the IRS, at Pentagon prices," says the National Federation of Independent Business Web site.

Surely, though, nothing better fits that description than the current private health insurance system. (And, notably, both Social Security and Medicare are actually quite efficient, if not necessarily compassionate.)