Full piece here.

Epstein’s position:

The best way to deal with the risk of catastrophe is for people to buy their coverage early, when they are young, so that premiums are low. In any well-functioning market, they can acquire a renewable policy with guaranteed rates. At that point, does it become morally reprehensible to deny additional coverage to those individuals who passed on this possibility? No. Sadly, the abysmal performance of the American healthcare system lies not in the market economy that Kristof deplores, but in the elaborate network of regulation that shrinks the domain of voluntary choices, and leaves consumers with fewer choices than they would have had if the government had just stood by.’

As of now, if you’re young & healthy, you are going to be forced by tax or ‘penalty’ into buying standardized policies in a government-run health-insurance exchange, perhaps against many of your interests, in order to pay for others who need health-care now, for a promise of future coverage.  This is how the moral question is being framed:  We’re all in this together, and we’re not letting anyone die anyways, so let’s get everyone on the same page and build a shiny, efficient health-care system.  The matter will not be left to individuals alone, nor individuals acting in the market alone, but rather many more decisions will be made and choices limited by the people running the government.

In this way, the ACA aims to keep much of the private delivery system we have now as a political compromise (functioning unsustainably, driving-up costs in certain areas), while attaching much of this old private system to its new government-run exchanges which it has promised would be working by now, and if not by now, certainly by November 30th, 2013.

In order to get these exchanges working, you, someone in your family, your neighbor, or maybe a co-worker is being sent a letter that says your current insurance plan will be dropped by such-and-such a date, and that you’ll need to buy one of the plans the government-run exchanges will make available.

Epstein finishes with where the moral blindness is as he sees it:

Mark these words: the breakdown in the individual insurance market is only a small foretaste of the total chaos from mass insurance cancellations that will come when and if the employer mandates go into effect.’

The American people sure are happy with their government, these days, and the government with the people, no?

Addition:  Avik Roy sums it up nicely:

‘Any serious health reform program—left, right, or center—would involve some disruption of our existing health-coverage arrangements. What makes Obamacare such a deeply flawed piece of work is not that it disrupts our existing arrangements, but that it disrupts those arrangements by forcing people to buy costlier coverage.’