Do you need a mandate to force you to buy something you want or need? This question isn't asked by those who support a health insurance mandate, such as Dr. Edward Miller and Scott A. Berkowitz of Johns Hopkins ("Hopkins leaders support health insurance mandate," Aug. 9). The reason we have so many uninsured Marylanders is that health insurance is either too unaffordable or it doesn't offer a good value to those who can afford it. A mandate won't solve either of those problems.

Responding to self-interested lobbying groups, well-meaning legislators have mandated that any health insurance sold in Maryland must cover over 60 procedures, something that has dramatically raised the cost of insurance in this state. If you want insurance that doesn't cover, say, in vitro fertilization, you can't purchase it. There are also a number of restrictions on the price and type of health insurance that can be sold in the state.

If you want to escape Maryland's tough regulations, too bad. If you live in the Eastern Shore town of Delmar and want to purchase a cheaper policy from a broker across the street in Delmar, Del., you are legally prohibited from doing so. Now, with the passage of the so-called "Affordable Care Act," restrictions like Maryland are in place at the national level. This legislation will increase the cost of health insurance and then use tax dollars to subsidize its purchase for some people.

If we allowed health insurance to be bought and sold like other goods there would be no need for a health insurance mandate. If people could tailor the health insurance policy to meet their needs and desires and if they could buy health insurance across state lines, the vast majority of people could afford a policy giving them what they want. While some people would not have enough income to afford a policy, that's why we have safety net programs like Medicaid.

Instead of supporting a mandate forcing people to buy a product that is too expensive and doesn't offer people what they want, Dr. Miller and Mr. Berkowitz should advocate giving health insurance consumers more power. These consumers, not government bureaucrats, know what they can afford and what type of insurance is best for them.