Voice versus Exit in Health Care Policy

M. Todd Henderson

This essay uses the recent controversy over President Obama’s mandate that insurance companies provide generous birth control coverage to explore larger issues about the optimal locus of health care decision making. Mandates may be justified in some instances, but they sacrifice choice and local variation and perhaps lead to worse social outcomes. The key question for policy makers is whether market processes or rule by expert is more likely to strike the right balance of choice and mandate.