ratbastid

Well, there pretty much is. Not legally mandatory, but in practice, it comes down to the same thing.

One of my first jobs out of college was in the marketing department of a local gourmet food store, with a restaurant and deli and bakery as well as international grocery, housewares, wine/beer etc. You got ANY idea how much product liability insurance a place like that carries?

When I was working there, a woman contacted us who had broken a tooth on a bit of olive pit that had been in her tapenade she'd bought fresh-made from the deli. The company's insurance covered her dental work, plus several hundred thousand bonus dollars. If insurance hadn't been there to go between, such a case could easily put a company like that out of business. This sort of thing is a function of the (insurance-cartel-enabled) litigiousness of American society, but it works out to be just as mandatory as if there was a law requiring it.

On the flip-side... A friend of mine went white water rafting during a trip to New Zealand. At one point, the river forks. No signs or anything. You just have to know that if you go left, you go over a 100-foot waterfall and die. This isn't a problem for New Zealanders, they are willing to take care of themselves. It's downright shocking for an American, who's used to being babied and coddled at the threat of massive lawsuits.

We're a little far afield of the health reform debate, now, but I think the insurance business has broader tentacles than just health insurance.