As we have noted, Obamacare violates medical ethics by first doing harm. In the early going, in violation of repeated presidential promises, Obamacare stripped many embattled Americans of the health plans they had selected. This pushed them toward the dysfunctional and insecure Obamacare website, where they would get the news about higher premiums and bigger deductibles. Even on December 1 key parts of the website were not even built, so those who “enrolled” might find on January 1 that they don’t have insurance after all. The doctors people were told they could keep are fleeing the system. That is quite a record of damage, but one Obamacare enthusiast wants the system to be even more punitive.

Akhilesh Pathipati is a Stanford medical student who has “worked on health initiatives in Massachusetts and California,” according to his author line in this Sacramento Bee piece. Obamacare “has had its share of well-publicized struggles,” he writes, “but it’s only a matter of time before the website glitches are gone.” Further, “the flaw in an otherwise straightforward design is a weak individual mandate.”

“Young people like me are the linchpin to making health care reform successful,” he says. But without their participation, “more gets paid out than gets paid in so premiums rise, and the system falls apart.” If the young and healthy “invincibles” determine that the costs are too high and decline to participate, Obamacare punishes them with a fine. As Pathipati has it, if a young man earning $40,000 a year declines even the cheapest plan, “opting out would only cost him a $300 tax penalty.” The Stanford medical student has the answer.

“The only way to ensure the participation of the young invincibles is to strengthen the mandate by making the opt-out tax as costly as buying insurance.” Got that, healthy young people? If you think Obamacare is not for you, Akhilesh Pathipati wants to jack up your fine, big time.

Pathipati acknowledges that young people are not signing up in sufficient numbers, and the prospect of stiffer fines is unlikely to make them do so. But young and old alike can learn a lesson here. When people become apologists for a fatally flawed system, they tend to put defense of that system above the welfare of its victims. Medical student Akhilesh Pathipati has yet to learn that if a treatment harms the patient one should stop the treatment.