As soon as we decided that hospitals were legally required to give you health care if you walked into the emergency room we decided that health care is a human right.
That isn't how it works. Hospitals are only required to provide just enough emergency medical care to stabilize you. They aren't allowed to refuse that much, even if you don't have medical insurance or other proof of your ability to pay. That doesn't mean you get the care for free, however: you will still be billed for it, and (IIRC) medical bills are one of the harder items to discharge in bankruptcy. The hospital may never get back the full cost of that emergency care, but they are free to try.
The actual cost of the portion of required emergency care which isn't actually paid back is small enough to be considered irrelevant.
As I see it, there are two major problems with the no-insurance penalty. First, the ACA's proponents claimed that the penalty was a fine, not a tax, right up until the Supreme Court said that it was only constitutional in the form of a tax. Meaning that the ACA was passed under false pretenses. Second, coupling revenue with policy undermines equality under the law. What's the difference, really, between taxing everyone 100% of their income, with a 70% rebate for those who "voluntarily" limit their speech to approved topics, and simply fining you 70% of your income for speaking on unapproved topics, leaving you with nothing? Apparently the constitutionality of any action depends on whether the government pursues it through the courts, where the Constitution occasionally applies, or through the IRS, where there are no limits. That is simply unacceptable for any constitutional democracy.
An income tax should be just that: a tax on income. It shouldn't vary from one bit of income to another depending on how much total income you have or how much you conform to the wishes of those in power. $X in income should always equal $Y in taxes. If you want a so-called "progressive" tax, implement a rebate system—but not through the IRS. The IRS's job should be simple and straightforward, without a bunch of loopholes and exceptions and tax breaks and special rates depending on how much you happened to make that year.
My idea of a proper income (more accurately profit) tax form:
- Line 1: Gross income (market price of all goods and services received)
- Line 2: Gross expenditures (market price of all goods sold / expenses payed)
- Line 3: Profit = Line 2 - Line 1
- Line 4: Tax = x% of Line 3 if positive, else zero
If you buy or sell a good at the market price, the additions to Line 1 and Line 2 cancel each other out. Line 3 is thus only affected by (a) selling services (which would include income from labor), and (b) buying or selling goods at a price other than the market price.
"Market price" is ill-defined, but if you insist on having any sort of income tax, I think it's more or less inevitable that you will need to somehow convert the value of non-cash goods into a common currency, even though the concept makes no sense economically. (Prices only exists for specific goods at the times they're sold; anything else is merely a subjective estimate.) Note that this makes no distinction between "business" and "personal" expenses, which was always a rather arbitrary dividing line anyway.