Mitt Romney has increasingly been making the claim that an Individual Mandate (IM) is a "conservative principle" and that many conservatives were for it before they were against it. The latter point is correct. An IM was not a hugely controversial issue among conservatives ten or fifteen years ago. It was advanced as a way to make the irresponsible pay their fair share instead of depending on the government for "free" health care.
However the first part of his claim is only situationally correct. In making this argument, Romney is using a favorite tactic of the left known as a false dilemma. An IM becomes conservative in principle only if you first make the decision that health care should and must be provided to everyone. Having accepted the proposition that in a modern society health care is a right, then the logical progression is to have an IM in place to make sure everyone pays for that "right". After all an IM is a far more "conservative" solution than the other option which would be to raise taxes to pay for everyone's insurance premiums.
Among the dozens of reasons that enlarging government is always a bad idea is because it always leads to demands for an even larger government. Much like cancer, government grows and consumes and grows and consumes while sapping the energy of its host to an ever greater degree. In government's case, the weakening of the host is then used to justify more government and the cycle accelerates and repeats without end.
When Congress in its infinite wisdom passed the Emergency Medical Treatment and Active Labor Act (EMTALA) over 25 years ago, it was a fatal step toward a world of government ran health care. The passage of EMTALA essentially meant that the uninsured and those unable to pay suddenly had the right to demand emergency treatment at all hospitals. EMTALA was passed by a Republican Senate and signed into law by President Ronald Reagan.
So Mitt Romney, as full of baloney as he generally is, points out a problem that conservatives need to consider and reconcile. If not an individual mandate then what? To do nothing means the current system crashes in the near future. Tinkering at the edges with tort reform and allowing more choices in insurance, won't solve the problem caused by irresponsible lazy people and their progeny.
To prevent national bankruptcy and to discredit the Mitt Romneys of this world, conservatives need to take seriously the healthcare mess that currently exists and identify options to solve it that emphasize both personal responsibility and individual freedom in the 21st Century and beyond.