NASHVILLE — Former U.S. Senate Majority Leader Bill Frist’s endorsement of a limited individual insurance mandate as part of health care reform isn’t going down well with some conservatives.

In a column in this week’s U.S. News & World Report, Dr. Frist, a Tennessee Republican and physician, wrote that he believes in limited government, individual responsibility and generally opposes “individual mandates,” except “where markets fail, individuals suffer and society pays a hefty price.”

“Let’s face it,” Dr. Frist continued in the column, “in a country as productive and advanced as ours, every American deserves affordable access to health care delivered at the right time. And they don’t have it today. It is time for an individual health insurance mandate for a minimum level of health coverage. Catastrophic coverage would be an appropriate place to start.”

In a dueling opinion piece, former U.S. House Majority Leader Dick Armey, R-Texas, chairman of the conservative Freedom Works organization, countered that “only the most blinkered of partisans can look at the ‘individual mandate’ and not see it as the answer to the health insurance industry’s prayers.”

“It is a law that forces everyone to buy its product,” Mr. Armey wrote. “What industry would not want this?”

Dr. Robert Moffitt, director of the conservative, Washington-based Heritage Foundation’s Center for Health Policy, said Wednesday of Dr. Frist, “I think he’s wrong ... I don’t think it (a mandate) advances the cause of a functioning market in this environment. (And) I think there should be an automatic bias in favor of personal liberty.”

Frist spokesman Chris Walker said that when “you’re looking at a debate as intricate as health care, there’s going to be differences.” He said people agree on 80 percent of the issues and disagree on 20 percent, making for a “healthy debate.”

Several of the reform bills pending in Congress, including a U.S. Senate bill sponsored by Senate Finance Committee Chairman Max Baucus, D-Mont., have requirements that everyone buy insurance, with few exceptions.

The insurance industry has said it cannot afford to support the overhaul, which prohibits it from denying coverage for persons with pre-existing health problems, unless everyone is covered.

The Baucus bill, as amended, would mandate that everyone carry health insurance or face an excise tax of $1,900 on their income tax returns.

In a blog posting earlier this week, Ben Cunningham with Tennessee Tax Revolt said Dr. Frist “believes your federal government should force you to buy health insurance. Bill Frist believes you are incompetent to make decisions about your own personal welfare and must therefore be coerced by threat of fine and imprisonment to do the ‘right’ thing.”

In an interview Wednesday, Mr. Cunningham noted he was speaking for himself and not the conservative group.

“I’m sure that Bill Frist has good intentions,” he said, “but the purpose of government is not to impose Bill Frist’s good intentions on other people.”

Tennessee Health Care Campaign Executive Director Tony Garr, whose group supports health care reform, said an individual mandate is necessary to make health reform work.

“We want everyone to pay in and everybody to benefit according to ability to pay,” he said. “The only way you can get there ... (is to) have individual mandates.”

Mr. Garr said that is how a third-party payer system works in Switzerland and the Netherlands.

In his column, Sen. Frist said individual mandates center on issues such as “fairness.” No family should fear bankruptcy because of major medical liabilities arising from injuries, a child’s cancer or heart attack, he said.

The individual mandate “is the only way to achieve affordable insurance coverage for every American in a pluralistic, public-private sector,” he wrote.