Ezra Klein has a piece in the forthcoming New Yorker titled “Unpopular Mandate: Why do politicians reverse their positions?” He describes the evolution of Republican views on the individual requirement to purchase health coverage. He rightly notes that the mandate has been “at the heart of Republican health-care reforms for two decades.”
There are some obvious reasons for their attention. Suppose we wish to protect every sick or injured American from the risk of financial catastrophe. We might accomplish this task in several way. Whatever we do, we must somehow address the possibility that people might gamble by going uncovered when they are healthy, and then seek to buy coverage under favorable terms when they get sick. It is a main concern of any serious national reform, particularly one that places heavy emphasis on individual coverage within the private insurance market.
This Sunday’s Wall Street Journal editorial page takes up these issues, as it considered Republican responses to whatever the Supreme Court chooses to do. Journal editorial writers characterize the issue thusly (h/t @sahilkapur and @brianbeutler):
If Republicans had any wit they’d consult the innovative work of the scholars Tom Miller and Jim Capretta on continuous insurance coverage and “guaranteed renewability” while still allowing insurers to price risk. Instead many of them want to maintain ObamaCare’s blanket pre-existing conditions rules, which is insane. That’s the reason Democrats cooked up the individual mandate in the first place, to help mitigate the cost spiral that these rules cause.
I don’t happen to like Miller and Capretta’s approach. I worry about its implications for tens of millions of uninsured people. But consider the bolded words above. As Ezra’s piece describes in detail, the Journal’s little essay isn’t a precisely accurate accounting of the mandate’s pedigree. If you don’t believe him, you can get more details at this website:
…the very idea of an individual healthcare mandate originated from the conservative think-tank The Heritage Foundation. But don’t take my word for it, read about it here.
Moreover, many prominent conservatives have supported the use of the individual healthcare mandate. Some noteworthy conservatives who have supported individual healthcare mandates are:
-President George H. W. Bush (source 1 and source 2)
-Speaker Newt Gingrich R-GA (source)
-Senator Orrin Hatch R-UT (source)
-Senator Charles Grassley R-Iowa (source)
-Senator Bob Bennett R-UT (source)
-Senator Christopher Bond R-Missouri (source)
-Senator John Chafee R-RI (source)
-Rep. Bill Thomas R-CA (source)
-And at least 16 other GOP Senators who have since retired from the Senate (source)
Actually, in 1993 when then-President Clinton was attempting to reform healthcare, Republicans who opposed Clinton’s idea of an employer mandate, supported the idea of an individual mandate. An individual mandate, the Republicans argued, would be a “free-market solution” to reform healthcare, part of a “social contract” that would help people take responsibility for themselves and avoid the immorality of freeloading off the government. Clinton’s plan, on the other hand, was seen as a “true government take-over” of healthcare, the worst form of the dreaded “socialized medicine.”
Romney is occasionally asked by the more conservative/libertarian voters, why he used an individual mandate. Romney replies:
“The key factor that some of my libertarian friends forget is that today, everybody who doesn’t have insurance is getting free coverage from the government. And the question is, do we want people to pay what they can afford, or do we want people to ride free on everyone else. And when that is recognized as the choice, most conservatives come my way.”
Yeah–that passage and the famous Romney quote are from mittromneycentral.com. This is a non-affiliated pro-Romney site where one can catch Romney’s schedule, read pro-Romney essays on diverse subjects. It has handy links to make Romney campaign contributions, buy “noboma2012” license plate covers, and more.
Republicans’ gymnastics around the Affordable Care Act have been noteworthy, Yet as Klein observes, partisans of all stripes execute surprising substantive shifts that match their momentary political needs and that gin up suitably forgetful or hypocritical indignation regarding the centerpiece of an opponent’s presidency. Maybe that’s the zero-sum nature of the political game these days.
It’s less forgivable when newspaper reporters and op-ed writers play by the same rules. The Wall Street Journal is a fine paper. Its news coverage enriches our country’s political and policy debate. Meanwhile, the Journal’s editorial page detracts from these same debates through Pravda-like intellectual dishonesty and gracelessness that reinforces our political system’s worst defects.
[Cross-posted at The Incidental Economist]