Obamacare

Democrats Learned About ObamaCare's Individual Mandate From Watching the GOP

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It is an important but often overlooked fact that the individual mandate to purchase health insurance, the least popular and most constitutionally dubious provision in the health care overhaul signed last year by President Obama, originated at The Heritage Foundation, a prominent conservative think tank with strong ties to congressional Republicans. In between its inception at Heritage and its passage as one of the key elements of ObamaCare, it got a trial run in Massachusetts in the state-based health care overhaul passed by current GOP presidential wannabe Mitt Romney, who on Tuesday admitted having gotten the idea for the mandate in part from Heritage.

At The Wall Street Journal, James Taranto, who worked at Heritage when the mandate first made waves, provides a brief history of the provision's development:

Heritage did put forward the idea of an individual mandate, though it predated HillaryCare by several years. We know this because we were there: In 1988-90, we were employed at Heritage as a public relations associate (a junior writer and editor), and we wrote at least one press release for a publication touting Heritage's plan for comprehensive legislation to provide universal "quality, affordable health care."

As a junior publicist, we weren't being paid for our personal opinions. But we are now, so you will be the first to know that when we worked at Heritage, we hated the Heritage plan, especially the individual mandate. "Universal health care" was neither already established nor inevitable, and we thought the foundation had made a serious philosophical and strategic error in accepting rather than disputing the left-liberal notion that the provision of "quality, affordable health care" to everyone was a proper role of government. As to the mandate, we remember reading about it and thinking: "I thought we were supposed to be for freedom."

Was Heritage's proposal different from the one that's now law? Yes, in some ways. But not enough to escape the core charge that the fundamental policy idea that would become ObamaCare's individual mandate grew out of what Heritage proposed. Taranto again:

The Heritage mandate, at least in theory, would have been less burdensome than the ObamaCare one. You'd have to be covered against catastrophically costly conditions but could choose to buy additional insurance or pay out of pocket for everyday medical needs. On the other hand, Butler's vague language–"it might also include certain very specific services . . . and other items"–would seem to leave the door wide open for limitless expansion.

Whatever the particular differences, the Heritage mandate was indistinguishable in principle from the ObamaCare one.

This tells you something about why Republican party leaders have had such a hard time addressing health policy issues over the last few years. Rather than make a prolonged case for health policy that does not involve endless expansion of entitlements and insurance subsidies, the GOP has instead focused primarily on reacting to Democratic proposals. The individual mandate was an attempt to beat Democrats at the universal coverage game and preempt the what would become HillaryCare. Medicare's prescription drug benefit was passed by a Republican president and a Republican Congress under the pretense that if they didn't do it, Democrats would, and it would be worse. In the debate over ObamaCare, Republicans spent more energy arguing against the law's Medicare payment cuts than any other part of the law. Riding a wave of anger over ObamaCare's passage to electoral victory in 2010, party leadership continued to refuse to talk about broader entitlement reform. And now they're on track to nominate a presidential candidate who, in his only gig as an elected official, signed a state-based law that would provide the model and foundation for ObamaCare—their top legislative target. 

Previously in the-GOP-doesn't-do-health-policy: Republicans Didn't Make the Case for Medicare Reform

NEXT: Gaddafi Snuff Footage

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    1. I stopped by just to post this. Looks like you preempted me by a few hours, though.

      Well played,Joe…Well…played…

  1. Rather than make a prolonged case for health policy that does not involve endless expansion of entitlements and insurance subsidies,

    … and lose.

    I mean, I completely agree with your critique. I just also think that the prolonged and consistent principled argument would have lost, and lost consistently.

    1. Sucks either way.

      In the end, it’s partially the fault of the electorate.

    2. I mean, I completely agree with your critique. I just also think that the prolonged and consistent principled argument would have lost, and lost consistently.

      Fuck that “we can’t argue for free markets because everyone on the DC cocktail circuit hates them” bullshit.

      Freedom is much more important than Senator douchebag (r) getting better committee assignments after the next election.

  2. That ‘editorial we’ is really annoying.

    1. “The Royal ‘we’! You know, the editorial.”

      1. +1 caucasian for you

    2. I believe that “we” refers to him and onother person who also worked at Herritage and now works for the WSJ as it would be odd to be both “a junior writer and editor” at the same time.

      1. He could have started his time there as a junior writer and ended as an editor.

      2. I believe that “we” refers to him and onother person

        “we were employed at Heritage as a public relations associate”

        Then he needs to brush up on elementary grammar.

    3. It makes him sound like a giant d-bag.

      1. You may not read Taranto very often, but there’s basically a big wink accompanying his whole “we” thing. His prose in general is pretty breezy and conversational, and the “we” amounts to a poke at stuffy old newspaper conventions.

  3. It’s really not that hard to understand its it?

    * A Mandate is a necessary requirement of an environment where forced universal coverage is to be provided by private insurers.

    * A Mandate is Unconstitutional at the Federal level.

    * A super-regulated “private” system with Mandates, such as RomneyCare, is a de facto socialized medical system.

    * Mitt Romney can suck it.

    1. John Kerry…er, Mitt Romney, will say anything to get elected President.

  4. “”* A Mandate is Unconstitutional at the Federal level.””

    Hoping so. I say it is, you say it is, neither one of us sits on SCOTUS. But since the commerce clause can be stretched to cover goods that don’t cross state lines. I wouldn’t be surprised if SCOTUS approves.

    Besides Medicare Part D mandates anyone over a certain age must have a drug plan.

    1. …neither one of us sits on SCOTUS.

      So far as you know, bwahahahahaha!

  5. Apart from all the manufactured hysteria, this is fairly simple:

    Either you believe (a) in universal access to healthcare or you think (b) healthcare should be a privilege of people with money, like yachts or tennis courts.

    If you believe (a) then there are various solutions, but none of them is achievable in a free market.

    Liberals believe in single payer to achieve healthcare as a right.

    Republican voters believe in government healthcare for themselves, just not black people.

    Libertarians believe healthcare should be yacht-like.

      1. Oddly, I don’t have a yacht. I have a little 14-foot aluminum jon boat. It’s plenty for dropping my line in the Chesapeake and it’s cheap to keep.

        I believe healthcare should be like food. If you want a ribeye, you can pay $22/lb at Texas Roadhouse, $15/lb at Whole Foods, $10/lb at Giant, or $7/lb at Sams Club. At any of those four levels you still end up with a nice ribeye dinner.

        With either a “single-payer” or the current “third-party-payer” systems, when was the last time you shopped around for the best deal on, say, a knee replacement? My neighbor sure didn’t. Neither did my brother in law. That’s why there’s so little competitive pressure for healthcare providers to economize. And the regulatory process they’re under makes it difficult too.

        1. They charge 22 bucks for a ribeye at TRH there? Jesus.

          1. Well you get your salad and your baked potato, and you don’t have to cook it yourself which is kind of the point of going out to eat.

            1. Yeah, I get that. I’m just saying its alot cheaper here in Cleveland. Probably because Libs have been running this city for 40 years and nobody can afford 22 bucks for a ribeye here anyway.

          2. Actually, the last time I went to one was in a very “tony” part of a very large city. They might be cheaper here. I prefer my own cooking to most restaurants so I don’t tend to eat out near home.

          3. It wasn’t a whole pound. Also see below.

            1. Huh, something’s wrong. It’s not putting my messages where I hit “reply to this.”

    1. What I find most interesting about this comment is the complete reversal of the usage of the terms “right” and “privilege” from how those terms are defined by libertarians. Where Tony sees a “right”, the rest of us see a Government granted “privilege” (i.e. a welfare grant dressed up as a “Positive Right”). And where Tony sees a “privilege”, the rest of us see a “right” (i.e. the freedom to allocate your resources as one chooses).

      THAT is the real philosophical difference on display in the healthcare debate.

      1. That’s because people like Tony believe in a “right” to steal.

      2. ^^^ This.

    2. Or perhaps it’s a service someone provides, and it’s up to you to pay for services you want.

      1. THANK YOU!

        Excuse me…

        Thank you!

    3. Either you believe (a) in universal access to healthcare or you think (b) healthcare should be a privilege of people with money, like yachts or tennis courts.

      Tony, as someone who labors to take you seriously and respond to your points and not make ad-hominem attacks against you, you make it very difficult to take seriously with comments like this.

      There are reasonable arguments for a single-payer system (I happen to not agree with, well, any of them) but wording shit like this presents an impossible dichotomy.

      As our broken healthcare system stands right now, I cannot afford yachts or tennis courts, yet I have pretty much full medical coverage, less a deductable and some copays, depending on which network of physicians I choose.

      You’d at least be more accurate if you said that Libertarians believe healthcare should be super-market-like. But you go so far over the top, it seems a rational conversation is misunpossible.

      1. But if we’re talking about a pure private market, imagine you had a preexisting condition, such as “being old.”

        1. You had to double down with being old as a preexisting condition?

          As someone else said, “you make it very difficult to take seriously with comments like this”.

          1. As if businesses don’t compete for whatever market share exists. If one company isn’t so interested in them, another will be happy to say, “Come to us!” Where I bank, they tell my they love all the new clients they’re getting from Bank of America’s new debit fee scheme.

            Old folks are big consumers of healthcare, and they have plenty of time to shop around for everything else in their lives. Stores don’t give senior citizen discounts because they’re sweet, they do it because they want their business. Put patient payer on the same tax footing as third-party payer and single payer, then watch seniors make the prices plummet!

            1. Old folks are big consumers of healthcare because they get it paid for by a government program.

          2. Are you suggesting that it’s possible in a private market for everyone to afford insurance?

        2. “But if we’re talking about a pure private market, imagine you had a preexisting condition, such as “being old.””
          Yes, shithead, and once you *weren’t* old and what happened then, shithead?
          You are pathetic.

    4. Tony, Libertarians believe healthcare should be yacht-like

      That is so but they call the yatch RMS Lusitania, and they give everyone eighteen minutes to save your own ass.

      1. For liberals, healthcare is a ship called the Achille Lauro. When your condition gets too complicated or expensive, you’re ushered to the deck for some fresh air, and then…

        1. PLF = AMA.
          I think the argument could be put forward

        2. Geroninmo!!!

    5. “Either you believe (a) in universal access to healthcare or you think (b) healthcare should be a privilege of people with money, like yachts or tennis courts.”
      No, shithead; one more false dichotomy.
      If you *ever* posted anything that wasn’t dishonest, I’ve never seen it, shithead.

      1. Do you or do you not believe that if you can’t afford health insurance that you should do without?

    6. Apart from all the manufactured hysteria, this is fairly simple:

      Either you believe (a) in universal access to healthcare food or you think (b) healthcare food should be a privilege of people with money, like yachts or tennis courts.

      If you believe (a) then there are various solutions, but none of them is achievable in a free market.

      Liberals believe in single payer to achieve healthcare eating as a right.

      See how stupid your idea is by changing one word.

      There is nothing magical about healthcare. It is a service like any other and universal access means the ability to buy the service without government interference.

      1. I don’t think you’ve rendered it stupid in the slightest. People should and do have a right to food. Ever heard of food stamps?

        Food’s not quite as expensive as heart surgery, but they’re both often necessary to life, as in “the right to.”

        It has nothing to do with magic, but with basic human needs. Those are things normal people think are more important than the demands of free market deities.

        1. Needs are not rights, slaver. Your need is not a claim on others.

          1. Except your need to have your property protected by men with guns. Other people can pay for that, right?

    7. I’m black, and I’m not familiar with a Constitutional right to healthcare. Take your race-baiting BS elsewhere. You suck.

  6. I want daddy to take care of me.

  7. Come on Tarranto, name names. Who dreamed it up and pushed it? Presumably that person(s) still around the conservative movement today and needs to be pointed to and embarrassed over and over again.

    1. This is gonna be like the search for Cartman’s father, I just KNOW it.

    2. I think he did, Stuart Butler and Edmund Haislmaier.

  8. You mean Ronald Bailey didn’t think of it all by himself?

  9. It is an important but often overlooked fact that the individual mandate to purchase health insurance . . . originated at The Heritage Foundation

    I asked the other day why Heritage was being held up to us as if it were some paragon of libertarian virtue? Here’s a case in point why it ain’t!

    1. I agree. I see it this way. If one were to accept that you’re going to have some level of socialized (nationalized) medicine, there’s a very strong desire to make it so people can’t “opt out” of the system. These systems often depend on everyone contributing, because if everyone doesn’t, then the system will fail. Sort of like Social Security. It’s a ponzi scheme of young earners paying the benefits of older retirees. Healthcare begins to look the same way when it becomes increasingly socialized: young, healthy workers paying for the healthcare of older, less post-productive citizens. If young people are able to ‘opt out’, the pyramid collapses.

      Heritage is a conservative organization which seems to put forth policy proposals which fit within the general framework that doesn’t upset major applecarts. At least that’s my sense. I don’t follow Heritage too closely.

      1. Demographics are collapsing the pyramid even without the opt out. The U.S. fertility rate is barely at replacement level, 2.06 births per woman. That’s not a pyramid, that’s more like a Jenga tower.

        Much of the rest of the world is in the same yacht, except further out to sea. Canada is at 1.58 meaning the next generation will be 79% the size of their current population. UK, 1.91. Germany, 1.41. Russia, 1.42. China, 1.54.

  10. James Taranto, who worked at Heritage when the mandate first made waves

    That’s “former Reason intern James Taranto”. Or, “former Reason intern and Matador*, James Taranto”.

    *Cal State Northridge alum, though if he actually fought bulls, that would be awesome.

  11. Who the fuck cares if some idiots at Heritage, twenty five years ago, came up with the idea of mandates?

    Some dumbfucks in the progressive movement came up with the idea of Jim Crow and eugenics.

    I’ve never heard an asswipe in the media say that the holocaust was originally a democrat idea.

    1. I didn’t know the democrats had a branch in Nazi Germany!

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