Sunday, February 19, 2012

Conservatives Were For the Health Care Mandate That Everyone Have Insurance Before They Were Against It – And Democrats Were Against It Before They Were For It

Funny How History Has a Way of Remembering

The New York Times occasionally engages in actual reporting, and recently it reported on the history of the policy idea that individuals should be required to have health insurance.  The rationale behind this policy is and has always been that since society will not deny health care to anyone in dire need, allowing some individuals to go without  insurance just place the burden of the cost of their care on the rest of us.

As the Time story reports, Republicans and Conservatives originated the idea of the mandate and at one time vigorously supported it.

The concept that people should be required to buy health coverage was fleshed out more than two decades ago by a number of conservative economists, embraced by scholars at conservative research groups, including the Heritage Foundation and the American Enterprise Institute, and championed, for a time, by Republicans in the Senate.

The basis for requiring insurance is contained in this oft repeated hypothetical

“If a young man wrecks his Porsche and has not had the foresight to obtain insurance, we may commiserate, but society feels no obligation to repair his car,” Stuart Butler, a distinguished fellow at the Heritage Foundation, said in a 1989 lecture on how to ensure affordable health care for all Americans. “But health care is different. If a man is struck down by a heart attack in the street, Americans will care for him whether or not he has insurance.”

Part of Mr. Butler’s solution back then? “Mandate all households to obtain adequate insurance.”

But of course people like Mr. Butler have changed their minds

The Heritage Foundation has taken pains to distance itself from its past support of an individual mandate: it wrote a court amicus brief noting its change of heart, and Mr. Butler wrote an op-ed article in USA Today this month headlined “Don’t blame Heritage for ‘ObamaCare’ mandate.”

Democrats have gone in the opposite direction,

After Mr. Clinton’s health care proposal died, Democrats began searching for more politically palatable solutions.

But there was still little Democratic support for an individual mandate, as Senator John Breaux of Louisiana found when he proposed one several years later. But officials, centrist policy groups and even liberal research organizations slowly warmed to the idea.

And even Mr. Obama has changed his position.

When Mr. Edwards ran for president again in 2008, his health plan called for an individual mandate for all. Mrs. Clinton followed suit. But Mr. Obama resisted the idea as a candidate, calling for a mandate for children only.

The difference in all of this is that while both sides have changed positions, Democrats seem more willing to openly admit that fact, and to try to make people understand why they changed.  Conservatives just want to argue against reality, and never ever admit that they were wrong.

Finally the best statement can be made by this individual.

 Mark V. Pauly, a professor of health care management at the University of Pennsylvania’s Wharton School who was a co-author of an influential 1991 paper that called for an individual mandate, said that he was discouraged to see so many Republicans shunning an idea they had once supported.

“My view was, I still agree with myself,” he said in an interview. “ (emphasis added)

You have to like that last sentiment, that a person still agrees with himself or herself.  Maybe that’s something Mr. Romney ought to try sometime.

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