ObamaCare’s Heritage
Did the ideas behind ObamaCare originate at the Heritage Foundation? I would say “no.” They originated with Alain Enthoven. But Heritage played a role. Here is James Taranto, whistle blowing in The Wall Street Journal:
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.”
See also Avik Roy (at Forbes) and Peter Suderman (at Reason).
Traditional conservatives of yesteryear were not necessarily opposed to government mandates of different kinds, as long as they were the right flavor.
The idea of an individual mandate appeals (in theory) to Republicans who champion personal responsibility. The problem: Pubic health advocates convinced Democrats to force everyone to have comprehensive coverage and taxpayers to subsidize most people getting coverage in the yet-to-be-created Health Insurance Exchanges. I would be more inclined to accept an individual mandate if it merely required people to have a limited benefit plan or a high deductible plan. Either of these would be enough to protect 98% of the population. Unfortunately, the advocates that advised the Democratic Leadership in Congress wanted huge cross subsidies and huge taxpayer subsidies. Neither are sustainable.
Sorry to learn of this history.
Of course the Heritage Foundation is very much against ObamaCare. But giving Heritage some of the credit for the ideas behind the Patient Protection and Affordable Care Act was pretty cleaver on the part of the President.
Yes, a major mistake.
Fortunately, the market oriented health policy community is diverse, unlike its opposition, and it wasn’t long until the error was pointed out.
Now, can we acknowledge that Heritage blew it, accept that well informed, sensible, people now understand why individual mandates are A Very Bad Thing, and move on to repealing ObamaCare and instituting real reforms?
Hi John, the Enthoven link directs me to a piece on FDA drug shortages…
@Avik
We’ve corrected the link to reflect Enthoven’s Health Affairs article, The History and Principles of Managed Competition
that’s something I didn’t know about Heritage
Our friends at the Heritage Foundation have long since recanted their belief in the individual mandate and have toiled heroically in the fields against Obamacare.
Indeed, I wonder if when this whole thing is over we might thank Heritage Foundation and Governor Romney for the idea of the individual mandate and a “penalty” for not acquiring government-compliant health insurance?
If President Obama had not wanted political cover for Obamacare, and an ability to credibly pin the blame on Governor Romney, Obamacare would not contain an individual mandate, but it would have had even more tax hikes – which would have had the same economic effect.
But they would not have had the same legal effect – and the lawsuits against Obamacare’s constitutionality would never have arisen.
J. Graham,
That theory is pretty convoluted. Methinks you have been reading too much Machiavelli.
Goodman is too much of a gentleman to mention this, but I have copies of letters from him, Ed Crane, and myself from 1992-1993 addressed to Stuart Butler and Ed Feulner objecting to Heritage’s robust support for not only an individual mandate, but also everything that must accompany it — government dictated benefits, massive regulations, etc.
Heritage was using FEHBP as a model, but it missed that 1. Participation in FEHBP is NOT mandatory, and 2. FEHBP uses strict community rating, which is never a good idea.
I believe Heritage became far too enamored of being a hotshot player in DC, and forgot the meaning of free markets.
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