Over at the New Yorker, Ezra Klein has a lot of fun pointing out the origins of the individual mandate — that the Heritage Foundation gave it its “political début” — and that it was pushed by Republicans. And guess what? He’s right. (Note: See update below.)
Acknowledging this is the first step toward recovery. Of course, these revelations regarding the mandate’s birth haven’t been provocative for quite some time. But that hasn’t stopped liberal writers from dining out on them. And so, it is my hope that we might finally make that passé.
Klein is right about its origins.(There, I’ve said it.) But on a broader level, he’s wrong to assume conservatives haven’t sincerely arrived at the right conclusion. In trying to figure out what happened, Klein explores several options, including the obvious point that (gasp!) Republicans might have been susceptible to groupthink.
But he misses the obvious possibility that Republican support for the mandate might have been a deviation from conservative sensibility. After all, the idea gained steam during an era when George W. Bush’s “big government” brand of Republicanism was dominant, and fell out of favor during a time when that worldview was rejected (do you think today’s Republican House would pass Medicare Part D?). My point is that this change is organic, and the predictable result of conservatives becoming conservative again.
And here’s a bit of backstory to confirm that narrative.
The individual mandate was discussed by Stuart Butler in 1989, a health care policy expert at Heritage. (It is perhaps worth noting that this came in 1989 — immediately following the presidency of Ronald Reagan, when Republicans were re-branding as a “kinder, gentler” party.) Butler would spend years advocating a very limited mandate — one that was centered on the premise of ensuring people were protected from catastrophic expenses, such as major surgery and chronic illness.
Republican support for the mandate was certainly aided by the need to propose ideas opposing Hillary-care in the 1990s. In this, Klein is absolutely correct. That support continued in the early 2000s, with Mitt Romney implementing a version of Butler’s plan in Massachusetts — and Newt Gingrich serving as a vocal advocate of the idea.
It wasn’t until 2009, as Klein mentions, that the GOP finally reached the point of objecting to the mandate on Constitutional grounds. He seeks to explain how this is possible on a cognitive level — and his answer, unsurprisingly, suggests partisan hackery — not a sincere change of heart — were the major drivers. On this, Klein betrays his liberal worldview.
The individual mandate is many things, but conservative it is not. The very idea that government can and should compel people to purchase a product within certain specifications is anathema to anyone who prizes liberty and limited government.
Liberals suggest they adopted the idea from conservatives, and they’re correct. That point was interesting. But it is also irrelevant. The fact that Republicans spent a few decades peddling an idea they now consider odious is embarrassing. But the reason they now oppose it should be celebrated by conservatives. Waking up to the truth is a good thing.
UPDATE: The good folks at Heritage reached out to me to note that the concept of an individual mandate was discussed among health care economists throughout the mid-1980s: “We need to keep in mind that these were pre-Internet days, but we have come across at least one mention of the individual mandate that predates 1989 Stuart’s mention of it, and that was ‘Coverage and Care for the Medically Indigent: Public and Private Options‘ by Randall R. Bovbjerg and William G. Kopit, a paper written in 1986, or three years before Stuart’s piece.”