NPR: Republicans Were For Individual Mandate Before They Were Against It

Monday, February 15, 2010

A few years ago, Republicans not only didn't believe that requiring individuals to purchase private insurance was unconstitutional, they were promoting that very idea as a cornerstone of their own version of health reform. Check this out from an NPR story this morning:
[Senator Hatch's and Grassley's] opposition to making health insurance mandatory, however, is ironic. The last time a major health overhaul was debated, when Bill Clinton was president, the Republican alternative bill featured the exact requirement both senators are now berating, and both Hatch and Grassley were cosponsors of that bill.

So what's changed since then? Politics, mostly. Len Nichols of the New America Foundation says the individual mandate was actually created by Republicans and only later embraced by Democrats. In fact, says Len Nichols of the New America Foundation, the individual mandate was originally a Republican idea. "It was invented by [conservative health economist] Mark Pauly to give to George Bush Sr. back in the day, as a competition for the employer mandate focus of the Democrats at the time."

He's referring to health economist Mark Pauly of the Wharton School at the University of Pennsylvania. Pauly says it wasn't him alone, he was actually part of a small group of conservative health economists and lawyers who cooked up the idea in the late 1980s...a group of economists and health policy people, market-oriented, sat down and said, "Let's see if we can come up with a health reform proposal that would preserve a role for markets but would also achieve universal coverage, and I think the individual mandate was derived mostly from the power of logic." That logic being that even the most generous subsidies or enticements, he says, could only get you so far...

Now one of the key justifications for requiring everyone to have at least catastrophic health insurance is what economists call the "free-rider effect." If you're in an accident or you come down with a dread disease, you're going to get taken to the hospital and someone's going to pay. And that was something that appealed to Republicans, at least back then, says Pauly...
Well, apparently this Republican, free market, capitalist idea no longer appeals to Republicans anymore. Just as the Reagan Administration, market-based idea known as "cap and trade" is now the devil incarnate for Republicans who otherwise think that Reagan is a minor (major?) deity. Also, just as many Republicans supported an independent, bipartisan budget commission until...wait for it...President Obama endorsed the idea. Then, Republicans like Mitch McConnell voted against the very idea they had championed. Oh, but wait, don't Republicans always tell us they really want to work with President Obama and that they really don't want him to fail? Yeah, and if you believe that, I've got a nice Republican-invented individual mandate to sell you!