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Conservatives and the Individual Mandate

David Frum chides conservative opponents to the individual mandate, using the now-familiar refrain that it was originally a conservative idea. But is that really true?

The hard part isn’t having principles. The hard part is remembering them.

Was it only yesterday that conservatives argued that state-mandated health and retirement savings accounts were the secret to a well-functioning national healthcare system? Singapore and Chile were the star examples—Singapore even more than Chile. Here’s the online magazine of the American Enterprise Institute praising the Singapore health model in 2008…

In addition to that article, he also cites “a glowing report on Singapore from Cato’s Michael Tanner.” There are, surely, other examples.

But the fact that some individual scholars at some conservative (or, in the case of Cato, libertarian) think tanks or that a single article in a conservative/libertarian magazine supports an idea doesn’t necessarily mean that “conservatives” writ large support something, or even that it’s a widespread idea among conservatives.

As Ramesh Ponnuru points out,

[W]e shouldn’t overstate the case. I think an accurate description of the history of rightist opinion on this question would look at three separate groups: politicians, think tanks, and grassroots conservatives. This last group never really focused on the individual mandate, and never really had any reason to. I doubt that it would ever have been popular with this group.

The think tankers were divided, with the Heritage Foundation an outlier. It was an outlier, too, in the broader right-of-center intellectual world. (For whatever it’s worth, I was reading NR pretty closely in the mid-’90s and do not recall its ever endorsing the mandate.)

The politicians were the group most likely to embrace the individual mandate. Most of them gave no serious thought to the issue but thought it would be helpful in resisting various liberal health-care plans, and knew that the Heritage Foundation favored it.

So yes, conservative opinion on the mandate has changed. But I don’t think it’s right to suggest that most conservative voters or conservative policy thinkers ever supported it. I think what happened is that as soon as grassroots conservatives focused on the mandate, they hated it—and they were right to hate it, in my view-and both the politicians and that one outlier think tank responded to their sentiment.

He notes examples of prominent conservatives excoriating the idea at the time, too.

Political movements are complicated things, indeed. American conservatism, certainly, is a pastiche of many groups who disagree with one another on a host of issues. When people make such silly charges as “How can conservatives claim they love freedom when they want to regulate what goes on in the bedroom,” for instance, they’re conflating two strains of conservatism comprised of people who can’t stand one another.

Additionally, as I’ve noted before, Heritage’s endorsement of the idea came in 1994 during the “HillaryCare”* debate. That’s important because it wasn’t being advanced as a standalone policy proposal but rather as a more free market approach to the goals being touted by the Clinton Administration. Note, for example, that there was no push to implement it when a Republican took office and held it for eight years. And this was a Republican president who massively increased the government healthcare footprint by championing and passing into law the Medicare prescription drug boondoggle.**

On this particular issue, I myself am far outside the conservative orthodoxy. Indeed, while I suspect he and I privately agree, I’m to the left of President Obama on this issue, favoring some sort of single payer system with a private, supplemental insurance add-on for those who can afford it over the available alternatives.

As to the mandate itself, I’m in exactly the camp Ramesh describes: I never gave it a moment’s thought prior to the post-2009 healthcare reform debate. It just wasn’t on my radar screen. I happen to both think it’s a pretty good idea within the constraints of what’s politically possible (which, I hasten to add, my own preference for single payer is not) and that it’s quite probably unconstitutional.

___________
*While I continue to support the coinage “ObamaCare” as a non-pejorative description, “HillaryCare” has no benign meaning.

**In the sense of being unaffordable. The underlying argument, that medical coverage that doesn’t include coverage for necessary drugs is not medical care at all in today’s world, is actually one I found and find persuasive.

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About James Joyner
James Joyner is the publisher of Outside the Beltway, an associate professor of security studies at the Marine Corps Command and Staff College, and a nonresident senior fellow at the Atlantic Council. He's a former Army officer and Desert Storm vet. He has a PhD in political science from The University of Alabama. Views expressed here are his own. Follow James on Twitter.

Comments

  1. Hey Norm says:

    How in the world do you write that post without mentioning that the presumptive nominee of the Republican party actually passed legislation containing the individual mandate? Is that an outlier too?
    I’m astounded.

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  2. Brummagem Joe says:

    I notice Romneycare where the mandate is central goes unmentioned in all this. Certainly at the time Romneycare was introduced in about 2004 it was being widely praised and touted as a consevative approach to solving our healthcare problems. What Ponnuru seems to be engaged in here is another of his casuistic attempts to put distance between conservatives and a concept that was certainly a widely accepted element of conservative thinking before it was co-opted by Obama. After all that’s what he’s paid to do. As to its constitutionality many honest conservatives including Frum and Laurence Silberman deem it constitutional.

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  3. Ben Wolf says:

    @Hey Norm: I would say Mitt Romney is most definitely an outlier, hence his lack of appeal to the GOP base. We should also keep in mind the mandate was passed in a relatively liberal state. I don’t think conservatives ever widely supported this, as they didn’t even seem to notice there even was a healthcare issue in this country.

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  4. progcivlib says:

    And we’re squarely in the “No real Republican would support…” territory. These people that vote consistently Republican, write for Republican publications and represent Republican constituencies have promoted it, but the REAL Republicans never even talked about it! So they’re not really going back on what they advocated! Again with starting at the conclusion (the individual mandate wasn’t a Republican policy idea) and working back from there. Brilliant as usual.

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  5. @progcivlib:

    You’re missing James’s point entirely. The mandate idea was being pushed by a small segment of the conservative think tank movement inside the beltway. It was never part of a national platform on which Republican politicians ran and was hardly ever popular with the people who vote for those politicians.

    Heritage is part of the conservative movement for certain, but it is not the entire conservative movement and it’s somewhat silly to take one of its policy positions and ascribe it to every single person who calls themselves “conservative”

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  6. James Joyner says:

    @Brummagem Joe: The post is about conservative support for the individual mandate, implicitly at the national level. That Romney, who a majority of conservatives don’t much seem to like, passed it at the state level in probably the least conservative state in the country, is hardly germane.

    And, no, as Ponnuru explains, the concept was by no means “certainly a widely accepted element of conservative thinking before it was co-opted by Obama.” It was almost completely off the radar screen.

    Again, conservative Republican George W. Bush, who had no qualms about expanding government intrusion into the healthcare arena, didn’t try to pass it. Indeed, I don’t recall his ever mentioning it. And he had eight years, more than half of which came after RomneyCare was passed.

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  7. progcivlib says:

    @Doug Mataconis: So it’s a strawman instead? Awesome! It’s being labeled as a conservative idea – not as an idea to which all conservatives ascribe.

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  8. Hey Norm says:

    @ James…
    Romney, the Republican Presidential Nominee…ie leader of the party, passed it at the state level and prescribed it repeatedly as a national solution.
    Nice try.

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  9. @progcivlib:

    Most fiscal conservatives and advocates of limited government would argue that there is nothing conservative about an individual mandate regardless of the rhetoric its supporters may have used to advocate on its behalf.

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  10. James Joyner says:

    @progcivlib: The fact that a handful of conservative intellectuals were touting an idea doesn’t mean that conservatives writ large–or even a significant number of conservatives–supported the idea.

    @Hey Norm: But Romney is deeply unpopular with conservatives. And, even if one considers him a conservative–and I do–and thinks the mandate is a reasonable solution to a sticky problem–and I do–his support of it doesn’t make it a popular idea by conservatives, or one that was widely embraced once upon a time. In fact, it simply wasn’t.

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  11. Anderson says:

    The fact that Romney, faced with a GOP primary and not the Massachusetts electorate, is running away from Romneycare, is sufficient to prove JJ’s point.

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  12. Hey Norm says:

    So the presumptive leader of the party is unpopular…that’s a pretty small nail to hang your hat on.
    Nixon explored the idea in the ’70′s. Bush-41 wanted to do it but didn’t think he could get Democratic support. Bob Bennett helped draft a Senate Bill that contained it. Romney embraced it. Newt embraced it. Cato embraced it. Heritage wrote the damn thing.
    C’mon guys…this is a ridiculous position.

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  13. Hey Norm says:

    Also…the idea that Romney is conservative is laughable. That’s like saying Bush43 was Conservative.

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  14. Hey Norm says:

    “…The fact that Romney, faced with a GOP primary and not the Massachusetts electorate, is running away from Romneycare, is sufficient to prove JJ’s point…”

    Um…no…that’s not what that proves. That only proves the Etch-a-Sketch meme.

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  15. Brummagem Joe says:

    @James Joyner:

    And, no, as Ponnuru explains, the concept was by no means “certainly a widely accepted element of conservative thinking before it was co-opted by Obama.” It was almost completely off the radar screen.

    Maybe my memory is faulty but I clearly remember rapturous editorialising about Romneycare as a conservative alternative to the Clinton approach by all the usual Republican suspects.

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  16. merl says:

    @Hey Norm: I was thinking about Nixon and healthcare, too.

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  17. Brummagem Joe says:

    @Anderson:

    The fact that Romney, faced with a GOP primary and not the Massachusetts electorate, is running away from Romneycare, is sufficient to prove JJ’s point.

    Actually all it proves is that conservatives (including Heritage!) have hypocritically changed their mind about the mandate since it became a central part of the ACA.

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  18. Hey Norm says:

    @ Joe…

    “…by all the usual Republican suspects…”

    But it wasn’t every single last conservative in the country…only the party leaders and most prominent opinion-makers…so it doesn’t count.
    You know how free-thinking Republicans are. They never follow in lock-step.

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  19. Brummagem Joe says:

    @Hey Norm:

    But it wasn’t every single last conservative in the country…only the party leaders and most prominent opinion-makers…so it doesn’t count.

    The approaching coronation of Romney seems to be provoking a stream of irrationality in JJ. The mandate based approach to healthcare reform ( a la Romneycare) certainly wasn’t official party policy but was widely bruited abroad as a Republican solution by the GOP thinking (I use that term advisedly) classes who to the best of my recollection were falling over themselves to congratulate Romney. I’m sure some judicious searches in the WSJ ed archives and a few other Republican venues will turn up no shortage evidence of this support.

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  20. JohnMcC says:

    This post and the comments that follow point to the need for a follow-on discussion of What Is Movement Conservatism. I knew the ‘conservative movement’ 45 years ago and was part of it in my own small way. Then there was Nixon. Still understood “conservatives” during the Reagan years. Since ’92 however it appears to me that the “movement” of so-called-conservatism has veered off the rails into a strange direction and accelerated wildly. And I don’t understand why self-professed “libertarians” haven’t abandoned ship, why the Neo-Conservatives still hold honored positions and how the “social conservatives” don’t perceive the cynicism of the mega-rich.

    Quite a zoo y’all have there! Why don’t you tell us how it looks from the inside?

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  21. Franklin says:

    JJ: I’m to the left of President Obama on this issue, favoring some sort of single payer system with a private, supplemental insurance add-on for those who can afford it over the available alternatives.

    For some reason I did not know this … interesting.

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  22. progcivlib says:

    @James Joyner: Romney is so deeply unpopular with Republicans and conservatives that he’s running away with the Republican nomination. Now we’re back to the “no real conservative” argument again. C’mon. It was a Republican policy proposal, proposed by actual Republicans, implemented by actual elected Republicans. Whether or not some of the party disagrees with it is beside the point. By that argument the Government option wasn’t a Democratic proposal. It was proposed by Democrats, advocated on behalf of by some Democrats, but because some segments of the party would rather have a single-payer system and thought it didn’t go far enough, that means it must not have been a Democratic proposal. Great country we’re creating here.

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  23. Dunbar says:

    I will support the individual mandate and Obamacare if it covers US citizens only: no illegal immigrants. I feel that anyone who shows up at a hospital or doctors office must have some sort of insurance. The people should not have to pay for someone’s elses hospital bill. This is commonly called “freeloading”.

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  24. Brummagem Joe says:

    @Franklin:

    JJ: I’m to the left of President Obama on this issue, favoring some sort of single payer system with a private, supplemental insurance add-on for those who can afford it over the available alternatives.

    I don’t think JJ is necessarily to the left of president Obama he just doesn’t have to deal with political realities. Ultimately this is the model we are going to have to adopt although “some sort” is a bit vague. But yes some sort with much tighter governmental control of pricing in the delivery area.

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  25. anjin-san says:

    But Romney is deeply unpopular with conservatives

    I keep hearing this. Who do conservatives think should be President? James? Doug? Who’s that man?

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  26. David M says:

    @Dunbar: That’s pretty much the short argument in support of the mandate, although your “US citizens only” statement doesn’t make a lot of sense.

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  27. anjin-san says:

    The people should not have to pay for someone’s elses hospital bill. This is commonly called “freeloading”

    I’m curious. Do you have a million or two stashed away to cover costs in case you suffer a catastrophic illness or accident?

    If not, what plan do you have for paying the bills that does not involve “freeloading”?

    And please don’t tell me your insurance will cover everything.

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  28. James Joyner says:

    @Brummagem Joe:

    The mandate based approach to healthcare reform ( a la Romneycare) certainly wasn’t official party policy but was widely bruited abroad as a Republican solution by the GOP thinking (I use that term advisedly) classes

    It’s even narrower than that: A relative handful of conservative wonks were championing the idea. But the point Ramesh makes and I second is that it’s not an idea that was really on the radar screen of conservatives writ large nor, outside of Massachusetts, was it enacted by conservatives when they had the con. So, yes, it’s “a conservative idea” in that it’s one that some conservatives originated and others touted. But, no, it’s not “a conservative idea” in the sense of one being favored by most conservatives.

    The distinction is a huge one in this case because Frum and others are claiming that there’s been some sort of hypocritical switch when, in reality, that’s not the case.

    I don’t think JJ is necessarily to the left of president Obama he just doesn’t have to deal with political realities.

    Right. That’s what I meant by “while I suspect he and I privately agree.”

    Ultimately this is the model we are going to have to adopt although “some sort” is a bit vague.

    Vague both because it’s tangential to the post and because I don’t have a full-blown model crafted. Something along the lines of the French or Swiss models is what I’m thinking of–basic coverage on a Medicare-style model (i.e., private practitioners paid a set fee by the government rather than a UK-style government hospital system) and with an ability for those who want and can afford it to have Lexus care on a supplemental out-of-pocket or private insurance basis.

    Like or Dislike: Thumb up 2 Thumb down 0

  29. Brummagem Joe says:

    @James Joyner:

    It’s even narrower than that: A relative handful of conservative wonks were championing the idea.

    I would dispute this JJ. Norm gave a bunch of think tankers and elected officials who were talking about this. At the time Romneycare passed it was widely talked about amongst the Republican chattering classes as a distinctively conservative approach to healthcare reform as opposed to the more dirigiste formulas of Hillarycare. I realise this is impressionistic based on events 8 years ago but I’m quite sure I’m correct.

    As to the rest I broadly agree. Regardless of whether ACA is rejected or not the underlying issues of flaws in the system and it’s escalating cost are not going away. Republican ideas of Voucherisation and dumping Medicaid on the states are pure fantasy. So a rejection of ACA which is an incremental solution that heads in the French direction ultimately courts a much more radical approach. A not unusual outcome when more modest reforms are blindly obstructed.

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  30. Brummagem Joe says:

    @James Joyner:

    It’s even narrower than that: A relative handful of conservative wonks were championing the idea.

    BTW JJ if Ponnuru’s piece get some attention I’ve no doubt the research ops of the usual liberal suspects are going to turn up an avalanche of approvals for the mandate idea from the usual conservative suspects.

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  31. Tlaloc says:

    You’re missing James’s point entirely. The mandate idea was being pushed by a small segment of the conservative think tank movement inside the beltway. It was never part of a national platform on which Republican politicians ran and was hardly ever popular with the people who vote for those politicians.

    So it’s not enough for a policy to be pushed by a party’s political structure and backed by the political party’s creative elements it has to be supported by the rank and file plebians before we can call it the party policy? The problem there is the GOP has, at least in all modern times, always been a hugely top down control structure. The tea party is an enormous aberration, which is a good part of why the the party (and do not kid yourself- the inside the beltway folks ARE the party) is so flabbergasted about how to deal with them. The party dictates and the rank and file follow up with a hearty “yes, sir.” That’s the way the GOP functioned. So to claim that the policy pushed by the party is not really party policy because some impotent little pissants later said they didn’t like it is kind of asinine.

    Know what I mean?

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  32. Tlaloc says:

    It’s even narrower than that: A relative handful of conservative wonks were championing the idea.

    *spit take*

    Yeah complete unknowns like Gingrich (a pure nobody in the 90s) and Romney. Gosh why do those names sound familiar? I mean it’s not like your small group of conservative wonks currently comprise half of the republican field of president or anything (and 100% of the people with an actual shot of winning the nomination).

    This is really descending into revisionism.

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  33. Tlaloc says:

    Republican support for the individual mandate

    As far as I have been able to find, Stuart’s 1989 brief is the first published proposal of an individual mandate in the context of private-sector-managed health systems. In 1991, Mark Pauly and others developed a proposal for George H.W. Bush that also included an individual mandate. While others credit Stanford economist Alain Enthoven with the idea, Enthoven’s earliest published reference to an individual mandate was an indirect one in the 1992 Jackson Hole paper.

    In 1992 and 1993, some Republicans in Congress, seeking an alternative to Hillarycare, used these ideas as a foundation for their own health-reform proposals. One such bill, the Health Equity and Access Reform Today Act of 1993, or HEART, was introduced in the Senate by John Chafee (R., R.I.) and co-sponsored by 19 other Senate Republicans, including Christopher Bond, Bob Dole, Chuck Grassley, Orrin Hatch, Richard Lugar, Alan Simpson, and Arlen Specter. Given that there were 43 Republicans in the Senate of the 103rd Congress, these 20 comprised nearly half of the Republican Senate Caucus at that time. The HEART Act proposed health insurance vouchers for low-income individuals, along with an individual mandate.

    Newt Gingrich, who was House Minority Leader in 1993, was also in favor of an individual mandate in those days. Gingrich continued to support a federal individual mandate as recently as May of last year.

    http://www.forbes.com/sites/aroy/2012/02/07/the-tortuous-conservative-history-of-the-individual-mandate/

    20 senators plus the House leadership is a hell of a lot more than “a few wonks.”

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  34. PogueMahone says:

    But the fact that some individual scholars at some conservative (or, in the case of Cato, libertarian) think tanks or that a single article in a conservative/libertarian magazine supports an idea doesn’t necessarily mean that “conservatives” writ large support something, or even that it’s a widespread idea among conservatives.

    Maybe, but the conservative base didn’t cry “Socialism!!; Tyranny!!!; Freedom!!!” Did they?

    Additionally, as I’ve noted before, Heritage’s endorsement of the idea came in 1994 during the “HillaryCare”* debate. That’s important because it wasn’t being advanced as a standalone policy proposal but rather as a more free market approach to the goals being touted by the Clinton Administration.

    Shorter J.J.:
    Because the mandate was used against HillaryCare, it was okay with conservatives. Now, because it has been co-opted by Obama, it is no longer okay with conservatives.

    Cheers.

    Like or Dislike: Thumb up 7 Thumb down 0

  35. Trumwill says:

    @Brummagem Joe: I think your memory is faulty. I was defending it at the time a let’s-see-how-it-works experiment. My view was… not popular… among conservatives, who supported HSA’s as the free market approach.

    I won’t speak to how popular the mandate was among conservatives in the 90′s, but when it came up in the 2008 election among the conservatives I was hanging with at the time, it came up with negative connotations.

    I scanned the National Review archives when it passed in 2006. Not much commentary. Ramesh Ponnuru was against it. Goldberg started off conflicted (notably, his “pro” argument was on federalist “let’em try it” grounds) though was sold against it. There was also a pro/con set of pieces around that time (Heritage doing the “pro”). So at best, I think we’re looking at ambivalence, though again I remember a lot of criticism and my tentative support for it being relatively unpopular at the time.

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  36. @James Joyner:

    I think it was an endorsement that a Republican governor signed a mandate.

    And actually the idea that it is ok for states but not nationally is the very definition of a legalistic argument.

    From a citizen’s perspective it matters not who put a mandate upon him.

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  37. Brummagem Joe says:

    @Trumwill:

    My view was… not popular… among conservatives, who supported HSA’s as the free market approach.

    With all due respect we’re not talking about you unless you consider yourself amongst the Republican chattering classes. In fact your examples suggest my memory was correct if the ambivalence at the arch conservative NR is any guide. In more mainstream venues I clearly remember a lot of praise for Romney’s MA plan.

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  38. Brummagem Joe says:

    @Tlaloc:

    20 senators plus the House leadership is a hell of a lot more than “a few wonks.”

    This meme by Ponnoru which JJ and Doug are just echoing is total bs. I’ve been reading about the mandate approach as the conservative alternative to the state controlled Hillarycare single payer approach for at least 15 years. I remember talking to health insurance execs about it in the late 90′s.

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  39. Rick DeMent says:

    Also the mandate fit n with the conservative idea of personal responsibility. After all why should we all have to pay higher insurance premiums because of a bunch of free loaders. No, sorry this goes at the heart of the conservative principal of personal responsibility … well at least that what Newt was saying at the time.

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  40. @James Joyner: You don´t need to offer supplemental Lexus health coverage. In several countries of Latin America everyone has universal health coverage, while there are incentives for people to buy private health insurance(If you don´t want to face lines on the hospital, for instance). You could offer universal health coverage on a basic level while allowing people to buy private care(For instance, in Brazil a very generous universal health coverage provided by the government coexists with very generous tax deductions for people to buy health care.)

    To me, the only solution for health care in the US would be to expand Medicare to everyone, while restricting it´s coverage(Yes, make granny buy private insurance to complement) while increasing the number of doctors.

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  41. Brummagem Joe says:

    @André Kenji de Sousa:

    (Yes, make granny buy private insurance to complement)

    For 80% of grannies and grandads in the US SS is at least 50% of their income. Have you any idea what supplemental insurance for a 70 year old would cost?

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  42. Joseph Mucia says:

    @Doug Mataconis:

    How do fiscal conservatives and adovcates of limited government think the individual mandate is unconstitutional but that private savings accounts as a replacement for Social Security is the best thing since sliced bread?

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  43. @Brummagem Joe: @Brummagem Joe: People in Brazil, a country poorer than the United States, do that. Besides that, if they can´t pay for supplemental insurance then they shouldn´t buy it.

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  44. An Interested Party says:

    To me, the only solution for health care in the US would be to expand Medicare to everyone…

    In other words, a single-payer system…while this is the most logical and makes the most sense, don’t ever expect something like that to get past the current crop of conservatives and libertarians in Congress…

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  45. Brummagem Joe says:

    @André Kenji de Sousa:

    Besides that, if they can´t pay for supplemental insurance then they shouldn´t buy it.

    Unfortunately the grandads and grandmas of America who are an immensely powerful voting bloc are not going to be satisfied with your Model T health insurance plan and they’ll express their feelings at the ballot box. This is why Medicare and SS are known as the third rail of politics.

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  46. WR says:

    @James Joyner: ” That Romney, who a majority of conservatives don’t much seem to like,”

    With all due respect, when you type a sentence like this you actually sound more like Bithead claiming W was never a real conservative than your normal, wise self. I know it’s fun to say that everyone hates Romney, but he’s about to be the nominee of the Republican party. So apparently they don’t dislike him that much.

    But somehow you seem to have decided that if every conservative everywhere in the country doesn’t embrace Romney, he can’t be the choice of conservatives, just as you’re stating that if every conservative everywhere in the country didn’t embrace the mandate, it couldn’t be a conservative idea, even if it emanated from conservative “thinkers”.

    By that token, the nuclear freeze movement of the ’80s wasn’t a liberal idea, because not all liberals rushed to embrace it.

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  47. DRE says:

    @James Joyner: I would agree with you that the mandate was never a goal of conservatives. What it was however was a conservative response to a liberal push for public healthcare funding. Conservatives opposed the idea of any government intervention in the provision of public health, including strong opposition to Medicare. The mandate was a way of saying. “if the government is going to get involved, it should only be through a private market based approach”. Just like they have gone from openly opposing Social Security and Medicare to trying to privatize them. They have now gone on record as sying that a private market approach is unconstitutional because it relies on Commerce power and people can not be forced to engage in commerce.

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  48. Trumwill says:

    @Brummagem Joe: The point is not what my thoughts were, but of those around me. I ran in conservative circles at the time, and I was virtually alone in my tepid support of it. I don’t think the ambivalence was the product of not caring what would happen if it were implemented on a national scale, but rather due to the fact that it was in Massachusetts and they are not particularly concerned about the welfare of that state. Who, other than the Heritage Society (who first proposed it and was therefore tied to it) and Newt Gingrich (who was in his Gadfly phase), do you remember being supportive of Romney on that endeavor?

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  49. Commish says:

    So, James, what about that HEART Act of 1993? Helpful comparison chart here.

    Cosponsors:
    Sen Bennett, Robert F. [UT] – 11/22/1993

    Sen Bond, Christopher S. [MO] – 11/22/1993

    Sen Boren, David L. [OK] – 5/17/1994

    Sen Cohen, William S. [ME] – 11/22/1993

    Sen Danforth, John C. [MO] – 11/22/1993

    Sen Dole, Robert J. [KS] – 11/22/1993

    Sen Domenici, Pete V. [NM] – 11/22/1993

    Sen Durenberger, Dave [MN] – 11/22/1993

    Sen Faircloth, Lauch [NC] – 11/22/1993

    Sen Gorton, Slade [WA] – 11/22/1993

    Sen Grassley, Chuck [IA] – 11/22/1993

    Sen Hatch, Orrin G. [UT] – 11/22/1993

    Sen Hatfield, Mark O. [OR] – 11/22/1993

    Sen Kassebaum, Nancy Landon [KS] – 11/22/1993

    Sen Kerrey, J. Robert [NE] – 5/17/1994

    Sen Lugar, Richard G. [IN] – 11/22/1993

    Sen Simpson, Alan K. [WY] – 11/22/1993

    Sen Specter, Arlen [PA] – 11/22/1993

    Sen Stevens, Ted [AK] – 11/22/1993

    Sen Warner, John [VA] – 11/22/1993

    Sen Brown, Hank [CO] – 11/22/1993

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  50. James Joyner says:

    @Commish:

    what about that HEART Act of 1993?

    This is literally the first I’ve heard of it. The named sponsor is a liberal Republican and the co-sponsors are a mix of liberals and moderates, with a couple of conservatives thrown in. It did not pass. But, again, this is the first I’ve heard of it and I was not only following the health care debate at the time quite closely but I was working on a PhD in political science, with an American Politics subfield, at the time.

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  51. Brummagem Joe says:

    @James Joyner:

    with a couple of conservatives thrown in.

    Er…they’re all Republicans. The point is that this idea was not some craziness coming out of an obscure Republican think tank. I repeat in the 90′s I was involved in managing some manufacturing companies and I can remember quite clearly in the late 90′s discussing with executives at our carrier the mandate idea as a conservative alternative to the single payer approach which was generally perceived as the Democratic position. I think DRE sums up the position more or less accurately. Republicans may have been driven by pressure to be seen to have a response on universal healthcare but their response to anyone who followed this stuff was maintenance of the private market sustained by the mandate.

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  52. James Joyner says:

    @Brummagem Joe:

    The point is that this idea was not some craziness coming out of an obscure Republican think tank.

    Gotcha. There are two only slightly related arguments going on here:

    1. The mandate is an idea proposed by legitimate conservatives years ago and one that attracted the support of a not insignificant number of conservative intellectuals and at least some Republican politicians. Therefore, Republican cries of “socialism” are suspect.

    2. Because we can point to some conservatives who supported this idea in the 1990s, conservatives who oppose it now are hypocrites and/or partisan hacks.

    You’re arguing 1 and I largely agree with you. The point of this post, however, is to argue against 2.

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  53. DRE says:

    @James Joyner: You should have some sympathy with Frum here. He would rather argue 2 because a corollary of 1 is that when some conservative politicians call for privatizing medicare or social security (or any other entitlement) we are justified in believing that the true conservative position is to eliminate it.

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  54. DRE says:

    @DRE: Additionally I would point out that the “medicaid expansion is coercion argument” coupled with with the mandate argument would imply that an effective tax incentive is equally unacceptable and it’s not just a semantic problem. In other words, conservatives who support Ryan’s medicare proposals but say Obamacare is unconstitutional are either (1) liars trying to fool people into eliminating Medicare or (2) hypocrites and/or partisan hacks.

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  55. mannning says:

    Perhaps I am reading this backwards, but I contend that Republicans do not like Obamacare for its flaws and costs, and hence now seize upon the individual mandate as a Constitutional issue that has the potential to throw Obamacare out the window. Sure, they played around with the mandate in the past, but it never had a sufficient blessing from legal and legislative eagles then, I believe, and it went nowhere.

    It seems that the mandate issue would have (or should have) arisen in any event, as it appears to skirt very close indeed to the Constitutional edge, if not over it, regardless of the political origin of the idea.

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  56. An Interested Party says:

    Perhaps I am reading this backwards, but I contend that Republicans do not like Obamacare for its flaws and costs, and hence now seize upon the individual mandate as a Constitutional issue that has the potential to throw Obamacare out the window.

    Oh, in other words, Republicans are hypocrites who are only interested in winning political fights…wow, now there’s a shocker…

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  57. An Interested Party says:

    …well, I guess Mitch McConnell did tell us that with his comment about the single most important thing he wanted to achieve…

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