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March 27, 2012 9:37 AM A Day For Irony, Too

By Ed Kilgore

If you’d been out of the loop for the last three years or so and picked up a newspaper today, you might be more than a bit surprised to learn that Barack Obama’s entire legacy as president seems bound up in his administration’s defense of a health insurance purchasing mandate, in the midst of near-universal shrieking about the imminent death of freedom from conservatives.

The Washington Post’s N.C. Aizenman has the rundown, if you’re not already familiar with it:

The individual insurance mandate, which requires virtually all Americans to obtain health coverage or pay a fine, was the brainchild of conservative economists and embraced by some of the nation’s most prominent Republicans for nearly two decades. Yet today many of those champions — including presidential hopefuls Mitt Romney and Newt Gingrich — are among the mandate’s most vocal critics.
Meanwhile, even as Democratic stalwarts warmed to the idea in recent years, one of the last holdouts was the man whose political fate is now most closely intertwined with the mandate: President Obama.

You can read the whole thing, but the essential facts are that the individual mandate was born at the Heritage Foundation and became the default-drive mechanism in a generation of Republican health care reform proposals for protecting against “free riders” in otherwise voluntary, private-sector based systems for expanded coverage. It only became attractive to Democrats when they decided a similar approach could command bipartisan support—as it had in Massachusetts—as opposed to the more government-centered proposals progressives had embraced in the past.

By 2008, Republicans had begun moving away from any real interest in universal health coverage, but the mandate idea had not become actual heresy, much less toxic. And meanwhile, in the Democratic presidential nomination contest, Obama’s reluctance to accept the individual mandate—arguing that subsidies could lure enough people into a voluntary universal coverage system to make coercion unnecessary—became the single best-known policy difference separating him from Hillary Clinton. Budget realities as he took office quickly dissuaded Obama from the idea that sufficiently large subsidies could be offered to rapidly expand health coverage, so he embraced the mandate idea even as Repuoblicans turned radically against it under pressure from Tea Folk and in the pursuit of their own determination to oppose the new president’s every move.

The rest, as they say, is history.

Ed Kilgore is a contributing writer to the Washington Monthly. He is managing editor for The Democratic Strategist and a senior fellow at the Progressive Policy Institute. Find him on Twitter: @ed_kilgore.

Comments

  • T-Rex on March 27, 2012 9:44 AM:

    Conservatives wanted to make this his Waterloo, and they did -- except that he was the Duke of Wellington. Why can't they just go to Ile Ste Helene and shut up?

  • Jack Lindahl on March 27, 2012 9:48 AM:

    The fact is, most of Obama's policies wouldn't cause much discomfort to the average pre-Reagan Republican.

    We used to have a choice of somewhat left of center Democrats to somewhat right of center Republicans, with many politicians bridging that divide. But now, our choices have become limited to somewhat right of center incompetent Democrats to lunatic fringe crazed Republicans.

    hmm ... perhaps I'll stay home next November after all.

  • SadOldVet on March 27, 2012 9:50 AM:

    Some additional history...

    In 1798, the 5th Congress of the United States passed legislation which was signed into law by the second president of the United States, John Adams.

    The law as titled The Sailors Relief Act of 1798. It created a socialized health care system for military and civilian sailors. It mandated that all civilian sailors purchase health care insurance thru the socialized health care system.

    The first hospital established as part of this socialized health care was Johns Hopkins. The socialized health care system created by The Sailors Relief Act of 1798 was the foundation upon which the V.A. Health Care System was built.

    Our founding fathers, who were the framers of the Constitution, must have been really concerned that socialized medicine and mandated purchase of insurance would occur in this country -NOT!

  • martin on March 27, 2012 10:38 AM:

    Jack Lindahl :The fact is, most of Obama's policies wouldn't cause much discomfort to the average pre-Reagan Republican.

    My friends and I used to say Clinton was the best Republican president since Nixon. I guess Obama is the best Republican since Clinton :(

  • ckelly on March 27, 2012 10:47 AM:

    Ironic indeed. Perhaps Obama shouldn't have "compromised" to accept the mandate, forcing people to buy insurance from private insurance companies, giving us Republican-lite healthcare.

    Single-payer or at least public option anyone?

  • boatboy_srq on March 27, 2012 10:47 AM:

    Shorter Aizenman:

    Any and all prior GOP policy positions instantly reversed the day Obama voiced approval for them, simply because Obama supported a position they had held.

    If the public were waiting for proof that GOP demands for bipartisanship were a sham, and that opposition to any and all Democratic policies has become a requirement for GOP officeholders, only needs look at the last two years to find all that's needed.

    I still say I'm waiting for the day Obama comes out against any and all firearms regulations/restrictions, just to watch the GOP turn on the NRA.

  • Peter C on March 27, 2012 10:48 AM:

    It's time to give up on the idea that a charge of hypocracy has any sting for Republicans; it hasn't! They don't care what they said BEFORE, they believe what they say NOW. They hold that they were correct BOTH times because what they say is always correct. The strength of their arguments proceeds ONLY from the strength of their convictions, because they are not arguing to convince 'the mind'; they are arguing to convince 'the gut'. They know that (for a significant portion of the population), if people are afraid they will go with their gut over all else.

  • ceilidth on March 27, 2012 11:06 AM:

    My favorite part of this is the self identified Christians who may not believe in physical evolution but are rapid supporters of the social darwinian concepts of the poor deserving nothing because their real god is Ayn Rand.

  • Jon Rockoford on March 27, 2012 11:14 AM:

    I can't be the only liberal who's appalled by the individual mandate. I was appalled when it was a Republican idea, and I remain appalled now that it's supposed to be our policy.

    Is it unconstitutional to force me to buy a service from a private company under penalty of a fine? I don't know. But I'd rather pay a tax to the government so it can provide the same service to everybody. Is it all semantics and is the end result the same? Not really. I don't want private insurance companies involved in what should be a public good.

    Honestly, I think the best outcome for liberals is for the Supremes to strike down the mandate, thereby creating a situation where the insurance companies will face ruin since they have to cover even those who have preexisting conditions but without the ability to spread the risk by collecting revenues from those who are healthy. Plus, the Republicans running for office won't be able to run against Obamacare since the one element that inspires visceral animosity will be dead and thus it will be less likely that their teabaggers will be inspired to show up and take over the Senate. Then Obama will perhaps propose Medicare for all.

  • cmdicely on March 27, 2012 12:14 PM:

    You can read the whole thing, but the essential facts are that the individual mandate was born at the Heritage Foundation and became the default-drive mechanism in a generation of Republican health care reform proposals for protecting against "free riders" in otherwise voluntary, private-sector based systems for expanded coverage.

    Republicans aren't against the individual mandate because it is a mandate to buy insurance (sure, that's the legal argument, but its not the policy reason they went looking for a legal argument to take to the courts), they are against the other rules associated with health care reform in the Patient Protection and Affordable Care Act, including -- but not limited to -- the kind of insurance that the individual mandate mandates.

    Particularly, Republicans have for years -- this was a centerpiece, for instance, of the Bush Administration proposals on health reform -- sought to promote the idea of high-deductible insurance plans coupled with self-insurance through tax-favored savings/investment accounts (notionally, the idea here is to control costs by exposing consumers to those cost -- of course, exposing covered individuals to costs is exactly the opposite of the point of insurance.) However, the mandate does not allow such plans to satisfy the mandate (except for individuals under 30.)

  • Rudy Gonzales on March 27, 2012 11:24 PM:

    Prediction's aside, it doesn't matter much as the Supreme Court will manage to incite extremist on both sides of this law to rail against their decision. The bottom line is it has brought about talk about fixing the health care laws currently on the books.
    No one likes being told what to do, when it comes to Health Care, yet the TEA-GOP-Republican's tell a woman they have to have an Ultrasound/Sonogram if they are considering an abortion. Carville may be right, but this law with all it's purported downfalls has already had a tremendous positive effect. It these same TEA-GOP-Republican's who want to control this Health Care law passed by the last congress.(111th) Since the TEA-GOP-Republican's have worked at the grass roots level, slowly gaining control of local and states political offices, they have made great inroads into positioning themselves to fight this at the state level even if the law is upheld. A good example is Texas. "Those who don't participate in health care make it more expensive for everyone else," said Justice Ruth Bader Ginsburg, in support of the law. "It is not your free choice" to stay out of the market for life, she said. Justice Ruth Bader Ginsburg bring to mind stalwarts like Rick Perry of Texas. Governor Rick Perry threatened to veto any legislation creating any exchange, which would provide small business's pooling of services for more favorable rates and even subsidies. Yet Perry says Texas is open for business under Perry's terms. These exchanges are operated by the states as independent corporations with their own boards. Republican's previously backed and supported health care reform and sought it's implementation. Had they acted and brought forth their version of health care, they could and would have allowed stacking of the governing boards to be filled with their own people who would run the boards under their control. Perry currently rewards his closest friends and supporters with plush jobs with the best of perks. The current Health Care law was written with specific writing to limit any governors appointments to these boards and the boards have total independence from the governors and is directed by the federal government. These independent boards would follow federal law as directed by the federal government.