A summary of the conservatives giving birth to the health care mandate

I came across an October 2011 blog by Avik Roy of Forbes in which he clearly lays out the birth of the health care individual mandate, as created by Stuart Butler and Edmund Haislmaier of the conservative Heritage Foundation. They put forward the idea in 1989 and promoted it throughout the early 1990s.

At the time, they cited the need for “quality, affordable health care” for all. Of course, now that Barack Obama is in the White House, the folks at Heritage have changed their tune.

(Stuart Butler/Heritage Foundation)

Roy notes that the plan was introduced in a 1989 book, “A National Health System for America” by Stuart Butler and Edmund Haislmaier. In a 1991 lecture, Butler outlined the plan. He referred to the mandate as the “Health Care Social Contract” and fleshed it out in the lecture:

“We would include a mandate in our proposal -- not a mandate on employers, but a mandate on heads of households -- to obtain at least a basic package of health insurance for themselves and their families. That would have to include, by federal law, a catastrophic provision in the form of a stop loss for a family’s total health outlays. It would have to include all members of the family, and it might also include certain very specific services, such as preventive care, well-baby visits, and other items.”

Roy also refers to another conservative writer, Peter Suderman, who decries the Republican Party’s habit of reacting to Democratic proposals on health care rather than producing a GOP plan.

Suderman wrote: “The individual mandate was an attempt to beat Democrats at the universal coverage game and preempt … what would become HillaryCare. Medicare’s prescription drug benefit was passed by a Republican president and a Republican Congress under the pretense that if they didn’t do it, Democrats would, and it would be worse. In the debate over Obamacare, Republicans spent more energy arguing against the law’s Medicare payment cuts than any other part of the law.”

You can read Roy’s entire blog, which relies heavily on a Wall Street Journal report, here.