As the great question of the Constitutionality of the Individual Mandate works its way through America's courts, I wanted to take a step back and see where it really came from. How old is the basic idea and who first presented it as a fair, responsible way to make sure people didn't become "free riders" on the backs of those paying into the health insurance premium pool of cash?
In the 1970's, during the Nixon Administration, the Democratic Party began to advocate for a single payer plan to insure all Americans. Nixon and his party disliked the plan and explored alternate approaches, which included mandated health insurance for all Americans. Comprehensive reform was not successful in gaining enough Congressional traction to evolve into legislative action.
During the George H. W. Bush Administration, Senator Ted Kennedy from Massachusetts was pushing a Single-Payer system as a solution for the health care problem, and Conservatives pushed back with a defined Individual Mandate. Bush's plan, came from a health systems economist named Mark Pauly, was to tie the individual mandate to taxation, with means testing based on income that would effect the amount a person would have to pay. This would have catastrophic coverage, which would've left a number of large holes in the program. Also included was a clause that would cover all pre-existing. Two basic components of the Affordable Care Act.
Things crystallized further during the Clinton Administration and Hillary Clinton's efforts to address health care. Republicans, fighting back once again, submitted a formal proposal, "Coverage of Preventative Services: Provisions of Selected Current Health Care Proposals." This proposal included, on page 25, a provision for an individual mandate.
The line of Conservatives who supported this idea is a rather long one. It includes conservative watch dog group The Heritage Foundation. It also includes such high profile republicans Newt Gingrich, Mitt Romney, Orrin Hatch, Chuck Grassley, Bob Dole, Jim DeMint, Jon Huntsman, Mitch Daniels, Robert Bennett, Christopher Bond, Bill Frist, John McCain and Tommy Thompson. Not to mention the Nixon and Bush Sr. Administrations.
Its safe to say that the Republican Party has moved several steps to the right in recent years, so what was acceptable at one point in conservative ideology may not be embraced as passionately as before. It perfectly fine to disagree the idea is the best way to handle this. But its disingenuous to suggest that an idea, historically embraced by so many on the right, to be some radical, socialist and unconstitutional legislation.
Because the Affordable Care Act doesn't impose the mandate as a form of taxation, but rather as a required purchase, that's where a legitimate question is thought to exist. Several States have filed suit to protest this part of the ACA and whether or not they will succeed is up in the air. If President Obama had been less afraid of raises taxes during this time of economic recession, all of this could have been avoided. I think in a less rhetorically heated time, he would have.
As we move forward trying to understand how to best handle the delivery of health care and health care insurance in the US, we shouldn't demonize an idea that's been around, and was introduced over forty years ago. A more "adult conversation" is required than what we've seen thus far.
Source:
http://en.wikipedia.org/wiki/Health_insurance_mandate#US_States
http://www.huffingtonpost.com/2010/03/29/individual-mandate-now-vi_n_517097.html
http://dcprogressive.wordpress.com/2010/03/08/history-republicans-supporting-mandate/
http://www.altenhofel.com/blog/republicans-have-no-reason-be-against-individual-mandate
a more adult conversation-devoid of accusations of "socialism" (wave voodoo fingers here) please.
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