They Were For It Before They Were Against It

During the early 1990s, when President Bill Clinton tasked First Lady Hillary Clinton to lead the effort to overhaul the nation’s health care system, Republicans proposed an alternate idea to Hillary’s proposal, which envisioned a larger role for government in health care than what President Obama signed into law last March. That Republican proposal was a health insurance mandate that would require all Americans to have coverage, precisely the same obligation that Republicans have vehemently lambasted in the recent health care reform bill. Polled individually, all of the major elements of Obama’s health care overhaul are very popular with the notable exception of the health insurance mandate. You’ll be hard-pressed to find a politician or citizen anywhere who thinks it is a bad idea that parents can keep their children covered under their insurance plan until age 26, or that insurance companies can no longer deny children with pre-existing conditions coverage, or that insurance companies cannot cancel someone’s plan when they become ill.

In 2006, then-Massachusetts governor Mitt Romney signed into law a program that is strikingly similar to the Obama plan. Romney’s plan included the same health insurance mandate that is present in the 2010 bill. At the time, Romney defended it as “a personal responsibility principle.” Like President Obama’s plan now, the Romney plan relied solely on private insurers to cover the uninsured. Both also included other health insurance industry regulations to prevent the exclusion or denial of care to sick people and subsidies for low-income individuals. Both are conservative, market-based ideas that don’t expand government-run health insurance. Since then, Romney has changed his tune significantly.

Other prominent Republican politicians, including LDS Church members Sen. Orrin Hatch of Utah and Sen. Mike Crapo of Idaho, have also previously co-sponsored health care legislation that included a health insurance mandate. Even Massachusetts Sen. Scott Brown, whose victorious election last year was trumped by Republicans as a statement against the Democrats’ health care reform effort, supported the health insurance mandate in Romney’s plan when he was a state-level legislator. “In Massachusetts, it helped us deal with the very real problem of uncompensated care,” Brown said. So if Republicans were for it then, why are they against it now? Sen. Brown odiously tried to reconcile his support of the health insurance mandate in Massachusetts with his opposition to President Obama’s plan as a states’ rights issue.

Romney viciously accused President Obama of “betray[ing] his oath to the nation,” after the bill was passed. Romney’s attacks on the 2010 health care reform bill have been relegated to hyperbole and focus on minutia. Meanwhile, he has had to defend himself against (accurate) accusations from other Republican contenders that his health care plan hardly differs from Obama’s. The bottom line is that Obamacare practically equals Romneycare.

Republican opposition to Obama’s health care bill (particularly for those who previously supported the individual mandate) is nothing more than politics at its best. Romney is clearly running for the Republican nomination in 2012 and needs to run as fast and as far away from his middle-of-the-road accomplishments as governor to please the increasingly radical and detached-from-reality base of the Republican Party. We live in an age where the opposition party will do anything to prevent the President from having a “success,” even if it is a success with an idea they originally devised. How else do you explain Republicans’ attempts to block legislation like the new START treaty with Russia, the 9/11 first responders health care bill, the repeal of DADT? These last three measures had the broad support of the American public and the relevant experts. Yet at the end of the Lame Duck Session of Congress, you had Republicans complaining about Democrats’ attempts to push through these bills, which had been on the docket (and blocked by Republicans) for months. We truly live in an era of a sad state of affairs where the public good is regularly set aside for political theater and personal and political agendas.

Kevin Drum of Mother Jones Magazine has summed up some of my feelings of the current political state of affairs quite well:

I can’t remember when I’ve been more demoralized about American governance. I have this overwhelming feeling of barnacles building up relentlessly, untouchable because of interest group pressure on both left and right, and a complete inability and/or unwillingness to address any of it. Democrats have some things they want to do, but in addition to satisfying their own interest groups they have to settle for third or fourth best policies because Republicans have simply decided they don’t care about anything except tax cuts for the rich, hating gay people, and bennies for favored industries. In the middle of a massive recession they opposed a stimulus bill. In the aftermath of a financial crisis they opposed a financial reform bill. In the face of skyrocketing healthcare costs they demagogued modest cuts in Medicare spending. They spent months negotiating a spending bill — transparently, openly, via the ordinary committee process — and then killed it just because it would annoy Harry Reid. Global warming is a hoax, gay recruits will destroy the military, and creationism is an appropriate topic for high school biology classes. Our infrastructure is crumbling and our schools are mediocre, but the creeping encrustation of government prevents anything serious from being done about either. We’re in hock to Middle Eastern theocracies for our oil, and the laughable answer from the right consists entirely of nukes and a bit of marginal extra drilling around the periphery of America. An arms control treaty that could have been negotiated by Ronald Reagan himself [was] unsure of passage because too many Republican senators deem[ed] it unsafe to risk the wrath of Fox News or their tea party constituencies.

5 Replies to “They Were For It Before They Were Against It”

  1. It may simply be more than “politics at its best”; e.g. changing political views on the subject of health care. One of the difficulties with this legislation is determining the role of government in health care. With an aging population, and a system or mild form of socialized medicine already in place in the U.S., what will be the outcome of this type of system? Is it sustainable? Will abuse of the system (e.g. fraud) continue unabated? How will costs be contained? And what will happen to individual choice and responsibility.

    1. A look around the rest of the developed world shows that there are typically much better public health outcomes with nationalized health care systems. The U.S. spend a greater percentage of our GDP on health care than every other developed nation, but we often get much less than we bargain for. We perform worse on things like infant mortality, life expectancy, and more. The UK, for example, whose National Health Service that bears the brunt of GOP’s misleading rhetoric about so-called socialized health care, spends less than 10% of their GDP on health care. I’ve personally used the nationalized health care systems in Germany and the UK and found the quality to be excellent in both countries and the choice to be just as good as it is in the U.S. Yes- you can choose your doctor in the UK, and if you decide you don’t like him or her, you pick a different doctor. All German and UK citizens have access to quality care in their countries. However, the U.S. spends nearly 18% of GDP and we leave about 40 million Americans without insurance and in most cases, without access to quality care. The U.S. may have some of the best medical professionals and institutions in the world, but we have one of the worst health care delivery systems. What is clear about the U.S. health care system is that the pre-Obamacare system was unsustainable. The rate of health care inflation in the U.S. prior to Obamacare would literally bankrupt our country. Obamacare does not go far enough on cost controls. However, we’re already seeing positive signs wrt costs. The rate of insurance premium inflation increase has slowed since ACA was passed. We will see significant downward pressures on insurance premiums once the individual insurance mandate goes into effect in 2014.

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