Conservative opposition to the individual mandate is yet another illustration of the degree to which the Reps now opposed positions they long held. And, apparently, oppose them, not because they violate their political ideology but because Obama proposed them.
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Cutting off your policies to spite your opponents
By Ezra Klein
To step outside the latest Supreme Court case, it's worth remarking on the long-term damage conservatives are doing their cause by focusing their fire on the individual mandate.
The political case for their strategy is clear: The individual mandate, like most taxes, is unpopular. In fact, it's one of the only unpopular elements of the whole bill. But it's also one of very few ways to have a health-care system where everyone has coverage but private insurers dominate. In the long run, it may be the only way. That's why Republicans originally thought up the idea, and why it's mainly been associated with a Republican health-care bill. Mitt Romney, Chuck Grassley, Orrin Hatch, Bob Dole, Judd Gregg and Mike Crapo are just a few of the prominent Republicans who've cosponsored legislation with individual mandates.
More internationally, you may have heard of the conservative affection for Singapore's health-care system. Here's how the journal of the American Enterprise Institute describes Singapore's structure in a gushing article: "In Singapore’s system, the primary role of government is to require people to save in order to meet medical expenses they don’t expect." Another term for the government forcing you to put money into a vehicle that helps protect you from a health-care crisis is, well, an individual mandate.
Switzerland and the Netherlands also use individual mandates to sustain universal health-care systems that are less centralized than single-payer arrangements. It's a pretty common device. But if Republicans get it ruled unconstitutional in America, they'd be wise to ask themselves what other options they have: After all, the constitutionality of Medicare is not in question, and that's really the other model we could eventually trend toward. As Matt Miller put it in a column a few months back:
Conservatives, either from confusion, or for the sheer fun of taking a political bite out of Democrats, are fighting the one measure that's essential if private insurance is to retain its central role in American health care ... [But] be careful what you wish for. By fighting the mandate needed to make private insurance solutions work, and doing nothing to ease the health cost burden on everyday Americans, you'll hasten the day when the public throws up its hands and says, "Just give us single-payer and price controls." Don't think the anti-government wave this fall won't reverse itself on health care if the most private sector-oriented health care system on earth keeps delivering the world's costliest, most inefficient care.
By Ezra Klein | December 13, 2010; 2:21 PM ET
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