An excerpt from the remarks on MCH Director Don Hazaert before the Senior Advocates of Grand Rapids, Friday November 18, 2011 at Frederick Meijers Gardens

NEXT SLIDE- Mark Pauly

The father of the individual mandate is conservative economist- and former policy advisor to President George H.W. Bush- Mark Pauly who advocated for the adoption of a universal healthcare proposal that would keep government from eventually taking over the healthcare sector.   It is important for everyone, especially critics of the Affordable Care Act, to understand, that the individual mandate was not conceived as some form of creeping socialism but rather as a conservative, market-oriented alternative to what was seen as the eventual inevitability of a truly government run single-payer system in America.  And this is hardly an irrational position since every other Western industrialized nation has some form of government-sponsored healthcare system.

And so we are clear here, single-payer would mean something akin to the Canadian or European models where healthcare is paid for by the government, rather than by individuals and private insurance companies.

In his original strategy memo, Pauly wrote, “Our view is that excessive government intervention will make matters worse… Our strategy, therefore, is to design a scheme that limits governmental rules and incentives to the extent necessary to achieve the objectives,”  In an interview conducted just this year, Pauly added, “We did it because we were concerned about the specter of single payer insurance, which isn’t market-oriented, and we didn’t think was a good idea.”

So what Pauly is saying, as early as the late 80s and early 90s, is that at some point the Democrats will gain a Supermajority in the Senate and with a backing of Democratic President will deal with the healthcare issue in America one way or another.  When that day comes, Pauly argued, conservatives had better have a market-based alternative in place to take the air out of a move toward the Canadian style single-payer model.

So was Pauly right?  (brief group conversation)

NEXT SLIDE- Heritage Foundation

In the early 90s, the individual mandate was adopted and promoted by the conservative Heritage Foundation.  The Heritage Foundation, for those of you who don’t know, is the bell cow of conservative think tanks.  It is influential with many conservative policymakers and is the think tank that all other conservative think tanks, including our own Mackinac Center here in Michigan, lean on heavily for guidance.

The Heritage Foundation dubbed their plan a “Health Care Social Contract” and wrote, the “central element in the Heritage proposal is a two-way commitment between government and citizens.  Under this ‘social contract’ the federal government would agree to make it financially possible, through refundable tax benefits or in some cases by providing access to public-sector health programs, for every American family to purchase at least a back package of medical care including catastrophic insurance.  In return, government would require, by law, every head of household acquire at least a basic health plan for his or her family.”

Now what does that sound like to you?  The government mandates individuals purchase insurance.  In turn, the government makes insurance more affordable with tax subsidies and an expansion of Medicaid for the poor.  Sounds an awful lot like the Affordable Care Act, doesn’t it?  That’s because it is.

The Heritage Foundation model was the model Massachusetts Governor Mitt Romeny followed in reforming Massachusetts healthcare system back in 2005.   And it is the Massachusetts model on which the Affordable Care Act is designed today.

Let’s also note the date here on the Heritage Foundation proposal, July 1990.  Who was President?  George H.W. Bush. Remember, Bill Clinton was still playing his saxophone back in Arkansas and the Hillarycare debate was still several years away.  The individual mandate model was NOT developed as an alternative to Hillarycare.  It was developed for the exact purpose for which it was used: as a conservative, market-based alternative to single-payer.

So who else supported the individual mandate concept?  This list will surprise you.

NEXT SLIDE- Dole and Gingrich

I think most of you are familiar with former Senator Bob Dole.   Throughout the mid-90s, Dole and many Congressional Republicans, as you may recall, embraced and promoted the individual mandate as an alternative to what conservatives dubbed at the time HillaryCare.  Dole even later made the mandate a campaign issue in his 1996 run for the presidency.

This concept of mandated private insurance as an alternative to government run healthcare was also promoted by Newt Gingrich and his Center for Health Transformation.  As you can imagine, this has caused Newt to have to go through a lot of rhetorical acrobatics as of late as he tries to navigate his previous support for the individual mandate with the current political climate within the Republican Presidential primary process.

This theater of the absurd played out at a recent Western Republican Leadership Conference Debate when Newt Gingrich began to attack Mitt Romney, the former Governor of Massachusetts, for instituting the individual mandate model in his state.  Romney, appropriately, called Gingrich out following a verbal assault by Newt:

ROMNEY:  Actually, Newt, we got the idea of an individual mandate from you.

GINGRICH: That’s not true.  You got it from the Heritage Foundation.

ROMNEY:  Yes, we got if from you, and you got it from the Heritage Foundation…

What Romney is pointing out here is that Gingrich, like many conservatives from all over the country, took their cue from the Heritage Foundation and began promoting this individual mandate alternative throughout the last two decades only to than reverse themselves a couple years ago once it was adopted by a Democratic Congress.  But isn’t it still fair to hold people accountable for the fact they had been advocating for years the very model they are now criticizing?  Mitt Romney apparently thinks so.  I do too.

So it’s important for you to know that when you hear people at work or around the dinner table referring to “they” or to “those people” who brought us the individual mandate, whether they realize it or not, they are actually referring to some of the leading conservative minds of the last two decades.