What is Wrong With the Individual Mandate?

 
ParisParamus: Again, why is a mandate like Romneycare less conservative than raising everyone’s state income taxes to pay for the free riders? Or, why isn’t Romneycare fundamentally different than having raised everyone’s state income taxes and then offering a credit if you get private health insurance for not being less of a potential burden on the state? WHY? · Dec 28 at 10:28am

There is a simple answer to the question posed by ParisParamus. Government exists first and foremost for the sake of our protection. Without it, our lives and our property would not effectively be our own.Government exists also to promote our well-being. For its support, however, taxation is necessary, and we have tacitly agreed that, to be legitimate, these taxes must be passed by our elected representatives. By our own consent, we give up a certain proportion of our earnings for these purposes.

The money left in our possession, however, is our own — to do with as we please. It is in this that our liberty largely lies. Romneycare and Obamacare, with the individual mandate, changes radically our relationship vis-a-vis the government. The former presupposes that state governments have the right to tell us how we are to spend our own money, and the latter presupposes that the federal government has that right as well. Both measures are tyrannical. They blur the distinction between public and private and extend the authority of the public over the disposition of that which is primordially private. Once this principle is accepted as legitimate, there is no limit to the authority of the government over us, and mandates of this sort will multiply — as do-gooders interested in improving our lives by directing them encroach further and further into the one sphere in which we have been left free hitherto.

NewtGingrich6.jpgManagerial progressives see only the end — preventing free-riders from riding for free. And they ignore the collateral damage done by way of the means selected. Mitt Romney and Newt Gingrich have no understanding of first principles. For both of these social engineers, citizens are subjects to be worked-over by the government for their own good. Both men are inclined to treat us as children subject to the authority of a paternalistic state under the direction of a benevolent and omniscient managerial class.

There is, however, this difference between Romney and Gingrich. The latter may or may not fully grasp why the Tea Party rose up against the individual mandate, but he recognizes that they did so, and he knows what is good for him — so he has now backed away from the fierce advocacy of this despotic measure that once characterized his posture. The former is more stubborn. Politically, he is tone deaf. He seems constitutionally incapable of grasping the argument, he insists that the individual mandate is consistent with conservative principle, and he will not back off.

MittRomney3.jpgRaising taxes to reward free riders is, of course, objectionable. We should oppose it on principle. But it does not in and of itself narrow in any significant fashion the sphere of our liberty. It is a question of the proper use of the public purse. The individual mandate sets a new precedent. It extends government control to the private purse.

Back in May, in a post entitled The Last Man Standing, I wrote, “Frankly, I shudder at the prospect that Mitt Romney will gain the Republican nomination.” And I offered the following as an explanation:

As I argued in my book Soft Despotism, Democracy’s Drift, there is built into liberal democracy a natural tendency to drift in the direction of the administrative state with its concentration of power in the executive branch of the central government and its entitlement programs. This propensity can only be successfully resisted if we understand its origins and if we take cognizance of the manner in which the American regime, as envisaged by the Founding generation, was designed to stand in its way. This propensity has been systematically and quite effectively exploited by the Progressives and their heirs now for something like a century. What they understand that we need to understand is that a reversal of the trend is well nigh impossible – well nigh, let me add, but not quite. Well nigh because those in possession of entitlements will scream bloody murder if they are threatened. And not quite because, thanks in part to our unwitting benefactor Barack Obama, we no longer have the resources to support the entitlements state. We can certainly raise taxes, as President Obama and the Democrats intend to do, but that does not mean that in the long run we will take in more revenue – and it is massively increased revenue that the entitlement state needs. The Progressives are banking on the unwillingness of a considerable part of the electorate to give up the subsidies on which they live, and on this they have always to date successfully banked. Right now, however, the fiscal crisis of the welfare state offers us an opening, and I am confident that Mitt Romney will miss it. He is the sort of man who never misses an opportunity to miss an opportunity.

Since 1928, when Calvin Coolidge relinquished the Presidency, the office has been held by a number of Republicans – Herbert Hoover, Dwight D. Eisenhower, Richard M. Nixon, Ronald Reagan, George H. W. Bush, and George W. Bush. Only one of these has displayed an understanding of the problem we face, and he was, for understandable reasons, too preoccupied with wining the Cold War, to confront that problem with all of his energy. Hoover, Eisenhower, Nixon, Bush père, and Bush fils were all what I call managerial progressives. Their claim over against the liberals was that they could manage the administrative state more efficiently and effectively than their counterparts. Rarely if ever did any of them mention the Founders. Rarely if ever did they appeal to the first principles of our form of government as they are expressed in the Declaration of Independence. Rarely if ever did they appeal to the Constitution in opposition to the jurisprudential drift of the Supreme Court. Limited government was not part of their vocabulary. They were without clue.

The reasons are simple enough. Not one of these men was properly educated in the principles of American government. They had their virtues. They were practical men, can-do sorts with a pretty good understanding of how to get from here to there. In terms of moral understanding, as it is applied to political matters, however, they were bankrupt or pretty nearly so. The ordinary senior at Hillsdale College these days has a better grasp of the Declaration of Independence, the Constitution, and the conditions of freedom than did any of these men.

The same is true of nearly all Republicans. They come into Congress, the Senate, and state government from the Chambers of Commerce. Few of them have any sort of political education. Most are businessmen. If they have something more than an undergraduate education, it is reflected by their possessing a law degree or an MBA – which is to say, they have been trained to be managerial progressives. Our law schools and our business schools owe their origins to the Progressives. They were created for the purpose of encouraging what Franklin Delano Roosevelt called “rational administration.”

The reason why I oppose Mitt Romney is simple, He was born to destroy everything that we have accomplished since the Tea-Party Movement emerged in the Spring of 2009. Romney is the very model of a managerial progressive. He has one great virtue. He knows how to run things; he knows how to organize things. He would make a good Secretary of Commerce. He has no understanding of the principles that underpin our government. And, in fact, like most businessmen, he is a man almost devoid of political principles. Give him a problem, and he will make a highly intelligent attempt to solve it. Ask him to identify which problems should be left to ordinary people and what are the proper limits to government’s reach, and he would not understand the question. He is what you might call a social engineer; and, in his estimation, we are little more than the cogs and wheels that need to be engineered.

Not surprisingly, Romney is a political chameleon. When he ran for the Senate against Ted Kennedy in 1994, he rejected the legacy of Ronald Reagan and embraced abortion. When he ran for the Republican presidential nomination, he altered his profile in both regards. It seems never to have crossed his mind when, as Governor, he confronted a Democratic legislature in Massachusetts intent on introducing socialized medicine that the individual mandate is tyrannical. Flexibility is what substitute for virtue in his case.

Romney’s political instincts are disastrous. He will betray the friends of liberty and limited government at the first opportunity. If he is nominated, the people who joined the Tea Party and turned out in 2010 to give the Republicans an historic victory are likely to stay home. If, by some miracle, the progenitor of Romneycare actually defeats the progenitor of Obamacare, he will quickly embrace the entitlement state and present himself as the man who can make it hum, as he did in Massachusetts. He is not better than Hoover, Eisenhower, Nixon, Bush père, and Bush fils. He is cut from the same cloth, and in practice he is apt to be far, far worse. The consequence will be the death in American life or at least the decay of the impulse embodied within the Tea-Party Movement.

Everything that I have learned about Mitt Romney in the six months that have passed since I wrote these words has served only to confirm my fears. I have no idea whether the Republicans will prevail in November, 2012. That they have an historic opportunity is clear. But it seems highly likely that their standard-bearer will be a man firmly and fiercely committed to the very same progressive principles that animate their opponents.

In 2002, while running for the governorship in Massachusetts, Mitt Romney said, “I have progressive views.” In the most recent Republican Presidential debate, held shortly before Christmas, he strongly denied that his views had changed in the interim on anything but abortion. For the most part, I think, we should take him at his word. He was in 1994 and in 2002 a man with “progressive views,” and he still is.

I would like to believe that, if Romney is the Republican nominee (as I have long believed he will be), conservative voters will hold their noses and vote against Barack Obama (as I will do). The support that Ron Paul is now drawing in Iowa and elsewhere suggests, however, that this is in no way certain. Even, however, if Romney and the Republicans win an historic victory in 2012, I doubt that anything will be done by this managerial progressive to roll back the administrative entitlements state. If I am right in my fears in this regard, the Tea Party impulse will dissipate; the Republican party will split; the Democrats will return in 2016; and 2012 will be seen in retrospect as just another bump in the long, gentle road leading us to soft despotism.

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  1. Profile Photo Inactive
    @TheKingPrawn
    ParisParamus: The government of MA, all state governments, were already reimbursing hospitals (and, I assume, some other medical providers) for the medical care they were providing. Pre-mandate, your tax dollars were already paying for this.

    The state is only kicking in for the indigent. For those who are not indigent the cost is passed on through the market instead of the state. Hospitals and doctors get shorted by some percentage of people who could pay but don’t, they raises prices to cover the losses. Insurance premiums go up because the price of services go up. We do not pay through the government for free riders. Making people get insurance who can afford it is supposed to eliminate the deadbeat cost to healthcare providers thus lowering both the cost of services and the cost of insurance for all. How’s that working out for them so far?

    • #61
  2. Profile Photo Inactive
    @ParisParamus

    The King Prawn,

    I’m not sure if what you wrote above is pro- or anti-mandate. It sounds like a defense, but I don’t think you meant it to be?

    • #62
  3. Profile Photo Member
    @MBF
    ParisParamus: If you don’t have the cash to pay, the hospital isn’t going to get the money from you.

    This person you describe here, how are they able to afford premiums if they don’t have cash?

    If they can afford premiums, why can’t they work out a payment plan with the facility in question?

    We expect people to finance housing over multiple decades, why not expect the same for life saving medical care?

    • #63
  4. Profile Photo Member
    @TommyDeSeno
    ParisParamus: Nicely put.

    Moreover, you haven’t proposed an alternate solution to pay for these expenses.

    Some of us have.

    Bring back “hospitalization” and “Catastrophic” insurances. Since statistically the risks of these incidents are low, premiums are low. This is how we operated 50 years ago.

    It was in the 1970’s (Nixon tapes have confirmed) that insurance companies talked the world into insuring everything, from your $70 office visit right down to the 10 cent aspirin.

    That’s why insurance costs have skyrocketed well past actual medical costs for the average person. We walk out of our doctor’s offices and say, “Whew! Glad I paid that $1,500 monthly insurance premium! Otherwise, I would have had to give that doctor 70 bucks!”

    All those months you don’t see the doctor, your money goes to insurance companies and not to the medical field. Truly senseless.

    Bring back Hospitalization and Catastrophic policies. Pay your primary doctor for your visits. They will compete for your money (remember house calls?).

    Give the free market the opportunity to fix the system.

    • #64
  5. Profile Photo Inactive
    @ParisParamus

    This person you describe here, how are they able to afford premiums if they don’t have cash?

    Umm.. That’s the nature of an insurance premium: you pay a fraction of the value of your coverage to cover the likelyhood you will actually need that coverage…

    • #65
  6. Profile Photo Member
    @MBF

    “So what are you implying, that Romneycare was inaugurated for purely political reasons?  That there was no real fiscal problem to solve?  Please explain.”

    They need healthy young people to start paying into the system to offset the government mandated charity for so called pre-existing conditions.

    • #66
  7. Profile Photo Inactive
    @ParisParamus

    Some of us have.

    Yes, and I agree. But the question is whether Romney was ever going to get a free-er market solution introduced in BLUE Massachusetts. So he did the best he could in the environment. And to blame him for his environment is just plan stupid.

    • #67
  8. Profile Photo Member
    @MBF
    ParisParamus: This person you describe here, how are they able to afford premiums if they don’t have cash?

    Umm.. That’s the nature of an insurance premium: you pay a fraction of the value of your coverage to cover the likelyhood you will actually need that coverage… · Dec 29 at 9:22am

    The first question was only to get you to admit that the person in question has at least some ability to pay something. Now please answer the two remianing questions.

    Thanks for the free lesson on how insurance works, though.

    • #68
  9. Profile Photo Inactive
    @TheKingPrawn
    ParisParamus: The King Prawn,

    I’m not sure if what you wrote above is pro- or anti-mandate. It sounds like a defense, but I don’t think you meant it to be? · Dec 29 at 8:43am

    Anti-mandate. If you read the linked article you’ll see that the Romneycare mandate did not do what it was intended to do. Premiums have gone up in Mass. and faster than premiums in other states. It was a nice try. Compared to the single payer system which would have otherwise come into existence it was the best he could do. But, the reality is it still does not work as intended. Romney is standing by a failed experiment. That is counter to everything he did as a businessman. If something didn’t work he abandoned it, but with this one thing he is remaining faithful out of political obligation.

    • #69
  10. Profile Photo Member
    @Rodin

    I take Professor Rahe’s point about the distinction between health insurance and auto insurance. But doesn’t the argument about safety in the use of vehicles on public roads open an avenue for health insurance mandate that is logically consistent with auto insurance but nearly indistinguishable from the Obamacare/Romneycare mandate?

    Specifically, public health is harmed in dense physical environments such as planes, buses, trains, concerts, apartment living, shopping malls, etc., whenever someone is ill with a contagious disease that could have been prevented or corrected with routine access to medical care? Could the state then levy a sum on tickets or other payments for use of or access to such dense physical environments, to cover the cost of medical care for everyone? In this way people would pay only for use or access, but few individuals would entirely avoid the levy.

    If that is a more constitutional approach but more expensive to administer is there really a clear victory for individual liberty?

    • #70
  11. Profile Photo Inactive
    @TheKingPrawn
    Rodin: Specifically, public health is harmed in dense physical environments such as planes, buses, trains, concerts, apartment living, shopping malls, etc., whenever someone is ill with a contagious disease that could have been prevented or corrected with routine access to medical care?

    Just because one is forced to purchase insurance does not mean he will use it.

    • #71
  12. Profile Photo Inactive
    @ParisParamus

    I understand the initial distinction between a car insurance “mandate” and a health insurance mandate: no one is forcing you to drive. I still think there’s a distinction, but it’s somewhat blurred when you consider that Romneycare doesn’t oblige you to do anything until you are earning a certain amount of income–just as you don’t pay any state income taxes until some level of income.

    Again, in an academic setting, I would be on Prof. Rahe’s team. When it comes to Presidential politics, we need to adjust for, what I believe, Thomas Sewell said (as conveyed by Dennis Prager): at an intersection, being right and dead isn’t much of a victory. If you sit on your hands and don’t get on Team Romney, and Obama wins Term II, you might be right. And we may very well be dead.

    • #72
  13. Profile Photo Member
    @PaulARahe
    ParisParamus: It is not a tax. It is a fine — for breaking the law.

    That’s a semantic, not substantive difference–because the government was already paying for what the new horrible “fine” now pays for. It’s not the stuff upon which to demonize a Presidential candidate. · Dec 28 at 8:05pm

    Edited on Dec 28 at 08:21 pm

    Utter nonsense. A fine is a punishment; a tax is a contribution on our part to the public purse. Progressives systematically blur legal distinctions. They describe allowing us the use of our own money as a tax expenditure.

    • #73
  14. Profile Photo Member
    @Rodin
    The King Prawn

    Rodin: Specifically, public health is harmed in dense physical environments such as planes, buses, trains, concerts, apartment living, shopping malls, etc., whenever someone is ill with a contagious disease that could have been prevented or corrected with routine access to medical care?

    Just because one is forced to purchase insurance does not mean he will use it. · Dec 29 at 10:41am

    True enough. But actual use is irrelevant to the constitutional argument over the levy for access or potential use. What is scary is the next step: “You’ve paid for it and by God you’re going to use it to protect the rest of us!”

    • #74
  15. Profile Photo Member
    @PaulARahe
    ParisParamus: Nicely put.

    Not really. The government of MA, all state governments, were already reimbursing hospitals (and, I assume, some other medical providers) for the medical care they were providing. Pre-mandate, your tax dollars were already paying for this.

    Moreover, you haven’t proposed an alternate solution to pay for these expenses. Moreover, you haven’t, and no one here, has offered a bright-line, hard distinction between the “legitimate” notion of a state income tax, and the evil, socialist, statist concept of a a mandate-penalty–that’s because there isn’t one. It’s a question of degree. to which I agree that Massachusetts has oppressively high state income taxes. But so does New York, and arguably ten other states.

    Whatever. This is not a basis on which to demonize Mitt Romney. It’s logically inconsistent, and leads to things like RON PAUL!! and a second Obama term. · Dec 29 at 8:11am

    Edited on Dec 29 at 08:35 am

    No, ParisParamus, the nomination by the Republicans of a man with “progressive views” hard to distinguish from those of Barack Obama is what might lead to a second term for our current President.

    • #75
  16. Profile Photo Member
    @PaulARahe
    ParisParamus: Some of us have.

    Yes, and I agree. But the question is whether Romney was ever going to get a free-er market solution introduced in BLUE Massachusetts. So he did the best he could in the environment. And to blame him for his environment is just plan stupid. · Dec 29 at 9:25am

    So he did the best he could in the environment? And then he recommended what he did as “a model for the states” and even “a model for the nation.” If what you say is true, ParisParamus, Mitt Romney is not a man who misunderstands. He is a scoundrel of the first water.

    I have noticed that, when cornered, Romney’s partisans always revert to this excuse — which makes him look much, much worse.

    Who is demonizing Mitt Romney now?

    • #76
  17. Profile Photo Member
    @Rodin
    The King Prawn

    ParisParamus: If you sit on your hands and don’t get on Team Romney, and Obama wins Term II, you might be right. And we may very well be dead. · Dec 29 at 10:43am

    I think the real difference we have in these discussions is that those who are not onboard with Romney do not see his victory over Obama as being significantly different enough from his loss to Obama as to qualify as a conservative victory or, more importantly, a victory for liberty. · Dec 29 at 11:01am

    I am pretty confident that everyone on Ricochet will be casting a “no” vote on Obama in 2012 whatever our expectations about the effectiveness of the Republican candidate.

    • #77
  18. Profile Photo Member
    @PaulARahe
    Rodin: I take Professor Rahe’s point about the distinction between health insurance and auto insurance. But doesn’t the argument about safety in the use of vehicles on public roads open an avenue for health insurance mandate that is logically consistent with auto insurance but nearly indistinguishable from the Obamacare/Romneycare mandate?

    Specifically, public health is harmed in dense physical environments such as planes, buses, trains, concerts, apartment living, shopping malls, etc., whenever someone is ill with a contagious disease that could have been prevented or corrected with routine access to medical care? Could the state then levy a sum on tickets or other payments for use of or access to such dense physical environments, to cover the cost of medical care for everyone? In this way people would pay only for use or access, but few individuals would entirely avoid the levy.· Dec 29 at 10:13am

    I am not certain I understand what you are asking. The most important difference is that, when we drive, we put others in danger. Auto insurance is required of us for that reason — not for our own health, but for the damage we may well do to others.

    • #78
  19. Profile Photo Member
    @PaulARahe
    ParisParamus:

    Again, in an academic setting, I would be on Prof. Rahe’s team. When it comes to Presidential politics, we need to adjust for, what I believe, Thomas Sewell said (as conveyed by Dennis Prager): at an intersection, being right and dead isn’t much of a victory. If you sit on your hands and don’t get on Team Romney, and Obama wins Term II, you might be right. And we may very well be dead. · Dec 29 at 10:43am

    Edited on Dec 29 at 10:44 am

    If we have to settle for Obama lite, I will vote for Obama lite and urge others to do so. That some will balk is, however, a given. The managerial progressives have blackmailed us in this fashion time and again, and they have sold us down the river every time. We voted for Nixon over Humphrey and got the EPA, OSHA, and affirmative action in return.

    • #79
  20. Profile Photo Inactive
    @ParisParamus

    A fine is a punishment; a tax is a contribution on our part to the public purse. sorry, they both are a taking from my wallet. They both may go to support things I may not agree with. They both may distort a private market for some good or service. A $1000 income tax is more “progressive” (politically progressive) than a $10 “penalty” I am forced to pay. Penalty and tax = no substantive difference, and any sane conservative should prefer the latter to the former.

    • #80
  21. Profile Photo Inactive
    @JamesOfEngland
    Paul A. Rahe

    James Of England

    The police power is not defined narrowly; this is almost the definition of “police power”. Rather, it grants power generally and then prohibits things thought of, much of which were not thought of by Adams, but by much later amenders. Things unconsidered are therefore generally permitted (although future generations can ban them). · Dec 28 at 6:42pm

    Sorry, James, this will not do. Technically, you may be correct. But I know enough about the thinking of people in eighteenth-century America (on which I penned a sizable tome) to be confident that it would have been simply unthinkable to propose requiring all of the citizens of Massachusetts or any other state to spend a chunk of their own money at the direction of the government. ·

    The militia act is not a justification for the proposition that Obamacare is Constitutional; the mandate to buy arms comes under a separate grant of power. It does offer support for the proposition that Washington’s America could imagine and tolerate mandates as a form of government power. Assuming for argument’s sake that mandates were not tolerable, though, the defense against that would be the C18 Massachusetts electorate.

    • #81
  22. Profile Photo Inactive
    @ParisParamus

    Instapundit linked to this thread, so I just want to say: hi mom!

    • #82
  23. Profile Photo Member
    @Rodin
    Paul A. Rahe

    I am not certain I understand what you are asking. The most important difference is that, when we drive, we put others in danger. Auto insurance is required of us for that reason — not for our own health, but for the damage we may well do to others. ·

    You have distinguished auto insurance from the individual mandate (as I interpret it) based on an elective decision coupled with a predictable harm (driving a vehicle that is capable of doing damage to persons or property) versus living and breathing. I am raising the question of whether you can apply that same test to public health in activities such as riding planes and trains, attending concerts, living in close quarters, etc.? Riding on a plane or train, or attending crowded concerts or living in dense living quarters such as apartments are elective. Although catching a deadly disease may not be a common occurrence with the upswing of tuberculosis it is greater than zero; “fender bender” diseases are more prevalent. The public health “mandate” for “crowd” insurance may be as rational as requiring insurance to drive automobiles. But I suspect the premiums would be lower.

    • #83
  24. Profile Photo Inactive
    @ParisParamus

    I think implicit in my position on this subject is pointing out that there has not been a President in the past 70 years who was not a “managerial progressive.”; Yes, Reagan may have been a lesser managerial progressive; Bush 43 more so; Romney would fall somewhere closer to Reagan, I suspect. But by calling Romney a “managerial progressive,” you’re implying there’s a viable alternative who is not, even though there has not been in any of our lifetimes.

    So I’ll take the lesser managerial progressive, and the guy who seems most likely to pave the way for even lesser managerial progressives in the future.

    • #84
  25. Profile Photo Inactive
    @TheKingPrawn
    ParisParamus: If you sit on your hands and don’t get on Team Romney, and Obama wins Term II, you might be right. And we may very well be dead. · Dec 29 at 10:43am

    I think the real difference we have in these discussions is that those who are not onboard with Romney do not see his victory over Obama as being significantly different enough from his loss to Obama as to qualify as a conservative victory or, more importantly, a victory for liberty.

    • #85
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