It Was a Heritage Foundation Technocrat That First Proposed a Health Insurance Mandate

Stuart Butler, father of the individual mandate

Be very suspicious of D.C think tanks.

Most working in the tanks get coopted and end up proposing horrific invasions on individual liberty. They usually propose the invasions as a milder form of invasion. They become technocrats for the state that specialize in obfuscating coercion.

David Warsh put out a great piece this Sunday providing background on the evil healthcare insurance mandate and how it was first proposed by a Heritage Foundation interventionist technocrat:

It was in 1989 that economist Stuart Butler proposed an individual mandate in a Heritage Foundation monograph, A National Health System for America, practically on the eve of Bush’s inauguration:

The requirement to obtain basic insurance would have to be enforced. The easiest way to monitor compliance might be for households to furnish proof of insurance when they file their tax returns. If a family were to cancel its insurance, the insurer would be required to notify the government. If the family did not enroll in another plan before the first insurance coverage lapsed and did not provide evidence of financial problems, a fine might be imposed.

That autumn, in Assuring Affordable Health Care for All Americans, a conference talk, Butler explained why the provision of health care is unlike almost all other markets:

If a man is struck down by a heart attack in the street, Americans will care for him whether or not he has insurance. If we find that he has spent his money on other things rather than insurance, we may be angry but we will not deny him services – even if that means more prudent citizens may wind up paying the tab.

Not surprising, when the other team advanced his proposal he denied it was his. Warsh again:

When the individual mandate became the basis of Obamacare, in 2010, Butler sought to wiggle out of credit for the idea:

The confusion arises from the fact that 20 years ago, I held the view that as a technical matter, some form of requirement to purchase insurance was needed in a near-universal insurance market to avoid massive instability through “adverse selection” (insurers avoiding bad risks and healthy people declining coverage). At that time, President Clinton was proposing a universal health care plan, and Heritage and I devised a viable alternative.

Butler is now a Senior Fellow in Economic Studies at the left-leaning Brookings Institution.

BTW, he also is responsible for introducing the idea of urban enterprise zones to the United States.  It's never free markets with this guy. It is always some kind of technical tweak that keeps government in the game and in control.

 -RW