I have kept the true story of the Heritage Foundation and the individual health insurance mandate under wraps for almost 20 years now, because up until now it has been too costly to tell it. But now it is too costly not to tell it.
This is not an attack on Heritage, which has long since mended its ways. But the story is now centrally relevant to the Republican presidential primaries.
In 1993, I was a refugee from the failed George H.W. Bush Administration, where I had served as Associate Deputy Attorney General of the United States, after my service in the White House Office of Policy Development, where I had worked for President Reagan. I was the Heritage Foundation John M. Olin Distinguished Fellow in Political Economy.
There I discovered the wonders of the Heritage health plan, devised to stop the Hillary health plan. Except that it followed the outlines of the Hillary plan far too closely. Worse, where it differed, it was destined to fail politically.
For example, the Hillary plan was based on an employer mandate, requiring employers to buy the health insurance plan for their workers the government specified they must buy. The Heritage plan was based on an individual mandate, requiring each worker to buy the health insurance plan the government specified they must buy. So the issue was framed as who should have to buy the health insurance, the employer as the Hillary plan required, or the worker, as the Heritage plan required. Not a winning issue for the Heritage plan.
Another key difference was that the health insurance plan Hillary would require the employer to buy would be a broad generous plan covering everything. But the health insurance plan Heritage would require the worker to buy would be a cheap bare bones basic plan. So the issue was framed as which do you want: broad, generous health coverage paid for by the employer, or cheap, bare bones coverage paid for by the worker? It seemed more like the Heritage plan was designed to fail politically.
But that would be the best possible outcome. For if it passed, the individual mandate would inevitably lead to full blown socialized medicine. As I tried to explain to then Heritage Director of Domestic Policy Stuart Butler, once the government enacts an individual mandate for health insurance, then it must specify exactly what health insurance, with what benefits and coverage, would satisfy the mandate. Once the government enters that political minefield, then politics would inevitably force it to specify a broad, extremely expensive plan that covers everyone and everything.