Let me get this out of the way first: When most on the left accuse the GOP of supporting the mandate before Obamacare, they point to the HEART Act of 1993. That is not a strawman. That is fact. Had you specified Romneycare with your 90% claim, it would have been clear. My strawman was not intentional at all.
I believe you that your strawman was not intentional... But it is a strawman nevertheless. From your own words, "When most on the left"...
1. I am not on the left. I am simply not an ideologue at all.
2. Even if I were on the left, I never mentioned the HEART Act in any case. Hence the strawman.
There was no claim that you are on the left. The overwhelming majority of people who point out that the GOP was 'for' the mandate before Obamacare are left-leaning (which also does not mean I'm saying you're left-leaning, in case you're getting that idea). Thus, the "when most on the left" claim doesn't necessarily include you, and still stands as a reason why I automatically went to the HEART Act of 1993.
Romney signed a bill in heavily Democratic Massachusett's, vetoing 8 sections, and the legislature immediately overruled 6 (and the other 2 eventually). The 34D-6R Senate, and the 139D-20R-1I House, passed a bill, sent it to the Governor, and then overruled all 8 of his vetoes.
Correct me if I'm wrong, but elected representatives (including the Governor) are supposed to govern according to their constituents, right? Wouldn't you think it likely in a heavily Democratic State Government, there will likely be things a GOP Governor will sign that aren't traditionally GOP party planks?
You are correct. That does NOT change the fact that actual bill he signed into law was touted by him, dozens of prominent Republicans, AND the Heritage Foundation itself.
What "dozens of prominent Republicans" touted MassHealth? I posted a link from Heritage that touted the passage of MassHealth as an overall good thing, but it also brought up things that it felt onerous (including the individual mandate).
As far as Romney's actual plan....
The mandate required people to have at least a basic level of coverage.
Today our laws prevent insurers from offering policies with only basic benefits. Bells, whistles, and costly options are mandated.
Insurers tell us they can develop plans costing less than half of today's standard rate of $500 for an individual. These plans still provide primary, preventative, specialty, and catastrophic care. The cost could be lower with higher deductibles and more restrictions. New York introduced a program in which private insurers offer rates as low as $140 a month. We can have a similarly affordable program in Massachusetts: Commonwealth Care Basic.
Finally, the element of the Massachusetts bill that has attracted the most attention and dispute is the "personal responsibility" provision, also known as the "individual mandate."
From the outset, Governor Romney stated that requiring individuals to buy health insurance in the currently fragmented and overly expensive insurance market would be wrong and counterproductive. But he also argued that if the market could be reorganized to make coverage universally available and portable, deregulated at least enough to make it affordable for the middle class, and subsidized enough to make it affordable for the low-income, then there would be no reasonable excuse for anyone to forgo health insurance.
Romney also pointed out that to allow people to go without health insurance when they can expect someone else to pay the tab for their treatment is a de facto mandate on providers and taxpayers. Romney's plan was to take that option off the table, leaving only two choices: either buy insurance or pay for your own care. He proposed that those who want to go without coverage could place $10,000 in an interest-bearing escrow account, which providers could claim against if the individual did not pay medical bills.
Unfortunately, the state legislature changed that idea into a mandate: either buy coverage or pay a fine. This provision is more onerous and philosophically objectionable, but it is unlikely to prove onerous in practice. That is because the legislation includes three avenues through which Massachusetts residents can meet the individual coverage requirement by purchasing an inexpensive health plan. First, the bill allows more carriers to offer HSA products with high-deductibles. Second, it also circumvents Massachusetts' overly regulated non-group market by allowing any resident to buy coverage as an individual through the Connector, where a wide choice of plans and premiums will be available. And third, it allows insurers to offer inexpensive "mandate-light" policies to young adults between the ages of 19 and 26, those most likely to go without coverage.
Romney's plan would have prevented "free riders," but wasn't really a mandate to purchase something. "Romneycare" included a mandate because the legislature (aka not Romney) put it in. Also to note, there were different options for coverage, and not the laundry list of "everyone has to pay for almost everything in every plan" requirement under the ACA.
What is called "Romneycare" isn't exactly what Romney put forth. The "individual mandate" part of "Romneycare" wasn't part of Romney's plan, but changed by State legislators (heavily Democrat as noted earlier).
Yes Romney pushed for a lower standard of coverage, which is more affordable, and I think, a better idea overall. None of that changes my overall point about the 90%.
As for the difference in Romney's plan for buy insurance, or put money in an account for your own care. That is a semantic difference. That is still a mandate.
I disagree with your 90% claim. It might seem like semantics, but Romney's vision was to prevent free riders either by people having insurance or being able to pay their own way. Obviously, if you want to prevent free riders, you either force people to buy insurance, or you make them prove they can pay, which is what the accounts/bonds do (Ohio does this for auto insurance; no need to buy it if you prove you can pay your claims on your own (3 ways you can prove it)). There really is no other way to go about it, unless you allow care providers to turn people away if they can't pay. Romney's plan also took the money set aside to pay providers for care given to those who can't pay and turned it into subsidies to help people pay premiums.
The differences probably strike you as subtle, but they aren't.
The biggest difference, in my mind, has to do with Constitutionality. Nowhere in the Constitution is there authority granted for the Federal Government to pay for/provide health insurance or health care for all US Citizens (health care for Veterans/Military would fall under the employer/employee category). State Governments may or may not have that authority granted. If it's not granted to the Federal Government, technically, the Federal government isn't supposed to do it, regardless of how many people want it. If you look at my arguments against universal health care, it's framed around needing a Constitutional Amendment.
According to The Federalist Papers, the Federal Government is supposed to focus on things that affect the country as a whole, not the country as a whole bunch of individuals. State Governments were to focus on things that affect their individuals.
Agreed. So your answer is...
Discontinue subsidizing the state medicaid programs, and discontinue medicare, and discontinue subsidies that support Obamacare.
And then what???
1. Let the States and the citizens of the States decide what is the best way to cover people.
2. Pass a Constitutional Amendment authorizing the Federal Government to create an agency like the NHS and run healthcare; providers would be employees of the "NHS" and would have wages set by the agency (would be significant wage reductions in most cases).
3. Pass legislation making it illegal for the same company to own both the care provider and care payer (much like the Mercy Health System and ProMedica in the Toledo area being the two largest owners of medical care providers (only 1 hospital exists in the area that isn't owned by either) and are part of a group that includes the two largest insurance providers in the area.
4. Break up the AMA's monopoly on accrediting doctors, and work on adding other types of acceptable health/medical interventions.
5. Force care providers to post "price lists" so people can choose.
What I support:
- A Conservative interpretation of the US Constitution
- Personal Responsibility
- Help for the truly needy
- Limited Government
- Consumption Tax (non-profit charities and food exempt)