Policy Paternity

Michael Cannon’s piece on the Massachusetts health program (“Romney’s Folly,” August 10) creates the impression that Gov. Mitt Romney and the Heritage Foundation wanted to impose a coverage mandate on employers. Not true.

Governor Romney, like Heritage, steadfastly opposed the employer mandate. He vetoed it, and the Democrats in the state legislature overrode it.

As for the individual mandate enacted into law, that wasn’t Romney’s idea, or Heritage’s. To cope with an estimated $1.3 billion in uncompensated care costs shifted onto taxpayers, Romney originally proposed giving Massachusetts citizens a choice: Either buy health insurance or post a bond to cover expenses associated with emergency-room care. If that is a mandate, then it is a mandate to pay one’s bills. There is nothing conservative or “libertarian” about making persons responsible for the consequences of their decision not to buy health insurance. Heritage felt the governor’s formulation of a personal choice — “insurance or bond, you decide” — was a practical and acceptable way to solve the problem of a “mandate” on taxpayers, in the form of free-rider costs and the expense of uncompensated care.

Cannon may disagree with that approach to solving a tough practical problem, or with the governor’s decision to sign the bill, but he also has a duty to stick to the facts. The facts are available in Heritage’s analysis of the law at the time of enactment (“The Massachusetts Health Plan: Lessons for the States”).

Robert E. Moffit

Director, Center for Health Policy Studies

The Heritage Foundation, Washington, D.C.

Michael Cannon replies: The legislature rejected Romney’s preferred individual mandate and rolled him on the employer mandate. Beyond that, my friend Robert’s account employs a fair amount of spin.

An individual mandate with a bond option is still an individual mandate, and gives government all the powers my article decries. And regardless, Romney signed the no-option individual mandate. No denying paternity there; it’s Mitt’s baby.

If Romney had truly opposed the employer mandate, he could have declared it a deal-breaker from Day One, or vetoed the whole package. All it would have cost him was $385 million of scammed Medicaid money that never belonged to Massachusetts in the first place. It’s what any good conservative would have done.

Romney’s unsuccessful line-item veto of the employer mandate, on the heels of signing the more dangerous individual mandate, was the sort of cynical stunt that big-government Republicans use to appear conservative — like supporting a massive tax increase but opposing withholding.

The conservative answer to uncompensated care is not to curtail the freedom of non-free-riders. It is to collect from would-be free riders as much as possible, and then write off the balance as the price of living in a decent society.

Correction

“Romney’s Folly” stated that Romney’s health-care plan cost $2 trillion. The correct figure is $2 billion.