• Stuart Butler’s change of mind

    Stuart Butler of the Heritage Foundation had a piece in USA Today over the weekend defending his opposition to the individual mandate and the ACA in spite of advocating for an individual mandate in the past. In fact, virtually all of the undergrads in my Fall 2011 Intro to the U.S. Health System class identified Butler and the Heritage Foundation as the ‘intellectual fathers’ of the mandate in their final semester long research paper on the mandate and the ACA (post at semester beginning, follow up post at the end).

    One of the most interesting things about Stuart’s piece in USA Today is that it doesn’t actually link to the initial document he wrote on the individual mandate in 1989 (his piece contains many other links). You can read it for yourself and his reasoning for changing his mind and then decide for yourself whether you think his (and Heritage’s) consistent and vociferous opposition to the ACA is consistent with their past views.

    In Suart’s piece, he says there are three key reasons that his past support of an individual mandate does not make his current opposition ironic or inconsistent.

    • Deep Motivation. He says he supported an individual mandate to protect everyone else from the uninsured (cost shifting), whereas the motivation behind the ACA’s individual mandate is to get persons to purchase expansive coverage for themselves.
    • Corollary policies. He proposed modification of the tax treatment of employer paid insurance and then providing subsidy to encourage persons to purchase catastrophic insurance on their own, encouraged by an individual mandate. And instead of a penalty/tax as in the ACA, he says his preferred option was someone who did not comply would simply not get the subsidy to purchase insurance.
    • Tactical Motivation. The individual mandate was most actively pushed in opposition to the Clinton Plan, which had an employer mandate at its heart. Opponents of the Clinton Plan needed something through which to oppose the Clinton Plan, and the individual mandate fit the bill.

    I completely believe the last reason noted above that motivated Butler and others to support the individual mandate in the past. On the first two, I am not so sure the distinctions warrant the degree of opposition to the ACA, but of course I can’t know the mind and motivations of another person, and my own perspective is cooked into that assessment. One of my goals as a blogger is to give people the benefit of the doubt (I like it when they do the same for me), and one thing I want to totally concur with Butler about is the correctness of being able to change one’s mind:

    Changing one’s mind about the best policy to pursue — but not one’s principles — is part of being a researcher at a major think tank such as Heritage or the Brookings Institution. Serious professional analysts actually take part in a continuous bipartisan and collegial discussion about major policy questions. We read each other’s research. We look at the facts. We talk through ideas with those who agree or disagree with us. And we change our policy views over time based on new facts, new research or good counterarguments.

    It is actually a bad sign if you never change your mind about anything. I appreciate Stuart giving an account for why he did so in this case, even if I don’t find it to be totally convincing.

    DT

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