Via Paul Krugman, The Heritage Foundation – a conservative Washington, DC think tank – back in 2003 proposed reform of the US healthcare system that is remarkably similar to the legislation passed last Sunday by the House of Representative. Stuart Butler, Vice President for Domestic & Economic Policy at The Heritage Foundation, supported universal health care coverage in order to
Provide support to people to obtain health care based on their need, not where they happen to work, or their eligibility for welfare, or their military record, or their age. Enable individuals and families to use this support to enroll in a seamless system of coverage according to their choice.
The central public policy objective of a health care system is to use public funds in an efficient and economical way to enable every household to obtain at least an acceptable level of health care services and protection from large financial burdens associated with ill health. Whether a US resident is able to count on that commitment should not depend on their current circumstances. Moreover, resources should be used as efficiently as possible to provide help those who need it most to obtain coverage. That requires us to overhaul current subsidy methods to target funds more efficiently and to achieve horizontal equity between similar people.
An important step towards that would be to overhaul the tax treatment of health care, gradually ending the regressive tax exclusion for employer-sponsored health insurance and replacing it with a more progressive subsidy. That is the logic behind the various refundable tax credit proposals in numerous proposals for addressing uninsurance. These proposals would increase the subsidy to lower-income households relative to upper-income households.
Stuart Butler, “Laying the Groundwork for Universal Health Care Coverage”, Testimony given March 10, 2003 before the Special Committee on Aging, United States Senate.
The only difference between this 2003 proposal, and the legislation passed last Sunday, is that Butler (and THF) prefer a federalist approach: “Congress would establish goals for universal coverage” and provide funding for states to reach those goals. Otherwise, Obama’s conservative reform legislation reads as if it were drafted by The Heritage Foundation.
The Heritage Foundation nonetheless has been consistently critical of the efforts of Democrats to reform health care. See, for example, here and here and here.
The final bill gets many things “right” from a conservative perspective (dropping the public option, for example, and preserving consumer choice except for abortion), so it is odd that there is not a word of praise from The Heritage Foundation on any aspect of the reform.
