Newt Gingrich has attacked Mitt Romney on the issue of the individual health insurance mandate, while chalking up his own past support for the idea as an indiscretion in the 1990’s. But as it turns out, those 1990’s stretch all the way to 2005 — and beyond, to 2008 — when Gingrich gave as passionate an explanation of the mandate idea as any current supporter could ever muster. . . .I'm interested not just in the fact that Gingrich took these positions, but in the way he argued for them. Even while supporting a supposedly liberal policy, he used self-consciously tough language:
At a forum in 2005, alongside then-Sen. Hillary Clinton (D-NY) and former Sen. John Breaux (D-LA), Gingrich explained the tradeoffs that both the right and the left would have to make in health care: For the right, some transfer of wealth is involved in providing health care for the working poor, the disabled, and other groups. And for the left, individuals should still have control over their health care, rather than total government management.
“I mean, I am very opposed to a single-payer system — but I’m actually in favor of a 300 million-payer system. Because one of my conclusions in the last six years, and founding the Center for Health Transformation, and looking at the whole system is, unless you have a hundred percent coverage, you can’t have the right preventive care, and you can’t have a rational system, because the cost-shifts are so irrational, and create second-order problems.”
This led Gingrich to a few conclusions of how to implement such a system: Convert Medicaid into a health insurance voucher system as it applies to the working poor (on the rationale that the creation of food-stamps do not involve the government running its own grocery stores); Create very large risk pools for individuals to purchase insurance (i.e., exchanges); and minimize insurance companies from cherry-picking customers.
But my point to conservatives is, it’s a model of responsibility. If I see somebody who’s earning over $50,000 a year, who has made the calculated decision not to buy health insurance, I’m looking at somebody who is absolutely as irresponsible as anybody who was ever on welfare. Because what they’ve said is, a) I’m gambling that I won’t get sick, and b) I’m gambling that if I do get sick, I can cheat all my neighbors.You can see him make those remarks starting around 3:45 in this video. He starts out by admitting it might sound "un-conservative," but arguing that it's analogous to welfare reform:
Now when you talk to hospitals, a very significant part of their non-collectables are people who have money, but have calculated that it’s not worth the cost to collect it.
And so I’m actually in favor of finding a way to say, if you’re above whatever — whatever the appropriate income level is, you oughtta have either health insurance, or you oughtta post a bond. But we have no right, we have no right in this society, to have a free-rider approach if you’re well off economically, to say we’ll cheat our neighbors.
Gingrich's argument is a good example of what I see as the fundamental divide in how liberals and conservatives think of themselves, or at least how they hold themselves out to the public. Liberals present themselves as caring. Conservatives present themselves as tough. I don't know of any other unifying theory that explains why conservatives/Republicans disagree with liberals/Democrats on so many disparate issues — economic, social, foreign policy.
Since Gingrich is committed to his image as a conservative, even if he takes a seemingly liberal or moderate position on health care, he isn't going to frame it as being concerned for those who lack health insurance. It's about cracking down on people who abuse the system. That's how conservatives like to talk, so I'm sure at the time he thought he was making a brilliant point that was consistent with conservatism. But for conservative Republican primary voters who are driven by opposition to Obama's health-care reform, I'm not seeing any reason to choose Gingrich over Romney.
UPDATE: Politico has a similar article:
If Republicans are flocking to Newt Gingrich to get away from Mitt Romney’s health care problems, they could end up with a nominee with … awfully similar health care problems.
Or maybe worse: While Romney signed a state mandate into law, Gingrich once went a step further and advocated a federal one.