First of all, here's an article from 2011 that gives hints of what my friend was talking about: http://www.forbes.com/sites/theapothecary/2011/10/20/how-a-conservative-think-tank-invented-the-individual-mandate/
I'm guessing that the quoted sections are from the book The Heritage Foundation put out in January of 1989....and is 140 pages, which I wasn't quite ready to commit to. I also found a shorter article posted in October of 1989 that highlights 'the Heritage Plan.' Unfortunately, it must have been scanned into their archives by an early text translating device, cuz there are loooooots of typos and weird spacing, etc. So for the portions that I've copied and pasted, I took the liberty of fixing it.
As for the individual mandate questions, here is the pertinent paragraph:
[Item #2] Mandate all households to obtain adequate insurance. Many states now require passengers in automobiles to wear seat belts for their own protection. Many others require anybody driving a car to have liability insurance. But neither the federal government nor any state requires all households to protect themselves from the potentially catastrophic costs of a serious accident or illness. Under the Heritage plan, there would be such a requirement. This mandate is based on two important principles. First, that health care protection is a responsibility of individuals, not businesses. Thus to the extent that anybody should be required to provide coverage to a family, the household mandate assumes that it is the family that carries the first responsibility. Second, it assumes that there is an implicit contract between households and society, based on the notion that health insurance is not like other forms of insurance protection. If a young man wrecks his Porsche and has not had the foresight to obtain insurance, we may commiserate but society feels no obligation to repair his car. But health care is different. If a man is struck down by a heart attack in the street, Americans will care for him whether or not he has insurance. If we find that he has spent his money on other things rather than insurance, we may be angry but we will not deny him services - even if that means more prudent citizens end up paying the tab. A mandate on individuals recognizes this implicit contract. Society does feel a moral obligation to insure that its citizens do not suffer from the unavailability of health care. But on the other hand, each household has the obligation, to the extent it is able, to avoid placing demands on society by protecting itself.
Ooookay. So that's a lot to take in. On one hand, they're saying it's an individual/household responsibility and not up to employers (hurray!) and on the other hand, the line about society feeling a moral obligation...? Ehhh not so much hurray there. I have really mixed feelings about this, because as long as "prudent citizens" MIGHT possibly be forced to pay for someone else's health care, then I suppose an individual/household mandate actually is the best way to ensure an even keel. Here's their conclusion:
All of these measures, from the basic tax treatment of health care to the encouragement of long-term care insurance, would introduce a far greater degree of consumer activism into the health care market. This strategy, combined with a requirement for basic health coverage and the focusing of government assistance to those who need it most, would change the foundations of health care in America. Rather than the current system with its built-in inflation and enormous gaps in coverage, the result would be a system providing not only coverage to all but also a powerful set of incentives for the health care industry to be as efficient and consumer sensitive as possible. In this way, America could create a national health system that combines universal health care with a degree of quality, access, and budget control that is unavailable in other national health systems around the world.
The full article can be found here: http://www.heritage.org/research/lecture/assuring-affordable-health-care-for-all-americans I heartily suggest reading it, though I don't know how accurate their info is these days on how the taxing/benefits/care system works (I wouldn't know, I've never been able to afford insurance, haha!) but overall they make a pretty good argument for the best way to run a national health care program.
And that's the crux of it. They're making a proposal for how to run a program for universal health care. I think the real question is, do we need it? Is it possible to make health care (not necessarily insurance, mind, but CARE) more affordable in another way...in a more traditional American way? That is, based on free market ideas. What if health insurance were regulated so that it could ONLY cover catastrophic incidents? Would the market react accordingly and suddenly prescriptions might be less expensive, and your normal annual check-up is something for which you put aside some money for a week, instead of a month? I'm all ears on this one, so feel free to leave a comment.
PS-I'm still slightly horrified that Heritage came up with a proposal for any sort of universal health care. But I think they saw the inevitability of the situation, so perhaps they were just trying to keep a step ahead and save what freedoms they could?
