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Obama's health reform isn't modeled after Heritage Foundation ideas

By Robert Moffit
Monday, April 19, 2010; A15

Think tank analysts usually brim with pride when the president of the United States goes around claiming that his policies are based on their work. But when President Obama tries to sell his health-care law as a moderate approach that borrows ideas developed by the Heritage Foundation, we get incensed.

The Obama health-care law "builds" on the Heritage health reform model only in the sense that, say, a double-quarter-pounder with cheese "builds" on the idea of a garden salad. Both have lettuce and tomato and may be called food, but the similarities end there.

This is why we at the Heritage Foundation respectfully ask President Obama and his acolytes to stop misrepresenting our research. We think this massive health law is abominable and should be repealed. And until Congress repeals it, lawmakers should starve this monstrosity of taxpayer funds.

Heritage has a long history of nonpartisanship. President Bill Clinton signed a welfare reform package whose key provisions did originate at Heritage. But in congressional testimony and elsewhere, we have been crystal clear about our position on this health-care law since Day One. So every time the president and his amen corner say that the Heritage Foundation engendered provisions of the law, Americans should realize that it's not an attempt to share credit but a disingenuous effort to sell this unpopular law.

Why does Obama still need to do that? The Associated Press had the answer last week when it reported that opposition to the health-care package, already high, jumped after the president signed it into law.

But let me answer the charges that central elements of the health-care law came from Heritage.

It began when President Obama told "Today" show host Matt Lauer on March 30 that "a lot of ideas in terms of the exchange, just being able to pool and improve the purchasing power of individuals in the insurance market, that originated from the Heritage Foundation."

First, Heritage did not originate the concept of the health insurance exchange. Furthermore, the version of the exchange we did develop couldn't be more different than that embodied in this law.

For us, the health insurance exchange is to be designed by the states. It is conceived as a market mechanism that allows individuals and families to choose among a wide range of health plans and benefit options for those best suited to their personal needs and circumstances. People would have a property right in their health policy, just like auto or homeowners' policies, and be able to take it with them from job to job.

Under the Heritage design, individuals could choose the health plan they want without losing the tax benefits of employer-sponsored coverage. The exchange we propose would be open to all state residents and -- very importantly -- be free of federal regulation.

Under the president's law, however, the congressionally designed exchanges are a tool imposed on the states enabling the federal government to standardize and micromanage health insurance coverage, while administering a vast and unaffordable new entitlement program. This is a vehicle for federal control of state markets, a usurpation of state authority and the suppression of meaningful patient choice. Heritage finds this crushing of state innovation and experimentation repugnant.

This law constitutes a massive alteration of the constitutional balance of power between the federal government and the states, and strikes at the heart of American federalism. This is probably not something President Obama gives a whit about, but we at Heritage do.

The other charge -- repeated on this page and elsewhere -- is that the federal individual mandate in Obama's health-care plan came from us.

For the record, we think that the law's federal mandate is unconstitutional. Our legal center, led by former attorney general Edwin Meese III, notes that Congress has no authority to force an American to buy any good or service merely as a requirement of being alive.

Yes, in the early 1990s, we, along with other prominent conservative economists, supported the idea of such a mandate. It seemed the only way to solve the "free-rider" problem, in which individuals can, under federal law, walk into any hospital emergency room nationwide and rack up big bills at taxpayer expense.

Our research in the ensuing two decades has led us to realize our initial idea was operationally ineffective and legally defective. Well before Obama was elected, we dropped it. In the spring 2008 edition of the Harvard Health Policy Review, I advanced far better alternatives to the individual mandate to expand coverage, relying on positive tax incentives and other mechanisms to facilitate enrollment in private health insurance. This is what researchers and fact-based policymakers do when they discover new facts or conduct deeper analysis.

The president and his supporters invoke the Heritage Foundation to convince the American people that his health bill is somehow a middle-of-the-road approach. It isn't. So please, Mr. President, stop it.

The writer, a deputy assistant secretary in the Department of Health and Human Services during the Reagan administration, is director of the Center for Health Policy Studies at the Heritage Foundation.

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