EXCEPT NIXON WAS A DEMOCRAT:

Contrary to rants that Obama's 2010 health reform, the Patient Protection and Affordable Care Act (ACA), is the most socialistic legislation in American history, the reality is that it is virtually textbook Republican health policy, with a pedigree from the Heritage Foundation and Massachusetts Gov. Mitt Romney, among others.

It's important to remember that historically the left-Democratic approach to healthcare reform was always based on a fully government-run system such as Medicare or Medicaid. During debate on health reform in 2009, this approach was called "single payer," with the government being the single payer. One benefit of this approach is cost control: the government could use its monopsony buying power to force down prices just as Walmart does with its suppliers.

Conservatives wanted to avoid too much government control and were adamantly opposed to single-payer. But they recognized that certain problems required more than a pure free-market solution. One problem in particular is covering people with pre-existing conditions, one of the most popular provisions in ACA. The difficulty is that people may wait until they get sick before buying insurance and then expect full coverage for their conditions. Obviously, this free-rider problem would bankrupt the health-insurance system unless there was a fix.

The conservative solution was the individual mandate--forcing people to buy private health insurance, with subsidies for the poor. This approach was first put forward by Heritage Foundation economist Stuart Butler in a 1989 paper, "A Framework for Reform," published in a Heritage Foundation book, A National Health System for America. In it, Butler said the number one element of a conservative health system was this: "Every resident of the U.S. must, by law, be enrolled in an adequate health care plan to cover major health costs." He went on to say:

Under this arrangement, all households would be required to protect themselves from major medical costs by purchasing health insurance or enrolling in a prepaid health plan. The degree of financial protection can be debated, but the principle of mandatory family protection is central to a universal health care system in America.

In 1991, prominent conservative health economist Mark V. Pauley also endorsed the individual mandate as central to healthcare reform. In an article in the journal Health Affairs, Pauley said:

All citizens should be required to obtain a basic level of health insurance. Not having health insurance imposes a risk of delaying medical care; it also may impose costs on others, because we as a society provide care to the uninsured. ... Permitting individuals to remain uninsured results in inefficient use of medical care, inequity in the incidence of costs of uncompensated care, and tax-related distortions.

In 2004, Senate Majority Leader Bill Frist (R-Tenn.) endorsed an individual mandate in a speech to the National Press Club. "I believe higher-income Americans today do have a societal and personal responsibility to cover in some way themselves and their children," he said. Even libertarian Ron Bailey, writing in Reason, conceded the necessity of a mandate in a November 2004 article titled, "Mandatory Health Insurance Now!" Said Bailey: "Why shouldn't we require people who now get health care at the expense of the rest of us pay for their coverage themselves? ... Mandatory health insurance would not be unlike the laws that require drivers to purchase auto insurance or pay into state-run risk pools."

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