Well, the phrase he prefers is “personal responsibility”, but here is Rick Perry strutting his stuff at an economic roundtable in Dubuque, Iowa on Tuesday, explaining why everyone should be paying for their own health care costs rather than free riding on emergency room care:
“I think personal responsibility is one of the very important traits historically of America….One way to improve personal responsibility, he said, would be “having even a small co-payment for those that are on limited or fixed incomes on their hospital visits — just a little co-pay where they got a little skin in the game, if you will.”
“Rather than just showing up in the emergency room because they know the government is going to pay for it is really beginning to teach people again there is a cost associated with all these programs,” he continued, “and that personal responsibility, you know, really begins with each one of us and helping people understand better that the government is not there to be the be all and end all for everything.”
To be clear, Perry is saying that people would use less care if they had to pay every time they went into the doctor’s office or received a treatment. This “skin in the game” approach is very popular in conservative circles, even if it hasn’t been shown to actually lower health care spending and may discourage people from obtaining the kind of preventive care that can forestall chronic conditions. But, Perry’s basic underlining philosophy of taking “personal responsibility” for one’s health care spending is actually very similar to the kind of thinking that underlies the individual mandate provision in the Affordable Care Act and the GOP’s push for the policy in the 1990s.
As former Republican Senator Bob Bennett recently explained it, “I first got involved in it when Mrs. Clinton was the first lady and started putting forth some ideas. And at that time, the conservative approach, to which I gravitated quite naturally, was to have an individual mandate.” He went on to justify the policy in the same exact terms as Perry: “if you are going to take the position that we do in this country that if someone is ill, we will take care of them regardless of their ability to pay. If someone shows up in the ER bleeding we don’t say, ‘if you don’t show me an insurance card we are going to throw you out in the snow and let you bleed to death.’”