David Warsh: Thank Utah as well as Mass. for movement toward universal health insurance

  The Mormon Tabernacle on Salt Lake City.

The Mormon Tabernacle on Salt Lake City.

SOMERVILLE, Mass.

There is no better example of the  use of the memory hole in the service of doublethink than Republican opposition to the individual mandate that is at the heart of   Obamacare. Requiring all individuals, even young and healthy ones, to buy health insurance through markets was a Republican idea, advanced in the early 1990s in opposition to a single-payer health system.  It was a thoroughly sensible approach to the problem of steadily rising health-care costs, and, as it turned out, the only practicable way to proceed.

I wrote about these beginnings last month. The news that the Republican leadership in the House  plans a second attempt to “repeal and replace” – apparently in the shadow of the president’s tax-reform plans – got me thinking about the subject again.

A couple of summers ago, I spent a pleasant day reading American Crucifixion: The Murder of Joseph Smith and the Fate of the Mormon Church (Public Affairs, 2014), by Alex Beam. Aside from the manuscript of the Book of Mormon, confided to him, in 1843, by an angel named Moroni, Smith left relatively little behind when he died, at age 38, besides a museum containing the mummies of “the Old King Pharaoh himself of the Exodus, with his wife and daughter.”

Otherwise, Joe Smith possessed “pretty much all the weaknesses a man could have,” in the words of the church elder who succeeded him. These included an enthusiasm for plural marriage so robust that it eventually included the wife of one powerful backer and the daughter of another – extensions that ultimately proved fatal. Smith was shot to death by members of a mob in in Carthage, Ill., in 1844.

Instead of dispersing, most of the members of the Church of Jesus Christ of Latter-day Saints fled Illinois  and moved some 1,300  miles through Indian country to the Great Basin of Utah, in a series of epic journeys. There they produced a community of faith that for more than 165 years has successfully preached a powerful gospel at home and abroad. How did the Mormon Church fare so well?

The answer, I knew, was Brigham Young.  I knew this mainly from reading the chapter on Young in The Vital Few: The Entrepreneur & American Economic Progress (Oxford, 1986), by Jonathan Hughes, of Purdue and, later, Northwestern University.  The chapter on Young follows one on another religiously inspired founder of an American state, the Quaker William Penn.  Other chapters portray the lives and works of Eli Whitney, Thomas Edison, Andrew Carnegie, Henry Ford, E.H. Harriman and J. Pierpont Morgan; as well as social entrepreneurs Mary Switzer (federal disability services) and Marriner Eccles (the Federal Reserve Board). 

If Smith was the church’s greatest talent, Young was the first Mormon mandarin (following the tripartite schema of Nicholas Lemann). Young was 30 when he first he read the Mormon testament. He was 45 when he took over leadership of the church.  In the great Mormon migration, on foot and by wagon, he produced, Hughes wrote, “a singular masterpiece of organization” –- and a political culture that proved durable.  For an elaboration of this remarkable achievement, the exertions and the foresight it required, see Hughes's book. 

In summary, Hughes wrote:

"In the trek, as in the early settlements, the 'ideological system' was a mixture of private enterprise tempered by cooperation wherever private means did not provide the ends sought by the church leaders. This view of economic organization never left the Mormons. It now pervades the United States….Conservatives, they preside over a most extensive welfare enterprise…. both 'free enterprise' and 'collectivist.'''

That in turn led me to read American Universities and the Birth of Modern Mormonism: 1867-1940 (University of North Carolina, 2016), by Thomas Simpson  It turns out that once things settled down in the Utah Territory– after the “Utah war” of 1857-58, in which the U.S. sent a 5,000-man expeditionary force to pacify the unruly polygamists, and after the four-year U.S. Civil War – Brigham Young authorized the beginnings of a reverse migration of Mormon students to Eastern universities.

This was the same sort of strategy pursued during the same years by separatist Japan under the charter of the Meiji Restoration. Japan sent many students to universities abroad in the late 19th Century and it produced similar results – a controlled modernization that nevertheless eroded the ecclesiastical insularity that it was designed to serve.  Much the same process unfolded in China after 1978 – the Great Leap Outward, as it was known.

Which brings me to my subject, Mitt Romney, governor of Massachusetts, 2003-07, and among the most prominent Mormons in American politics. It was Romney’s administration that took advantage of fortuitous fiscal circumstances to enact a universal health-care system with an individual mandate.  The measure was aimed about equally at citizens who were unable to obtain insurance because of pre-existing conditions and poor people who habitually obtained their health care in emergency rooms. 

The measure proved a considerable success.  The Obama administration saw the opportunity, seized it, and, with Democratic majorities in both houses of Congress, passed it into law in 2010.  A furious backlash ensued that summer.  The Tea Party midterm election produced a Republican majority in the House.  Positions hardened and the logic of the individual mandate was obscured.

Romney sought the Republican presidential nomination in 2008 on the basis of his success in Massachusetts, but lost out to Sen. John McCain (R.-Ariz.).  He tried again in 2012 and this time obtained the nomination, but only at the cost of disavowing the general applicability of his signature reform. Romney promised that were he  elected, he would immediately grant waivers to Obamacare to any state that wanted one, and said he would then set out to repeal the law.  He lost the election by a substantial margin.  Had he bided his time, might Romney might have made a strong run for the Republican nomination in 2016? (He turned 70 earlier this year.) Who knows? Time-biding isn’t easy in politics.

Recently Romney has been encouraged to consider running for the U.S. Senate in Utah, should 83-year-old Republican Orrin Hatch decide to retire. If that happens, Romney might once again become an influential voice for the individual mandate; he could serve two good terms on the national stage. The Utah electorate is apparently becoming a source of surging support for Obamacare in the face of attempted repeal – as might be expected of Brigham Young’s Utah.

Meanwhile, Rep. Jason Chaffetz, who represents Provo and the state’s Third Congressional District, announced last week without explanation that he wouldn’t stand for re-election in 2018, perhaps even resigning his seat – and thus the chairmanship of the powerful Government Oversight Committee – before then. Perhaps  Chaffetz hopes to run for governor in 2020. The Trump loyalist would not be a be a shoe-in.  Recent Utah governors have included two figures of national stature, Mike Leavitt and Jon Huntsman Jr., and the Mormon Establishment that produced them remains a potent source of fresh talent. Less reflexively Red than you think, Utah has suddenly become another of those laboratories of democracy to closely watch.

David Warsh, a veteran business writer and economic historian, is proprietor of economicprincipals.com, where this first ran.