Twenty minutes into last night's Republican presidential debate, Texas Gov. Rick Perry attacked the Massachusetts health care law signed by then-Gov. Mitt Romney. Perry said the program showed "what will not work, and that is an individual mandate in this country." People "don't want a health care plan like what Governor Romney put in place in Massachusetts," Perry concluded. "What they would like to see is the federal government get out of their business."
Half an hour later, Perry defended a 2007 executive order in which he ordered girls to be vaccinated against HPV, a sexually transmitted virus. "I hate cancer," Perry explained. "Cervical cancer is caused by HPV. … There's a long list of diseases that cost our state and cost our country. It was on that list. Now, did we handle it right? Should we have talked to the Legislature first before we did it? Probably so. But at the end of the day, I will always err on the side of saving lives."
This can't go on. Perry can't continue to denounce mandatory health insurance while defending mandatory vaccinations for a sexually transmitted virus, particularly when his rationale for the vaccine mandate—saving lives and money—mirrors the arguments for the insurance mandate.
Perry has been bashing compulsory health insurance for a long time. Last month, when the 11th Circuit Court of Appeals struck down the federal health insurance mandate, Perry crowed, "Yet another federal court has recognized that the Obama Administration's attempt to force each and every American to purchase health insurance is an egregious violation of our Constitutional rights." Last night, in his attack on Romney, Perry extended this argument to state-mandated health insurance.
These rules don't seem to apply to Perry, however. Four years ago, he issued an executive order instructing the Texas health commissioner to "adopt rules that mandate the age appropriate vaccination of all female children for HPV prior to admission to the sixth grade." Unlike Romney and President Obama, Perry didn't work out the mandate with his Legislature. He imposed it by decree.
Perry justified the order by citing public expense. In a statement announcing his decree, he explained: "Requiring young girls to get vaccinated before they come into contact with HPV is responsible health and fiscal policy that has the potential to significantly reduce cases of cervical cancer and mitigate future medical costs." When conservatives accused Perry of usurping parental authority, he replied, "While I understand the concerns expressed by some, I stand firmly on the side of protecting life."
Texas legislators answered Perry's fiat by overturning his order. Lacking the votes to stop them, he didn't veto their repeal bill, but he didn't sign it, and he defended the order. Last year, when he was asked whether the order had been a mistake, he answered, "No, Sir." "That issue was about being pro-life," Perry insisted. "I'm about pro-life."
Last month, kicking off his presidential campaign, Perry finally conceded that he should have engaged Texans on the HPV question instead of imposing his will unilaterally. He also said that instead of allowing parents to opt out of the vaccinations, he "should have allowed them to opt in." But last night, he went right back to defending the mandate. His arguments for it—reducing "cost" and "saving lives"—echoed his 2007 remarks, as well as the rationales for compulsory health insurance.
In the debate, Perry said his vaccine order "allowed for an opt-out. I don't know what's more strong for parental rights than having that opt-out." But the opt-out procedure specified in the order is cumbersome. It says parents can "submit a request for a conscientious objection affidavit form via the Internet." And the opt-out clause doesn't distinguish Perry's mandate from Romney's or Obama's. The Massachusetts law exempts from its insurance mandate anyone who "files a sworn affidavit with his income tax return stating … that his sincerely held religious beliefs are the basis of his refusal to obtain and maintain creditable coverage." The federal law excuses anyone who obtains a religious exemption because "he is conscientiously opposed" to accepting health insurance benefits.
Perry may be right that good health and fiscal policy sometimes require mandates. He's entitled, as he puts it, to err on the side of saving lives. He's just not entitled to deride his opponents when they do the same thing.