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May 12, 2011

Romney Vows To Grant All States Waivers For ObamaCare On Day 1. WSJ: RomneyCare Was An Abomination

A little preview of Mitt's big healtcare speech in USA Today.

But our health care system has several well-known problems: high and rising costs, significant numbers of Americans without insurance, and glaring gaps in quality and efficiency.

We can fix these problems. Unfortunately, with the passage of ObamaCare last year, the president and the Congress took a wrong turn. ObamaCare will lead to more spending, greater federal involvement in health care and negative effects on U.S. economic activity. The president definitely forgot the admonition to "do no harm."

My plan is to harness the power of markets to drive positive change in health insurance and health care. And we can do so with state flexibility (unlike ObamaCare's top-down federal approach), no new taxes (as opposed to hundreds of billions of dollars of new taxes under ObamaCare), and better consumer choice (as opposed to bureaucratic, government choice under ObamaCare). This change of direction offers our best hope of preserving both innovation and value.

If I am elected president, I will issue on my first day in office an executive order paving the way for waivers from ObamaCare for all 50 states. Subsequently, I will call on Congress to fully repeal ObamaCare.

The reforms that I propose, which are based on the same philosophical tenets as the reforms I offered during my last presidential campaign in 2008, return power to the states, improve access by slowing health care cost increases, and make health insurance portable and flexible for today's economy.

Follow the link for how he'd approach the issue.

Meanwhile, the Wall Street Journal would like to have a word not just about Romney's Massachusetts plan but also would like to know what the hell he was thinking in the first place.

First the mandates. In a debate in 2007 Romney said, "I like mandates. The mandates work".

As the WSJ demonstrates, no they don't.

In the name of personal responsibility, Mr. Romney also introduced the individual mandate, first in the nation, requiring everyone to buy coverage or else pay a penalty. Free riders, he said, transferred their own costs to others, either through higher premiums or taxes. This is the same argument the Obama Administration is now using to justify the coercion of the individual mandate in the federal courts. Because the states have police powers under the Constitution, Mr. Romney's plan posed no legal problems. His blunder was his philosophy of government.

The people who don't buy coverage though they can afford it aren't really a major fiscal problem—unless the goal of the individual mandate is to force them to subsidize others. People who are priced out of coverage require subsidies—so in practice the logic of the individual mandate is that it is a government mandate too. Entitlements automatically grow and grow, and then the political class begins to make decisions that used to be left to markets and individuals.

Massachusetts took off on this entitlement trajectory after Mr. Romney signed the bill in 2006 and stepped down to run for President two years later. Let's go to the data, all of which are state-reported, in search of evidence of Mr. Romney's "success."

The only good news we can find is that the uninsured rate has dropped to 2% today from 6% in 2006. Yet four out of five of the newly insured receive low- or no-cost coverage from the government. The subsidies will cost at least $830 million in 2011 and are growing, conservatively measured, at 5.1% a year. Total state health-care spending as a share of the budget has grown from about 16% in the 1980s to 30% in 2006 to 40% today. The national state average is about 25%.

The safety-net fund that was supposed to be unwound, well, wasn't. Uncompensated hospital care rose 5% from 2008 to 2009, and 15% from 2009 to 2010, hitting $475 million (though the state only paid out $405 million). "Avoidable" use of emergency rooms—that is, for routine care like a sore throat—increased 9% between 2004 and 2008. Meanwhile, unsubsidized insurance premiums for individuals and small businesses have climbed to among the highest in the nation.

Like Mr. Obama's reform, RomneyCare was predicated on the illusion that insurance would be less expensive if everyone were covered. Even if this theory were plausible, it is not true in Massachusetts today. So as costs continue to climb, Mr. Romney's Democratic successor now wants to create a central board of political appointees to decide how much doctors and hospitals should be paid for thousands of services.

Then they really get tough on him.

The Romney camp blames all this on a failure of execution, not of design. But by this cause-and-effect standard, Mr. Romney could push someone out of an airplane and blame the ground for killing him. Once government takes on the direct or implicit liability of paying for health care for everyone, the only way to afford it is through raw political control of all medical decisions.

Mr. Romney's refusal to appreciate this, then and now, reveals a troubling failure of political understanding and principle. The raucous national debate over health care isn't about this or that technocratic detail, but about basic differences over the role of government. In the current debate over Medicare, Paul Ryan wants to reduce costs by encouraging private competition while Mr. Obama wants the cost-cutting done by a body of unelected experts like the one emerging in Massachusetts.

Mr. Romney's fundamental error was assuming that such differences could be parsed by his own group of experts, as if government can be run by management consultants. He still seems to believe he somehow squared the views of Jonathan Gruber, the MIT evangelist for ObamaCare, with those of the Heritage Foundation.

And then they go in for the kill.

Seriously, it's a brutal take down.

For most politically active conservatives and Republicans (political blog readers for example) at this point you either buy Mitt's, "it's ok if states do mandates but not the federal government" explanation or you don't. My fear is that if Mitt is the nominee health care will either not be part of the debate or Obama will be able to paint Romney as the father of ObamaCare. Repealing HCR isn't likely to be the number one issue next year (the economy, the economy and the economy will bet the top 3 issues) but it should be in our arsenal. I'm not sure how Mitt can convincingly make the case.


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posted by DrewM. at 10:57 AM

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