Romney on Entitlements

Click here for all of David Frum’s blogposts on Mitt Romney’s “No Apology”.

In No Apology, Romney offers an ultra-brief chapter on entitlements. His solutions are ultra-technocratic.

[P]ublic awareness would certainly grow if we required the federal government to publish a national balance sheet and to annually amortize its long-term liabilities. … I suspect for example that if former president George W. Bush would have had to declare the actual balance-sheet impact of his Medicare Part D prescription-drug program – now estimated to be approximately $8 trillion – it would not have passed. (156-157)

Romney has smart things to say in favor of a gradually phased in approach to personal retirement accounts. He favors turning full authority over Medicaid to the states via block grants. (Interestingly: he favors the use of government’s monopsony power to extract better prices for Medicaid: “Rather than allowing Medicaid members to go to any hospital, states could negotiate with fewer providers to obtain better rates.” (162) Sounds like what the Dems want to do with prescription drugs.

In this chapter, Romney opens the defense of his own attempt at health care reform.

Our reforms in Massachusetts didn’t produce a perfect system, just one that was much better than what had been there before, and it taught us all valuable lessons on how to work collaboratively to reform health care. But the most important lessons – involve everyone, demonize no one, and be transparent – were never adopted by President Obama, Speaker Nancy Pelosi, Senator Harry Reid, and their surrogates. As a result, we have not achieved the kind of reforms that will tame health-care cost inflation. (163)

But more to come in the chapter ahead.