Entries Tagged as 'Romneycare'

Romneycare Bent the Cost Curve

January 5th, 2012 at 8:53 am 44 Comments

Via an interesting post by Chris Conover, I came across this recently released National Health Expenditure report, which has data on health-care spending up through 2009.  This data includes a state-by-state breakdown of personal health-care spending (a number that includes direct expenditures on health-care but does not include administrative costs).

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I Heart Romneycare

December 2nd, 2011 at 12:00 pm 38 Comments

‘Galatea’ is a columnist writing about her experience looking for work after her recent downsizing. Previous entries in her series can be read here.

Were you aware that there is at least one (1) conservative-ish person who is a fan of Romneycare? Hint: it’s me.

I know! My mom is a resident of Massachusetts and gets all your free health care money! Awesome, right?

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Res Judicata: Defending Romneycare

October 17th, 2011 at 1:51 am 17 Comments

The Massachusetts health care law signed in 2006 by Governor Romney has three main parts:

1. It requires all citizens to buy a state-approved health insurance plan,

2. It provides subsidies to certain low-income people to pay for insurance,

3. It requires employers to provide health insurance to their employees or pay a fee to the state.

I agree with parts 1 and 2. Health care is of course, a complex subject. But the crux of our problem is that individuals are not taking care of themselves. For decades the tax code has encouraged employers to provide a very expensive benefit to employees, health insurance.

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Worry About Costs, Not Mandates

October 11th, 2011 at 6:05 pm 29 Comments

Revelatory Headline: “White House used Mitt Romney health-care law as blueprint for federal law.”

I am no fan of Obamacare. The notion that a top down system will control costs flies in the face of the fact that virtually every advanced country on earth that has a top-down scheme to manage its health care system has a rate of growth in costs that matches ours. The only difference is that we start at a much higher baseline, the result of high prices and high availability of services and technology.

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The Romney We Need

David Frum September 12th, 2011 at 11:48 pm 91 Comments

Mitt Romney arrived loaded for bear this evening, pointing out, for example, that Rick Perry’s Texas created jobs at barely 1/3 the rate of Anne Richards’ Texas.

On Social Security, Romney battered Rick Perry’s call to have a debate about Social Security … some time in the far, far future, in a galaxy far, far away.

Rick Perry was reduced to his now familiar babbling incoherence, promising not to take away a program he has condemned as unconstitutional. Mitt Romney caught, diced and spliced Gov. Perry in deceitful misquotation.

All in all – a good night for Romney, a bad night for Perry.

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The Right’s Coming Romneycare Defense

David Frum June 2nd, 2011 at 9:00 am 82 Comments

Here’s an interesting exchange: NRO’s Kathryn Lopez and radio host Hugh Hewitt walking back from their ardent support for Mitt Romney of 2008.

LOPEZ: Is Romney the best man in the field?

HEWITT: There are lots of good men (and soon to be at least one woman) in the field. At this point it seems clear to me that Governor Romney is the most electable, though Governor Pawlenty is very close on that scale.

On the other hand, if Romney does prevail, give Hewitt credit for being among the first to articulate the rationalization that will allow talk radio to swing back into line behind Romney next year:

LOPEZ: Can Romney overcome what is conventionally, universally considered his health-care problem?

HEWITT: Yes. I gave a speech on this to the Federalist Society earlier this year, emphasizing the core values of federalism and state sovereignty, and I expect more and more conservatives as they focus on the race will discount Team Obama’s attempt to confuse the Massachusetts plan and Obamacare.

LOPEZ: Is it unfair to consider it the precursor to Obamacare?

HEWITT: Yes, but that is a powerful narrative for Team Obama to spin and their friends in the MSM have picked it up. Among the many huge differences: The Massachusetts plan was constitutional and Obamacare isn’t. The Massachusetts plan was a negotiated compromise between two branches and two parties while Obamacare was a one-party jam down. Obamacare raised taxes and cut benefits massively and Massachusetts care did neither. The list goes on and on.

Romney: No Apologies For Romneycare

May 12th, 2011 at 2:52 pm 64 Comments

Here is a link to Romney’s power point slide.

Here is where he defends the mandate:

For some, Romney’s ability to defend the mandate with a power point slide is either a great sign of his business sense, or just another reason to dismiss him as a technocrat who doesn’t view the world with a conservative ideological lens.

2:53pm:

Romney wanted the majority of his speech to focus on his plan to repeal the Obama healthcare law, but he knows that most commentators are watching this speech to see how he defends his mandate. He ended up defending the Massachusetts mandate passionately. Some would say he gave a stronger defense of why mandates work then Obama ever did for his own healthcare plan.

The problem Romney faces is that conservatives believe that the individual mandate is an unconstitutional infringement of liberty. Thus, the Romney solution to provide affordable healthcare in Massachusetts is thus:

-liberty killing

and

-and a template for Obamacare.

The Romney’s defense had several parts. While they made logical sense. They will likely not serve him well in the GOP primary.

1. Romney argues that since it’s a state-level policy, then a mandate in Massachusetts is ok. By this logic, President Romney would be ok if Vermont embraced single-payer, and a more conservative state decided to give no healthcare.

2. Romney also defended the mechanisms of the mandate itself. In this part of the speech, Romney clearly understood why a mandate makes technocratic sense. He understands the free rider problem that the mandate is meant to defeat.

3. Romney also tried to play down the mandate’s importance to his overall plan. He argued that the mandate didn’t really affect that many people in Massachusetts, arguing that 94% of the population was already insured so it was only meant to help 6%.

4. Unlike the Wall Street Journal, Romney thinks that 6% of people without insurance is a problem! “6% sounds small, but it is a half a million people.” Romney noted that being without insurance is “a frightening experience”.

5. And Romney ultimately will not apologize for providing insurance. He is aware that “that explanation is not going to satisfy everybody”.

And the ultimate reason he won’t apologize? “It wouldn’t be honest. I in fact did what I think was right for the people of my state.”

He later reiterates this during the Q&A session: “Am I proud of the fact that we did the best for our people and got them insured? Absolutely”

2:44pm:

Romney says he will introduce his own Medicare plan “but it wont be identical” to the Ryan plan.

This is big and counts as news. It means that Romney will not be running on the GOP budget.

2:30pm:

Romney is putting the issues with the Mandate front and center. I’ll post my extended notes on this soon, but the short preview is this: it won’t satisfy his critics, but at least Romney defends his mandate.

2:25pm:

It’s starting late, but Romney has begun.

A few quick notes: this is a presentation with power point slides. Not a speech with flags like his “Faith in America” speech.

2:06pm:

While we wait for the speech to start. CNN has live feed here. C-Span is also supposed to be carrying the speech but it hasn’t started yet.

—-

At 2pm ET today, Mitt Romney will give a speech about healthcare at the University of Michigan. Healthcare has been a millstone around Romney’s neck since his signature achievement as governor of Massachusetts: legislating universal coverage for all citizens by having an individual mandate to compel the purchase of insurance.  This policy is also at the center of Obama’s own healthcare law and one which Republicans have decided is an unconstitutional infringement of liberty. The challenge facing Romney is clear, is there anything he can say to put this issue to rest?

Romney has given various answers when asked about the similarities between his healthcare law and the president’s. When asked about it at the Republican Jewish Coalition’s meeting in Las Vegas, Romney said that if the president’s and his healthcare policies were so similar, then “why didn’t you [Obama] call me? Why didn’t you ask what was wrong? Why didn’t you ask if this was an experiment, what worked and what didn’t?”

However as we’ve noted at FrumForum, Romney himself hasn’t been clear about what has and has not worked with his own plan. Romney is certainly trying hard to convince Republicans that he is with them on the healthcare issue and will say that he thinks the law is unconstitutional. But Romney still defends what he did in Massachusetts. This contrasts with Pawlenty who is begging for forgiveness from the GOP electorate for his old support for cap-and-trade.

Romney has offered a preview of the health reform proposals he will run on in USA Today. If his speech stays close to the material in the op-ed, then we might get a lot of ideas on what Romney wants to do going forward, but few apologies for how he handled healthcare in Massachusetts. FrumForum will track the speech to see how Romney makes his case.

Follow Noah on Twitter: @noahkgreen


Journal’s Romneycare Attack Misses the Mark

David Frum May 12th, 2011 at 1:19 pm 23 Comments

Today’s Wall Street Journal savagely criticizes Mitt Romney’s health care record.

Let’s try to reverse-engineer the editorial to see what the editors believe Romney should have done instead.

When Mr. Romney took office in 2003, the state was already enforcing public utility-style regulation of insurers for premiums and multiple benefit mandates. The resulting distortions were increasing rates fast, along with the natural increases from good but expensive Massachusetts medicine.

In other words: rate regulation of insurers is bad. Using regulation to hold rates down causes rates to go up instead.

The conceit was that a universal reform would cover everyone and all but pay for itself by reorganizing the state’s health-care finances

Universal coverage: bad. Universal coverage will force costs up.

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.

Individual mandates: bad. The “free rider” argument only conceals state coercion.

The people who don’t buy coverage though they can afford it aren’t really a major fiscal problem …. 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.

Subsidies to cover private health insurance for those who cannot afford it: bad. They cause government to grow.

Entitlements automatically grow and grow, and then the political class begins to make decisions that used to be left to markets and individuals.

Political decisions about health coverage: bad. Instead the decision about who should not be covered should be left to markets: if the market does not assign you enough money for coverage, you should not have coverage.

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.

A decline in the number of the uninsured is good if and only if they receive no public aid. Then it becomes bad.

The assumptions encoded in the Journal editorial make nonsense of the Journal‘s conclusions.

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.

But of course the Paul Ryan plan for Medicare does feature a mandate – which is supposedly bad, according to the WSJ. And the Romney plan for Massachusetts did encourage private competition – and yet somehow failed to control costs, which shouldn’t happen according to the WSJ.

The WSJ wants to argue that “it’s not so much the money as the principle of the thing.” But of course the real evil as diagnosed by the Journal is precisely the money. So long as less money is spent, as Ryan proposes, then mandates cease to be a problem for the WSJ. If more money as spent, as occurred under Romney, then private market competition ceases to be an important benefit for the WSJ.

Put bluntly, it’s not a very attractive argument.

And it’s an argument that Mitt Romney could decisively refute today if he wished. He would begin: “Unlike the Wall Street Journal, I do not think that leaving millions of people uninsured is a good way to hold healthcare costs down.” You could even describe such an argument as “no apologies”.


Romney Can’t Keep Running From Romneycare

David Frum April 11th, 2011 at 4:41 pm 36 Comments

Mitt Romney’s announcement video leads with jobs. Good. It cites Romney’s real world business experience. Good.

It treats his healthcare plan as an embarrassing incident best left unmentioned. Good try.

Masscare was Romney’s signature achievement as an elected official. If it was a mistake, it’s very hard to explain why its author – as opposed to any of a thousand other successful business leaders – should be president. It’s not as if there is a vast repertoire of other governing accomplishments that could compensate for the putative error of this one.

And if Romney believes that Masscare was not a mistake, he’d better defend it. After all, his party critics and opponents will not refrain from attacking it.


Romney’s Healthcare Talking Points Still Need Work

David Frum April 3rd, 2011 at 2:15 pm 58 Comments

At the RJC annual meeting in Las Vegas, Mitt Romney delivered the big speech on Saturday.

He did a good job too, talking about issues from employment to Israel – everything really except guess what? As he finished and received his ovation, the woman to my right murmured “He’s got my vote.”

The audience noticed the omission too. At question time, the very first question was posed by a urologist who asked about the Romney healthcare plan in Massachusetts.

Here was Romney’s answer:

First, he defended the plan as a necessary response to the problem of unpaid healthcare in emergency rooms.

Second, he offered an excuse for the plan as a legitimate innovation at the state level.

Third, he attacked President Obama for extending the plan to more than one state.

Finally, he promised to repeal the national healthcare plan.

All this took perhaps 90 seconds. The audience applauded the fourth part – and the governor joked, “They tell me when the audience applauds, to stop talking.”

I doubt that answer will do the job for him.

In answer to a later question, Romney tried another approach. He joked that the president paid him the compliment of describing his plan as the inspiration for the president’s own plan. “In that case,” said Romney, “why didn’t he call me?” Romney suggested the president should have asked him what worked and what didn’t in the Massachusetts experiment.

This answer is getting more plausible.

Yet Romney did not himself specify what worked and what did not work, leaving the largest part of his case unmade. Ironically for him, a stronger defense of his own program would allow a more plausible attack on the federal program, as in:

We did this and that – it worked. But the feds added that and this – a costly mistake.

Every time I see Mitt Romney speak, I am struck by three things:

1) How hugely personally impressive he is, in ways big and small. He remembers the names of people in the audience. He knows the policy. He can be very funny. He’s sharp, prepared, ready for any question. Underneath it all, he manifests personal character and decency. An audience member reproached him for running “too gentlemanly” campaigns in Massachusetts, praised Donald Trump for “taking the gloves off” against President Obama and demanded whether he was prepared to do the same. In a way that left the questioner nodding and smiling, Romney restated his preference for a campaign not based on personal attacks.

2) Romney has a tic of inserting caveats into his campaign boilerplate. For example, he blisteringly attacked President Obama for canceling  the European missile defense program. Here was something the Russians wanted, and President Obama gave it away without getting anything in return. Yet Romney’s critique contained a clause to this effect, “Even if you wanted to cancel the program anyway…” Again and again, Romney would salt statements that his audience wanted to hear with little mental asterisks noting that maybe what they wanted to hear was not exactly accurate, or wise, or in accordance with his own private opinions. Ironically it is this unwillingness to do the full 100% pander that creates the impression of “inauthenticity.” A less honest man would seem more authentic, at least for the moment.

3) Romney is truly a candidate of upper America. In Las Vegas, he spoke movingly of the impact of unemployment. Yet he opened this fine passage in his talk with an anecdote about traveling out from the home of friends in North Las Vegas to tour other people’s foreclosed homes. He could view and empathize with the misfortune, but unmistakably he spoke of misfortune as something that happened to other people, people he did not know personally. American politics obviously has plenty of room for aristocrats. (See the Roosevelts, the Kennedys, the Bushes.) But typically, when people who start at the top enter politics, they either present themselves as tribunes of the under-privileged (like Teddy Roosevelt and John F. Kennedy), or else (like George W. Bush and to a certain extent Franklin Roosevelt) they tell a story of personal crisis and redemption.

Romney’s story is very impressive in its own way: born to a successful father, he achieved an even greater success of his own. Yet Romney seems to have arrived at his success so smoothly, so gracefully, and so without inner turmoil and pain as to open a huge gap between his experiences and those of virtually everyone else in the United States. If he is to be president, he must find a way to close it.